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Sun R and Wang H

community service variables, having unmet need for housework service is associated with higher odds of worry about
eldercare.
Among the control variables, older adults who were married and those with less ADL difficulty were less likely to
worry about eldercare than their counterparts.

4. Discussion

In light of drastic changes in family structure and rapid socio-economic development in China, this study used data from
a national survey to explore the presence of worry about eldercare among Chinese older adults between 2000 and 2010.
Within one decade, living separately from children had become the way of life for the majority of Chinese older adults. On
the other hand, the socio-economic conditions of older adults have been improving, with more covered by pensions and
medical care programs, thus, resulting in less worry about income and seeking medical care. Furthermore, the availability
of community services is on the rise. In the end, a little surprisingly, worry about eldercare among Chinese older adults
remained virtually unchanged during that decade, which could be a result of the competing effects of the two tracks of
changes aforementioned.
Our results clearly support Hypothesis 1 regarding the association between socio-economic conditions of older adults
and worry about eldercare. Those older adults who did not worry about their income or medical care coverage showed
significantly less worry about eldercare. Furthermore, those who lived in communities where available services could
meet their particular needs of daily living tended to have less worry about eldercare. These findings are consistent with
the health-care utilization model developed by Anderson and others (Andersen and Newman, 2005), where enabling
conditions are a set of critical factors that determine individuals’ access to health care. They include family resources such
as income, health care coverage, and other financial sources. In addition, the amount of health facilities and personnel in
a community is another dimension of enabling conditions. These also correspond to the affordability (ability to pay) and
availability (of services) factors within the framework of accessibility to health-care developed by Levesque, Harris, and
Russell (2013). Zhu (2015) found that, among Chinese oldest old, those who were economically independent and had
family members as the primary caregiver were less likely to experience long-term care unmet needs, which we assume to
be related to reduce worry about eldercare. Therefore, access to more resources and the provision of community services
do alleviate the concern of older adults about eldercare.
Meanwhile, between the two competing hypotheses regarding the effect of family relations when older adults’ socio-
economic resources and the provision of community services are taken into account, Hypothesis 2b is supported, which
predicts that family relations are still important and relevant. It is confirmed by the fact that the number of adult children
of older adults, older adults’ living arrangements, and their children’s filial piety are highly significant in both 2000 and
2010. This finding confirms the prominent role of the family in providing eldercare in many Asian societies, including
China. Having more children, living with at least one adult child, and children’s filial piety all provide higher possibility
and security for older adults to receive care from them. As discussed by Knodel and other scholars (Asis, Domingo,
Knodel et al., 1996; Knodel, 2012), receiving care from children is valued highly among many Asian older adults. It
serves not only a practical function but also as a symbol of children’s affection and the appreciation of the traditional value
of filial piety. This finding suggests that family relations remain a crucial element of the equation when older adults assess
their prospect of receiving eldercare.
China’s population aging happens at a time of rapid urbanization and industrialization, which have weakened the
functions of traditional family support (Jackson, 2010). The traditional mode of family care faces serious challenges.
Longer life expectancy comes with a rapidly growing older adult population and more non-communicable, chronic
diseases, which are related to functional impairments and disability. The demographic reality makes it impossible for all
older adults to live with their adult children. More older adults live alone or with their spouse only. All these points to a
pressing dilemma: On the one hand, there is an ever-growing demand for care and services to older adults; on the other
hand, individual families, the traditional care providers, are increasingly incapable of fulfilling their functions. Therefore,
the role of the public sector, including state welfare programs and community services, becomes increasingly prominent
in dealing with these challenges by providing income security, medical care, and social services.
Against such a backdrop, the results show some positive development for Chinese older adults. Overall, the personal
and economic circumstances of Chinese older adults have been improving. The results show that during the first decade
of this century, Chinese older adults became more educated, enjoyed higher home ownership, received more pension or
other public income, and more medical care coverage. These changes certainly reduce older adults’ worry about eldercare.
In addition, more and more people have recognized the necessity of getting support from the community to complement
the provision of eldercare fulfilled by individual families (Du, 2013). Similar trends are seen in other Asian Countries as

International Journal of Population Studies | 2019, Volume 5, Issue 2 9