Do Public Pensions Improve Mental Wellbeing? Evidence from the New Rural Society Pension Insurance Program

Association of the Type of Public Pension With Mental Health Among South Korean Older Adults: Longitudinal Observational Study

BACKGROUND

As income and health are closely related, retirement is considered undesirable for health. Many studies have shown the association between pension and health, but no research has considered the association between contribution-based public pensions or their types and health.

OBJECTIVE

This study investigates the association between the type of contributory public pension and depressive symptoms among older adults.

METHODS

We analyzed the data of 4541 older adults who participated in the South Korea Welfare Panel Study (2014-2020). Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression scale. Public pensions in South Korea are classified into specific corporate pensions and national pensions. For subgroup analyses, pensioners were categorized according to the amount of pension received and the proportion of public pension over gross income. Analyses using generalized estimating equations were conducted for longitudinal data.

RESULTS

Individuals receiving public pension, regardless of the pension type, demonstrated significantly decreased depressive symptoms (national pension: β=-.734; P<.001; specific corporate pension: β=-.775; P=.02). For both pension types, the higher the amount of benefits, the lower were the depression scores. However, this association was absent for those who received the smaller amount among the specific corporate pensioners. In low-income households, the decrease in the depressive symptoms based on the amount of public pension benefits was greater (fourth quartile of national pension: β=-1.472; P<.001; second and third quartiles of specific corporate pension: β=-3.646; P<.001).

CONCLUSIONS

Our study shows that contributory public pension is significantly associated with lower depressive symptoms, and this association is prominent in low-income households. Thus, contributory public pensions may be good income sources for improving the mental health of older adults after retirement.

Impact of pension income on healthcare utilization of older adults in rural China

OBJECTIVE

In China, rural residents experience poorer health conditions and a higher disease burden compared to urban residents but have lower healthcare services utilization. Rather than an insurance focus on enhanced healthcare services utilization, we aim to examine that whether an income shock, in the form of China's New Rural Pension Scheme (NRPS), will affect outpatient, inpatient and discretionary over-the-counter drug utilization by over 60-year-old rural NRPS residents.

METHODS

Providing a monthly pension of around RMB88 (USD12.97), NRPS covered all rural residents over 60 years old. Fuzzy regression discontinuity design (FRDD) was employed to explore the NRPS causal effect on healthcare services utilization, measured by outpatient and inpatient visits and discretionary over-the-counter drug purchases. The nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 provided the data.

RESULTS

Without significant changes in health status and medication needs, 60-plus-year-old NRPS recipients significantly increased the probability of discretionary OTC drug purchases by 33 percentage points. NRPS had no significant effect on the utilization of outpatient and inpatient utilization. The increase in the probability of discretionary OTC drug purchases from the NRPS income shock was concentrated in healthier and low-income rural residents. Robustness tests confirmed that FRDD was a robust estimation method and our results are robust.

CONCLUSION

NRPS was an exogenous income shock that significantly increased the probability of discretionary over-the-counter drug purchases among over 60-year-old rural residents, but not the utilization of inpatient or outpatient healthcare services. Income remains an important constraint for rural residents to improve their health. We recommend policymakers consider including commonly used over-the-counter drugs in basic health insurance reimbursements for rural residents; provide health advice for rural residents to make discretionary over-the-counter drug purchases; and to mount an information campaign on over-the-counter drug purchasing in order to increase the health awareness of rural residents.

The impact of pension insurance types on the health of older adults in China: a study based on the 2018 CHARLS data

Introduction

Pension insurance is an essential safeguard for the quality of life and health of older adults because it provides a stable and dependable source of income after retirement. China has constructed a multi-level social security system to accommodate the diverse needs of older adults, and offers various levels of pension insurance to maximize their interests.

Methods

This study uses propensity score matching and ordinary least squares techniques to analyze 7,359 data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) in order to explore the relationship between different pension insurance categories and the health of older individuals.

Results

The research findings reveal that advanced insurances greatly benefit the health of older adults more than basic pension insurances, and the findings pass the robustness test. In addition, the effect was found to be heterogeneous, depending on the location of retirement and the marital status of older adults.Our findings suggest that both material and non-material consumption may be potential mechanisms by which pension insurance affects the health of older adults, providing new evidence for the causal mechanism between pension insurance and the health of older adults.

Discussion

This study expands the scope of research on the health effects of pension insurance by covering a large representative sample across the country. The results show the important impact of the level of pension insurance on the health of older adults and can contribute to the development of social policies to promote the physical and mental health of older adults.

Internet use and health status among older adults: The mediating role of social participation

Background

The acceleration of population aging and the arrival of the informatization make more and more older adults use the Internet, and its use is having an impact on their health. However, the relationship between internet use and the health of older adults and the mechanism of the effect of internet use on the health are not very clear.

Methods

Multiple linear regression models to explore the correlation between internet use and health status in the 3,141 individuals aged ≥60 years were used. Propensity score matching (PSM) method was used to test the robustness of the regression results. In addition, sequential recursive models was used to examine the mediating effect of social participation on the relationship between internet use and health status.

Results and discussion

We found a significant positive relationship between internet use and health status, and social participation mediated the relationship between internet use and health status. In addition, the effect of internet use on health status was different among older adults in rural and urban areas.

Conclusions

The development and application of internet products adapted to the development of an aging society should be accelerated to meet their needs for continued socialization. The forms and activities of social participation for the elderly groups should be enriched and public service internet usage training seminars should be conducted to improve internet skills.

