Page 51 - IJPS-11-5

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

Table 2. Need for social services among older adults who Given the rural–urban differences in socioeconomic
need assistance in performing activities of daily living by conditions, health-care resources, and traditional values,
rural and urban residence, CLHLS, 2005 – 2018 rural older adults depend largely on family members for
care. However, with the younger generations increasingly
Need (%)
Total Rural Urban moving to big cities for better job opportunities, rural
older adults are left at home without proper care (Giles
Type of services needed et al., 2010; Wu et al., 2009). Moreover, the development
Personal care 61.8 63.0 60.7 of social services in rural areas is still in the preliminary
Home visit 76.7 80.3 73.5 stages (Wu et al., 2009; Feng et al., 2020), and it “faces many
Psychological counseling 64.9 65.8 64.2 practical challenges because of the physical environment
Daily shopping 54.7 56.5 53.0 and the lack of resources and infrastructure” (Feng et al.,
Social and recreation activities 58.6 60.1 57.4 2012, p. 2768). Taking all these factors together, rural older
adults are less likely to receive proper care and more likely
Legal aid 57.2 58.7 55.8 to have a higher need for all kinds of social services.
Health education 67.7 68.8 66.7
Among the determinants examined with the Andersen
Neighboring relations 58.9 61.3 56.7 model, we found that enabling and need factors, but not
Indices of need for social services predisposing factors, were significant predictors of the
Mean # of basic care services (ranges 0 – 4) 2.6 2.7 2.5 need for social services. Unlike some previous studies
0(%) 18.6 16.1 20.8 (Calsyn & Winter, 2001; Jackson & Mittlemark, 1997; Liu
1(%) 11.9 12.8 11.2 et al., 2014), we did not find that older age and being a
2(%) 11.4 11.4 11.5 woman were associated with an increased need for social
3(%) 8.8 8.8 8.9 services after enabling and need factors were adjusted
for. The major reason for these different results is likely
4(%) 49.2 51.0 47.7 because we focused on an ADL-disabled older population,
Mean # of social connections (ranges 0 – 4) 2.5 2.4 2.5 while others focused on the entire older population. In
0(%) 27.0 25.1 28.6 particular, the majority of our respondents were the oldest
1(%) 10.2 10.7 9.9 (aged 80 years or older). Because women and more aged
2(%) 6.6 6.6 6.7 adults are more likely to be ADL-disabled, it is possible and
3(%) 5.7 5.5 6.0 logical that our sample of ADL-disabled older adults has a
4(%) 50.4 52.1 48.9 similar need for social services regardless of age and sex.
We also found that, as expected, living with children was
Note: Chi-square tests were performed to test rural–urban differences. associated with a lower need for basic care services, while
All rural–urban differences are statistically significant at P<0.001,
except for health education (p<0.01). an unmet need for ADL assistance was associated with a
higher need for basic care services in both rural and urban
4. Discussion areas. These findings indicate that unmet needs could be
due to insufficient care from family members, who provide
Family care for older adults has been prevalent in China the majority of care for older adults; as Table 1 shows, about
due to the traditional norm of filial piety. However, this 88% of the sample had a family member as the primary
traditional practice faces challenges due to the increasing caregiver. Thus, older adults with disabilities may be more
size of the older population and the decreasing number of likely to seek from non-family resources for assistance with
potential family caregivers. These challenges raise an urgent unmet needs for care (Fu et al., 2017).
need for research that explains the need for social care Among the significant enabling factors, we found that
services among older adults, which can inform community economic independence was associated with reduced
program development and reduce family members’ care need for both basic care and social connection services
burden. Based on five waves of data from the CLHLS, a in urban areas but not in rural areas. We speculate
nationally representative longitudinal survey with the that substantial rural–urban disparities in economic
largest sample size of older adults in contemporary China, conditions and social welfare may account for this finding.
this study examined the need for home- and community- Most economically independent urban older adults have
based services.
pension income and are covered by medical insurance,
Overall, we found that rural residents had a higher need so they can afford to hire a caregiver and/or use services
for both basic care and social connection service programs from hospitals or special care facilities. Thus, urban older
than urban residents. This finding is not surprising. adults with disabilities may have a lower need for social

Volume 11 Issue 5 (2025) 45 https://doi.org/10.36922/ijps.448