Page 47 - IJPS-11-5

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

This study focused only on disabled respondents who For the purposes of this study, the five waves of the
need assistance with daily care. Declines in functional CLHLS data were pooled together to produce more robust
abilities are associated with an increased need for care estimates. This strategy has been used in previous research
from others (Cox, 2005). Thus, those with disabilities in (e.g., Gu et al., 2017; Zhu, 2015). The study sample includes
ADLs often have an urgent and higher need for services 8,548 older adults (aged 65+) who reported difficulties
(Shooshtari et al., 2012; Woodland, 2007). With few in performing ADLs during interviews conducted from
exceptions (e.g., Chen & Berkowitz, 2012; Li et al., 2017), 2005 to 2018. These respondents contributed 16,387
most previous studies have not differentiated between observations during the analytical period from 2005 to
older adults who have or do not have ADL disabilities 2018.
(e.g., Liu et al., 2014; Liu et al., 2015, Zhou & Walker,
2015). Because China is a developing country with limited 2.2. Measurement
resources and a rapidly growing size of older population, 2.2.1. Need for social services
home- and community-based services are often tailored to Need for social services was measured by eight variables
meet the more urgent needs of older adults with functional
impairments (Li et al., 2017). Understanding the needs asking whether the respondent needed assistance and
of older adults with ADL disabilities may provide more service with specific activities: (1) personal care, (2) home
specific and practical estimates for program design and visits and health checkups, (3) psychological counseling,
development. (4) daily shopping, (5) social and recreation activities,
(6) legal aid, (7) health education, and (8) neighborhood
2. Data and methods relations. Respondents were asked to provide a yes or no
response to each of the eight questions. To reduce the
2.1. Study sample number of outcome variables for better presentation and
For this study, we utilized data from five waves of the interpretation, we used an exploratory factor analysis to
CLHLS in 2005, 2008/2009 (hereinafter labeled as 2008), test the number of possible classifications that would best
2011/2012 (hereinafter labeled as 2011), 2014, and fit the data for these eight variables. We found that these
2018. The CLHLS was initiated in 1998 to study factors eight variables could be classified into two clusters. We
contributing to healthy aging and longevity (Zeng, 2012). thus classified the eight need variables into two summary
The first three waves of the CLHLS (1998, 2000, and 2002) variables (i.e., indices): the need for basic care services and
were not included in this study because information the need for social connection services. Basic care services
on social services was not collected in these waves. The included the first four variables: Personal care, home
CLHLS was conducted in a randomly selected half of the visits and health checkups, psychological counseling, and
counties/cities in 22 provinces throughout China. From daily shopping; social connection services included the
the 2008 wave onwards, one county from the 23 province remaining four variables: social and recreational activities,
rd
(Hainan Province) was added to the sample of the CLHLS. legal aid, health education, and neighborhood relations.
The survey oversampled octogenarians (aged 80 – 89), The value of each summary variable was a summation of
nonagenarians (aged 90 – 99), and centenarians (aged all dichotomous variables in that index, ranging from 0
100+) in each wave to maintain sufficient sample size and to 4. The reliability coefficients (alpha) are 0.87 for basic
statistical power. Respondent information was collected care services and 0.92 for social connection services. These
via in-home interviews. The age of a respondent was high coefficients indicate the adequate reliability of each
validated with various sources—e.g., birth certificates, summary index. Such practice has been frequently used
genealogical documents, household booklets, and/or the in the existing literature (Mhaka-Mutepfa et al., 2015;
ages of children and siblings—when available. Each able Pudrovska, 2015) and is thus considered appropriate.
respondent provided written informed consent to indicate
his/her willingness to participate in the CLHLS; for 2.2.2. Independent variables
respondents who were not able to write, a proxy (usually Based on Andersen’s framework and prior literature, we
the next-of-kin) was called in to sign the written consent included predisposing, enabling, and needed variables
with oral approval from the respondent. The response rate in the analyses. Predisposing variables included age (in
of the baseline survey was approximately 98%; however, years), sex, years of schooling (0, 1 – 6, and 7+), primary
the proportion of loss to follow-up at each subsequent lifetime occupation (white collar occupation vs. others),
wave was around 15 – 20% (Gu et al., 2021). Further details marital status (married vs. unmarried), and residency
of the sampling design and overall data quality have been (rural vs. urban). White-collar occupations mainly refer
documented extensively elsewhere (e.g., Gu et al., 2021; to professional, technical, governmental, institutional,
Zeng & Gu, 2008). or managerial personnel. Non-white-collar occupations

Volume 11 Issue 5 (2025) 41 https://doi.org/10.36922/ijps.448