Page 46 - IJPS-11-5

International Journal of
Population Studies Need for social services among disabled older Chinese

among disabled older adults using cross-sectional data refer to health conditions and illnesses that measure an
from a nationally representative sample. The study found individual’s level of need for care. Whether an individual
that preferences were primarily influenced by health uses services depends not only on their need for services
conditions, family care resources, and geographic region. but also on their predisposition to use them and whether
While these studies have made important contributions to they have the necessary resources (i.e., enabling factors)
understanding the need for social services in China, most to facilitate their use. These three categories of factors
research—aside from those by Zhou & Walker (2015) together determine the use of health care services.
and Xiao et al. (2023)—has focused on specific types of The Anderson model has been widely used to
services, such as home and psychological care, within predict the use of health services (e.g., Dunlop et al.,
limited geographic areas, predominantly urban or large 2002; Weaver & Roberto, 2017) and the need for care
city settings. Moreover, these studies often lack a nationally services (e.g., Calsyn & Winter, 2001; Richardson, 1992).
representative sample. Given the significant demographic, For example, old age, female gender, living alone, and
social, and economic shifts in China over the past functional limitations were all associated with a high
decade, there is a pressing need for updated research that need for services in Western societies (Calsyn & Roades,
encompasses both urban and rural regions. 1993; Jackson & Mittlemark, 1997). Among the three
Some key questions remain unanswered by previous categories of predictors, need variables were the strongest
research. What is the need for different social services predictors of service need (Calsyn & Winter, 2001). While
among older adults with disabilities in China? What factors research findings in Western countries provided important
contribute to the need for social services? Are there any evidence, determinants of service need could be different
differences between rural and urban residents? Answers in China, given that need can be influenced by cultural,
to these questions could improve our understanding of social, and economic factors in Eastern countries (Li et al.,
older adults’ need for non-family care programs and are 2017b; Liu et al., 2014). See a recent review by Chen and
key to developing and promoting social care programs in Gu (2021).
China. To address these questions, the present study uses Our study stresses potential differences in need between
five waves of data from the Chinese Longitudinal Healthy rural and urban residents because rural–urban disparities
Longevity Survey (CLHLS), a nationally representative may shape older adults’ need for social services. First, rural–
longitudinal survey, to examine (1) the need for social urban disparities exist in pension coverage (Zimmer &
service programs among older adults with ADL disabilities Kwong, 2003). State pensions are mainly available to urban
and (2) determinants of need based on Andersen’s social residents, whereas the majority of older rural residents
behavior model. In particular, this study classifies eight do not qualify for retirement benefit programs (Gu et al.,
social services into basic care and social connection 2021; Feng et al., 2012; Lee & Xiao, 1998). Second, rural–
services and examines how the need for services and its urban disparities also exist with respect to care resources
determinants vary with rural–urban residency. Therefore, such as access to care facilities. Since policies to support
this study not only provides a more comprehensive picture formal care favor urban residents (Feng et al., 2012; 2020),
of service needs than the previous studies focusing on the availability of social support is limited in rural areas;
one or two types of services but also reveals differences in when available, the cost of formal care is not affordable for
service needs between rural and urban areas.
most rural older adults due to their low economic status
We apply Andersen’s social behavioral model to (Gu & Vlosky, 2008). Third, attitudes toward formal care
examine determinants of the need for social services. The differ between rural and urban residents. Due to stronger
Andersen model was developed to explain why individuals traditional values, rural residents are more likely to follow
utilize health services (Andersen, 1995; Andersen & the practice of family care and are reluctant to be cared
Newman, 1973; Chen & Gu, 2021). According to this for by strangers (Feng et al., 2012). Therefore, even if rural
model, factors that predict health-care utilization are residents can afford formal care, they may still prefer
summarized into three types: predisposing, enabling, and receiving care from family members. Fourth, the massive
need. Predisposing factors are social structural elements rural-to-urban labor force migration since the 1990s
that influence an individual’s likelihood of using health has imposed more challenges on the traditional support
care services, including age, sex, ethnicity, education, and practice among rural older adults (Liu, 2014), separating
attitudes toward services. Enabling factors mainly refer to younger and older adults from rural households. In short,
resources that enable individuals to access health services, rural older adults face a higher risk of unmet need for care
such as income, informal and formal caregiving resources, due to lack of financial resources, loss of family care, and
and availability of community resources. Need factors lack of other forms of support.

Volume 11 Issue 5 (2025) 40 https://doi.org/10.36922/ijps.448