Discussion Paper No. 847

WHAT MAKES PEOPLE ANXIOUSABOUT LIFE AFTER THE AGE OF 65?
EVIDENCE FROMINTERNATIONAL SURVEY RESEARCH
IN JAPAN, THE UNITED STATES,CHINA, AND INDIA

Yoshihiko Kadoya

June 2012
Revised August 2013
Secondly Revised September 2015

The Institute of Social and Economic Research
Osaka University
6-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan

What makes people anxious about life after the age of 65?
Evidence from international survey research inJapan, the United States, China, and India*
Yoshihiko Kadoya†
Graduate School of Economics, Nagoya University

Abstract
This study investigated the causes of people’s anxieties about life after the ageof 65 years, using household data from countries with different social
contexts: Japan, the United States, China, and India. This research added
contextual aspects to the literature on social security and precautionary savings.
An ordered probit model was used to establish the causes of anxiety and ageneralized structural equation model was used to check the robustness of theresults. This study uncovered three major findings. First, anxiety levels aboutlife at an older age partly depend on people’s views of the future. Second, highfinancial status lessens people’s anxiety levels only if prices are stable. Third,
living with a child, contrary to expectations, does not necessarily lessen
people’s concerns about life after 65.
Keywords: aging policy, social security, future concern, precautionarysaving, comparative studies
JEL classification codes: E21; H53; I38
Forthcoming in Review of Economics of the Household*

This research used micro data from the Preference Parameters Study of Osaka
University’s 21st Century COE Program ‘Behavioral Macrodynamics Based on Surveys
and Experiments’ and its Global COE project ‘Human Behavior and Socioeconomic
Dynamics’. I acknowledge the program/project’s contributors: Yoshiro Tsutsui, Fumio
Ohtake, and Shinsuke Ikeda. This work was supported by JSPS KAKENHI Grant
Number 15K17075. I thank Charles Yuji Horioka, Midori Wakabayashi, Wataru Kureishi,
Shizuka Sekita, Keisuke Kawata, Eiji Mangyo, Sayaka Namamura, and Mostafa Khan for
their valuable comments.
† Graduate School of Economics, Nagoya University, Furo-cho, Chikusa, Nagoya
4648601 JAPAN E-mail: yoshi.kadoya@soec.nagoya-u.ac.jp

11. Introduction
Easing people’s concerns about growing old is one of the major challenges insocial security research in the era of global aging. The causes of aging-related
anxiety are often nebulous. This research cuts across different social contexts
to investigate the reasons for anxiety about life after the age of 65 years.
Population aging has become a major concern in many countries.
According to the Organisation for Economic Co-operation and Development(OECD 2006), the average ratio of people aged 65 and older to the population
aged between 20 and 64 years (hereafter, the old-age dependency ratio) inOECD member nations is expected to increase from 22.9 % in 2000 to 46.3 %in 2040. This trend is expected to occur also in East Asia. The old-age
dependency ratios in China, Thailand, and Indonesia are forecast to increase
from about 10 % in 2000 to 40 %, 37 %, and 25 %, respectively, by 2040
(United Nations 2011). Furthermore, population aging will begin to affecteven countries whose populations are growing, such as India. The old-age
dependency ratio in India is expected to increase from about 10 % in 2000 to
17 % by 2040 (United Nations 2011). These trends may bring about, or
exacerbate, serious social issues, including a shortage of labor and resources
for necessary social services, such as long-term care that would eventually
become necessary for substantially higher numbers of people.
Anxiety produces a substantial burden on individual wellbeing. The
constant state of anxiety could seriously affect quality of life by restricting
daily activities and difficulty in sleeping (Hoffman et al. 2008). In a serious
state, anxiety could also lead to depression, phobias, panic, and otherpsychological disorders. Furthermore, anxiety could lead to irrational thinking,like excessive health concerns, wrong beliefs, and social isolation. Usually, themiddle-aged groups of populations make significant contribution to societies
by their direct involvement in the workforce and via their experience. Anxiety
could impede the ability of these groups of people to contribute to theirsocieties. Anxiety has social implications alongside economic implications. It
could affect family and social relationships, causing those affected to cease toact as active and responsible members of family and society. The direct cost of
medical care from anxiety-related health problems and the indirect costs fromthe loss of productivity constitute the economic loss of this anxiety (Hoffman2

