Page 53 - IJPS-11-5

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

services. By contrast, most rural residents have no or very education, relevant work experience, and training, while
little retirement income and rely primarily on family for service programs lack quality management, monitoring
support (Li et al., 2013; Zou et al., 2024), and on average, systems, and government investment. Another study also
they have a lower economic status compared to their urban conducted in Shanghai shows that the types of services
counterparts. Even if rural older adults are economically offered at the community level are limited, and most
independent, their purchasing power remains low, which services only provide basic assistance to older adults with
may prevent them from affording scarcely available social ADL disabilities (Chen & Han, 2016). Therefore, even
services. As such, rural older adults who are economically when social services are available, the services provided to
independent may suppress their need for social services, older adults may not fully meet their needs, which could
producing no effect of economic status on the need for lead to an increased need for better social services.
unavailable services. Overall, this study provides several implications for
One need factor, severe ADL disability, was associated developing social service programs in both rural and urban
with an increased need for both basic care and social China. First, given the higher need and the importance of
connection services in urban areas but not in rural areas. family members for rural residents, there is an urgent need
This finding may also be attributed to the rural–urban to develop both basic care and social connection services
disparities in economic conditions (Zhang et al., 2017). in rural areas. Second, economic disparities contribute
With access to better economic conditions, urban older to rural–urban differences in need, which suggests that
adults with severe ADL disabilities are more likely to afford improving rural older adults’ economic conditions and
social care services. Consequently, they may have higher access to healthcare systems and services may increase their
expectations for such services. However, due to lower potential use of social services and decrease their reliance
economic status and limited caregiving resources, rural on family caregivers. Research has found rural residents
residents with severe ADL disabilities, often constrained are significantly less likely to use care services than their
by lower economic status and limited caregiving resources, urban counterparts (Li et al., 2018). Therefore, expanding
may suppress their need for assistance and continue relying service availability, improving the quality of care services,
primarily on family members for caregiving. and lowering the service cost by financing care services or
At the community level, self-reported availability of providing reimbursement is necessary to reduce rural–
social care services in the neighborhood was associated urban disparities in accessing and utilizing care services.
with an increased need for those services. Our measure Third, the availability of social services was associated with
of self-reported availability of social services is very an increased need for those services, which suggests that
similar to the previously studied concepts of awareness of the government should develop new services or expand
social services (Mitchell, 1995) or perceived availability existing services to help older adults achieve “aging in the
of social services (Tang & Pickard, 2008). Previous right place”; however, service programs should be evaluated
studies have shown that greater awareness of services for acceptance, accessibility, effectiveness, efficiency, and
available to older adults is associated with greater use of appropriateness to improve utilization.
those services (Bradley et al., 2002; Moon et al., 1998; This study has several limitations. First, in the CLHLS,
Ploeg et al., 2009; Tang & Pickard, 2008) and that the the measurement of social care services is broad and not
need for services is highly associated with the use of specific. For example, a question was asked to measure
services (e.g., Calsyn & Roades, 1993), our finding is not whether there was a need for personal care service.
unexpected. Furthermore, it should be noted that self- Respondents may lack clarity on the definition of personal
reported availability of services does not mean adequate care services, potentially leading to overestimation or
quantity, good quality, easy access, or effective delivery of underestimation of their need for such services. A clear
those services. Indeed, the coverage of social services is definition of each type of service, with specific examples,
very limited in contemporary China except in a few big is necessary to estimate needs more accurately in future
cities such as Beijing, Shanghai, and Tianjin; many services studies. Second, because the awareness of social services
cannot provide professional care due to lack of skilled does not provide information on whether those services
and trained staff, and the price of the services is beyond were accessible, whether they were utilized, or whether
most older adults’ affordability (Feng et al., 2012; Gu & utilization was satisfactory, we were unable to examine
Vlosky, 2008; Hung, 2022; Qian, 2017; Wu et al., 2005). the effect of service-related characteristics on older
For example, according to a study on community-based adults’ service needs, warranting future research on those
service centers in Shanghai (Wu et al., 2005), the largest measures. Third, our study focused on ADL-disabled older
and most developed city in China where social service adults only and did not address the need for social services
programs have been developed for decades, staff lack among the entire older population. Some older adults

Volume 11 Issue 5 (2025) 47 https://doi.org/10.36922/ijps.448