Does social pension buy improved mental health and mortality outcomes for senior citizens? Evidence from South Africa's 2008 pension reform

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The 2008 pension reform in South Africa improved access to healthcare.

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The 2008 pension reform improved mental health and 60-year-old deaths.

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The impact of the 2008 pension reform in averting 60-year-old deaths is higher in urban regions than rural regions.

In South Africa, men were traditionally eligible to receive government pensions at 65 years. However, that eligibility criterion was changed in 2008 to allow men to receive a pension payout at 60 years. This study is designed to quantify the impact of the 2008 pension reform on mental health outcomes (depression and traumatic stress) and deaths among 60-year-old men from disadvantaged households without advanced education. This analysis used secondary data issued by Statistic South Africa- General Household Survey. Men who reported earning a pension at 60 years from 2008 to 2014 were exposed to the 2008 pension reform and thus were classified as the treatment group. The 60-year-old men during 2002–2007 were ineligible to earn the pension, therefore considered the control group. We then used a Two-stage Least Squared Model (2SLS) to quantify the impact of the 2008 pension reform on healthcare utilization, depression cases, traumatic stress cases, and deaths among 60-year-old men. The model shows that the 2008 pension reform improved healthcare utilization by 3 % in the cohorts of men who benefitted from the 2008 reform. The 2008 pension reform averted depression cases, traumatic stress cases, and deaths among 60-year-old men by 3 %, 4 %, and 5 %, respectively. The impact of the 2008 pension reform in averting deaths among 60-year-old men was higher in urban regions than rural regions. We concluded that the 2008 pension reform successfully bought improved mental health outcomes and prevented depression, traumatic stress, and deaths among 60-year-old men.

Effect of Receiving Financial Support from Adult Children on Depression among Older Persons and the Mediating Role of Social Participation

Older persons are vulnerable to depression SFduring the ageing process. Financial resources and social participation are expected to have an impact on depressive symptoms. This study investigated the relationship between financial support from children and depression among Chinese older persons, as well as the mediating effect of social participation in this relationship. Data from 7163 participants aged 60 and above were extracted from wave 2015 and 2018 of the China Health and Retirement Longitudinal Survey (CHARLS). A multivariate regression analysis was performed on both cross-sectional data and two-wave longitudinal data to test our hypotheses. The results revealed that financial support from children was negatively associated with depressive symptoms in both the short-term and the long-term. In addition, this relationship was partially mediated by social participation in the short-term association and fully mediated by social participation in the long-term, where financial support was positively related to social participation, and social participation was negatively associated with depressive symptoms. This study offers an in-depth insight into the relationship between financial support from children and depression among Chinese older persons. Policies and initiatives to stimulate social participation should be promoted to improve older persons' mental health.

Stressful Life Events and Chinese Older People Depression: Moderating Role of Social Support

Aim: This study analyzes the effects of retrospective stressful life events on current depression among Chinese older people and how these effects are moderated by social support. Stressful life events comprise bereavement, divorce, health adversities, accidents, and financial losses due to fraud.

Data and Method: Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS) of the 2015 panel, and responses from 9,619 older people aged over 60 years were used. The least-squares regression method was applied to measure the linear effects. Propensity score matching minimized selection bias and enabled the measurement of the net effects of stressful life events. The bias-corrected matching estimator was also used to correct the inexact matching bias from propensity score matching.

Result: Experienced stressful life events and exposure to cumulative stressful life events were found to lead to depression in older people. When older people experienced stressful life events but with more social activities, and higher satisfaction and frequent contact with children, their depressive levels were lower. The results of the propensity score matching showed that stressful life events resulted in depression in older people. Furthermore, individuals with family support were able to moderate stressful life events effects; however, the moderating effects of social activity separately were negligible. In sum, with the moderating role of family support and social activity, the average differences in older people depression caused by stressful life events decreased.

Conclusion: Experiencing stressful life events is detrimental to the psychological health of the older people. Social support, including family support and social activity, has buffered detrimental effects on depression caused by stressful life events.

Interpretations: The study underscores the need to supply effective interventions for the older people who experienced stressful life events. First, society should improve the capability of community care centers to supply mental health services. Second, family members should pay attention to mental condition of older people, and specific support should concord with the needs of Chinese older people. In addition, support suppliers can move from being confined to kinship relationships to close relationships, such as the community partners and neighbors.

Do Social Pensions Affect the Physical and Mental Health of Rural Children in China? An Intergenerational Care Perspective

Research Purpose: This study aimed to explore the effect of China’s New Rural Pension (NRP) on the physical and mental health of rural children from the perspective of intergenerational care, and to examine whether family childcare types and the child’s gender affect the relationships between social pensions and the physical and mental health of rural children. Methods: We used data from the 2016 China Family Panel Studies (CFPS) of the China Social Science Survey Center, a nationally representative sample at the individual, family, and county levels from 25 provinces (cities and districts) in China. A total of 2142 sets of valid samples of children, the elderly, family economic and social conditions, and basic family information were retained after data screening. The regression discontinuity (RD) method was employed for the statistical analyses. Results: The NRP had a significant effect on both the mental health (β = −2.818, p < 0.1) and physical health (β = −2.214, p < 0.1) of rural children. This effect varied with the family childcare type and child’s gender. Conclusions: We reveal a positive effect of the NRP on the physical and mental health of rural children. Therefore, the establishment of a social pension system may be used as an effective approach to enhance the health of rural children. The impact of the NRP on the physical and mental health of children differs with the family childcare type and their gender, which should be taken into consideration when using social pensions to enhance child health.