et al. 2008; Hu 2002). Overall, anxiety creates an economic burden and social
imbalance in society. Therefore, it is natural for governments to be concerned
about this problem.
A critical aspect of this problem is that governments need to findefficient ways to ease people’s concerns about aging. To do so, they must firstunderstand the causes of aging-related anxiety. Although social security
systems help to lessen people’s anxieties, the resources available to develop
such systems will become more and more limited as the old-age dependency
ratio increases. Thus, social security systems need to focus their resources on
the direct causes of people’s anxieties about growing old.
The existing literature confirms the negative impact of income
uncertainty on consumption. When future income is not certain, consumers
tend to deviate from their consumption levels attained at permanent income
levels. In line with this economic theory, it is possible that anxiety about oldage, more specifically, the anxiety about future financial conditions, could
have negative impacts on the economy through reduced consumption.
Menegatti (2007) found evidence that income uncertainty negatively affects
consumption decisions. To reduce such negative impacts on consumption,
Menegatti (2007) emphasized the importance of precautionary savings.
Analyzing household data in the United Kingdom, Dardanoni (1991) provedthat future income uncertainty decreases consumption and increases people’s
desires for precautionary savings, which negatively affects the national
economy. Kazarosian (1997) and Carroll and Samwick (1998) endorsed thisclaim, using panel data on households in the United States. Social security,
however, mitigates such negative effects by easing people’s concerns about
their financial future. Engen and Gruber (2001) provided evidence that thedevelopment of an unemployment insurance system eases the degree ofconcern for the future and decreases the amount of precautionary savings.
Starr-McCluer (1996) claimed that withholding health insurance increases
people’s concerns about the future. All these findings point to the conclusionthat it is important for governments to ease people’s anxieties about the future.
It is noteworthy that middle-aged people are usually more concerned
about old age than the old themselves are. A number of previous studies thathave examined age differences in anxiety (e.g., Bland et al. 1998; Carta et al.

3

1991; Fichter et al. 1996; Jorm 2000; Weissman and Myers 1980;) claim thatpeople in their 40s, 50s, and early 60s tend to be more anxious than thoseolder than 65 years. Jorm (2000) explained that aging is associated with an
intrinsic reduction of susceptibility to anxiety. Nonetheless, the anxieties of
middle-aged people cannot be ignored, even though they may feel less anxious
as they grow older. People in this age range are very important for the national
economy, as they usually earn and spend more than other age groups.
Moreover, they probably feel the most insecure owing to the current
population trends that forecast an increase in the old-age dependency ratio.
What makes people anxious about their old age is uncertain; multiple
factors, including the status of people’s finances, families, and health, might
be at work. A person’s financial status determines his/her ability to purchasethe necessary long-term care when he/she becomes older and physically weak.
Family status, and the ability or willingness of families to care for older family
members, may influence aging-related uncertainty. Grossbard (2014) statedthat altruism was not the only factor that affects in-family caregiving.
Exchanges of work for money or inter-generational monetary transfers also
play significant roles in family caregiving. As a result, people could beanxious about life after the age of 65 even though they live with family
members. Health risk status almost surely influences people’s anxieties about
old age, both in terms of fear of discomfort or death and in terms of increasing
health care requirements. Furthermore, the measurement of all this uncertainty
must be observable and exogenous in order to produce accurate data and to
generate effective results (Browning and Lusardi 1996).
Past literature has established the effects of social norms and cultural
traits on the reporting of social anxiety. Most studies have used collectivism
and individualism as a proxy for cultural traits to examine whether social
anxiety differs significantly across countries with different cultural
backgrounds. Hofstede (1984, 2001) studied how collectivism andindividualism shape the behavior of people. Collectivist countries place highimportance on group affiliation and harmony and less importance on
individual gain. People from collectivist countries often are found to take careof their relatives and other group members in addition to their own family
members. On the other hand, individualistic countries have weak social

4networks and place strong importance on individual achievements and success.
Moreover, individualistic countries are found to be less tied with stringent
social norms than collectivist countries (Argyle 1986). Thus, social norms andcultural traits, reflected in whether countries are either collectivist or
individualistic, need to be examined to study people’s social concerns, likeanxiety (Hofmann et al. 2010). East Asian countries, like Japan and China, areconsidered collectivist countries whereas western countries, like the UnitedStates, are considered individualistic countries (Hofstede 2001). Heinrichs etal. (2006) and Okazaki (1997) reported that collectivist countries have greaterlevels of social anxiety than individualistic countries. A related study by
Norasakkunkit and Kalick (2009) studied the behavior of 127 Japanese and
126 American participants to establish the effect of cultural differences onsocial anxiety and well-being. The Japanese participants, who were influenced
by collectivism, were found to be more prone to social anxiety than theAmerican participants, who were influenced by individualism. However, thisrelationship held true only for anxiety and not for well-being. Thus, thefindings of these studies suggest that anxiety about old age could be related to
cultural norms and traits.
Table 1 describes the differences in social contexts across Japan, theUnited States, China, and India. A very large portion of Japan’s entire
population is aged, while Japan has an expensive pension scheme and auniversal long-term care insurance system. By comparison, although a large
portion of the United States’ entire population is also aged and covered by acomprehensive pension scheme, the long-term public care system ismeans-tested. The expectation is that China will shortly have a significant
elderly population due to its long-standing one-child policy, yet its social
security system is weak and underdeveloped. India’s social security system isalso weak; however, the speed of change in its old-age dependency ratio ismoderate because of its very large numbers of young people.
(Insert Table 1 around here)
In these circumstances, it is important to find the causes of anxiety
about old age and to find the factors responsible for cross-country differences.
To this end, this study conducts cross-country research to provide evidence on
the causes of anxiety after the age of 65 years. To conduct the study, first, a5questionnaire was designed to understand respondents’ degrees of anxiety
regarding their lives after the age of 65, and to gather data on the possible
determinants of such anxiety, such as the status of their finances, families, andhealth. The questionnaires were distributed to households in accordance withthe protocols used to obtain census data. Second, the research spanned
countries with different social contexts: Japan, the United States, China, andIndia. Since this is a cross-country analysis and regression models are used
separately for each country, the results should provide evidence of the causes
for old-age anxiety that are unaffected by the cultural differences of thecountries.
This study contributes to the existing literature in several ways. First,
it provides new cross-country evidence for the causes of anxiety after the ageof 65. Second, this study provides an opportunity to observe whether observed
cultural differences in the sample countries affect the causes of older people’sanxiety. Third, the results of this study provide important implications forpolicymakers to improve their understanding about the lives of old people.
The remainder of the paper is organized as follows. Section 2
describes the dataset and the data collection process in the sample countries.
Section 3 presents the empirical models and results. Finally, Sections 4, 5, and6 present the policy implications, discussion, and conclusion, respectively.
2. DataThis research used micro data from the Preference Parameters Study of Osaka
University’s 21st Century COE Program “Behavioral Macrodynamics Basedon Surveys and Experiments” and its Global COE project “Human Behavior
and Socioeconomic Dynamics.” The study used a multi-stage sampling andallocation method while sampling the data. Appendix 1 shows the detailed
discussion on the data collection and sample size determination process. Whilecollecting the data, a nationwide survey was conducted for both Japan and theUnited States. However, the data for China came from six major cities, whilethat for India focused on five major cities. The data were collected between
December 2011 and May 2012. A preference parameter study used different
approaches to receive responses from subjects aged between 20 and 69 years.
However, this research targeted respondents aged between 40 and 64 years

6because previous studies found that respondents of this age group are more
likely to be anxious about their old age (Carta et al. 1991; Fichter et al. 1996;
Jorm 2000; Weissman and Myers 1980). Data collection methods included
visits and placement surveys in Japan, mail surveys in the United States, andface-to-face interviews in both China and India. The response rates in Japanand the United States were 93.9 % and 75.3 %, respectively. The fact that
Osaka University’s survey project was a panel survey explains the highresponse rates in Japan and the United States. The panel survey started in 2009
and the present study used data from the survey’s 2012 round.
Table 2 indicates the survey variables. One question measured thelevel of each respondent’s anxiety about life after the age of 65, the dependent
variable. Responses indicating the degree of anxiety ranged from 1 (leastanxious) to 5 (most anxious). The independent variables are a proxy for thethree risk factors mentioned earlier: financial status, represented by financial
assets, housing, and social security; family status, represented by information
on marital status and children; and health status, represented by exercise habits.
There is little difference in the measurement of financial assets between thefour countries. While conducting the survey, respondents from Japan and theUnited States were asked to choose a balance of financial assets from different
ranges of asset values while respondents from China and India were asked tomention the approximate balance of the financial assets. The mean values ofthe scale in the questionnaire in Japan and the United States were used tomeasure financial assets, whereas, the actual values collected throughinterviews were used in China and India. The study measured levels of social
security using the mid-point of the social security scale used in thequestionnaire (Table 3). During the data collection process in China and India,
researchers added the option “no security insurance” because many subjects inboth countries gave that response. This is interpreted as zero coverage.
(Insert Table 2 around here)(Insert Table 3 around here)
Table 4 shows the descriptive statistics. The variable describing
financial assets indicates a huge gap between the developed nations in the
study (Japan and the United States) and the developing ones (China and India).

7

The rate of home ownership is rather similar in all countries, but the extent ofsocial security coverage for post-retirement living expenses is very low inIndia. In all four countries, the majority of the people indicated their family
status as married. The percentages of those who lived with a child are thebiggest in India, followed by China, Japan, and the United States. The UnitedStates has the biggest portion of people with exercise habits, whereas India has
the smallest.
(Insert Table 4 around here)
3. Methodology
This study used an ordered probit regression model to establish thecauses of anxiety after the age of 65 years. This model is a generalization of
the probit model, which is suitable for situations with more than two outcomesof an ordinal dependent variable. The dependent variable, namely, the level ofanxiety in old age, is an ordinal variable that is categorical and ordered. Since
there are five possible ordered outcomes of the dependent variable, an ordered
probit model is the best fit for this study. The non-linearity and ordered
responses in the dependent variable cannot be controlled by the linear
regression, and so, the ordered probit model used in this study should
successfully establish the causes of anxiety after the age of 65.
Possible endogeneity bias in the ordered probit regression model is aconcern for this study. The possibility of simultaneous causality between thedependent variable and some of the independent variables could reduce thestrength of the coefficient values. For example, the variable “exercise” could
produce simultaneous causality but the manner in which anxiety affects
exercise is not as strong as the manner in which exercise affects anxiety. As aresult, it seems that the magnitude of such simultaneous causality is not too
strong to affect the coefficients of the regression equation significantly.
Nevertheless, the generalized structural equation model was used to check
whether endogeneity causes the coefficients to be biased.
4. Results
This section first discusses the respondents’ degrees of anxiety about life after
65 years in each of the four countries. Figure 1 indicates the level of anxiety

8

by age group. People in the United States are the most optimistic about theirold age in general, whereas people in India and Japan seem to feel the mostinsecure. In particular, older generations in India appear to be the mostanxious about their lives as they age. In Japan, although younger generations
seem to be considerably concerned about their future, older generations, suchas those in the 55–59 year and the 60–64 year age groups, feel relatively
secure. In China, the level of anxiety is consistently moderate throughout thegenerations, even though the old-age dependency ratio is expected to increase
radically over the next few decades. The level of anxiety peaks in the age
range of 55–59 years in the United States, China, and India but in Japan, it
peaks in the range of 40–44 years.
(Insert Figure 1 around here)
We now turn to the causes of anxiety, analyzed using an ordered
probit model (Table 5). First, only in Japan does the “age” variable
significantly decrease anxiety, as seen earlier. Second, the “educ” variable
significantly lowers anxiety in China. Third, the “assets” variable significantly
decreases anxiety in Japan and the United States, endorsing the precautionarysaving theories in the literature. Contrary to expectations, the “assets” variable
increases anxiety in China. However, it has no significant effect in India.
Fourth, whereas the “own housing” variable does not significantly affectanxiety in Japan and the United States, it significantly decreases anxiety inIndia, and contrary to expectations, significantly increases anxiety in China.
Fifth, the “security” variable significantly decreases anxiety levels in Japan; sodoes the presence of a spouse. Sixth, the “exercise” variable significantly
decreases anxiety in Japan and the United States.
(Insert Table 5 around here)
5. Robustness checks
Heteroscedasticity, two-way causation, and collinear variables are somecommon problems that can affect the regression coefficient of the ordered
regression model. The robustness of the results obtained from the ordered
regression was checked against these issues. The robust regression produced
similar results to the original models. Although the values of the coefficientschanged moderately, the levels of significance did not change and the overall

9implication of the results remains the same (Table 6). Since the results of theordered regression are robust, the causes of anxiety after the age of 65 years
obtained from the regression equation need to be considered seriously.
(Insert Table 6 around here)
We used a number of independent variables in the ordered probit
models, and thus, the possibility of endogeneity bias should be examined. As
the endogeneity problem affects the value of coefficients, the causes of anxiety
identified from the ordered probit model need to be free from endogeneity bias.
We used the generalized structural equation model to check robustness against
endogeneity problems. Table 7 shows the results of the generalized structural
equation model. It appears that the value and significance of the coefficientsare quite similar to those in the ordered probit model, which means that
endogeneity problems did not cause bias in the estimation models.
(Insert Table 7 around here)
6. Policy Implications
Identifying the direct causes of people’s anxieties about old age enables thesuggestion of some policy implications. In order to ease aging-related
anxieties, the governments of Japan and the United States should focus on (a)policies that increase people’s financial assets (e.g., tax cuts) and (b) healthpromotion campaigns that encourage regular exercise. In addition, theJapanese government should focus on developing a generous social
security/pension system. Finally, the Indian government should implement
policies that facilitate home ownership (e.g., public home-loan programs).
7. Discussion
This study used ordered probit models to examine the causes of anxiety aboutlife after the age of 65. In addition, the generalized structural equation model
was used to check the robustness of the results against endogeneity problems.
Several of the results presented in Section 3 are unexpected. First, people in
China show little aging-related concerns despite the fact that the old-age
dependency ratio is expected to increase without any corresponding
development of social security. Second, a high level of financial assets lessens
concerns about the future in the two developed nations (Japan and the United

10States), but not in the two developing nations (China and India). In theory, thedevelopment of a social security system lessens people’s concerns about the
future. However, financial assets mitigate anxiety only in Japan and the UnitedStates, where the social security systems are comparatively well developed.
Third, home ownership eases anxiety only in India. Since housing is an asset,
those who own their own homes, generally, should feel more secure than those
who rent, but that was the case only in India. Fourth, living with a child did
not significantly lessen anxiety in any of the four countries. These results
contradict the traditional concept of regarding one’s children as potential
old-age caregivers. The following sub-sections investigate possible reasons
underlying these enigmatic results.
7.1 Reasons behind the optimistic outlook of people in China
The moderate level of anxiety about old age in China may be partly due topeople’s general views about the future. The research survey contained one
extra question, asking subjects to rate their agreement with the following
sentence: “Since the future is uncertain, it is a waste to think about it.” Figure
2 shows the answers from 1 (“completely disagree”) to 5 (“completely agree”).
Whereas the majority of people in the United States and Japan rather disagreed
with the sentence, people in China, in particular, rather agreed with it. Since
people in China generally do not place value on thinking about the future, they
are not anxious about their lives in old age, despite China’s rapidly aging
population and its underdeveloped state of social security.
Nonetheless, this does not necessarily explain the uniqueness ofChina. Contrary to expectations, the level of financial assets and homeownership uniquely increase the level of anxiety in China. Further studies anddetailed investigations are required to explain this result.
(Insert Figure 2 around here)
7.2 Reasons behind the effect of a high level of financial assets in China and
India
Part of the reason for the unexpected effects of financial asset levels in China
and India may lie in their economic trends. For example, Figure 3 shows
trends in the consumer price index (CPI) in the four nations. Only in Japan and11the United States has the CPI remained stable over the last several years; inChina and India, the value of money has changed dramatically. This may
explain the reason why current financial status does not mitigate concerns forthe future in China and India. Precautionary saving theories require a stable
CPI trend.
(Insert Figure 3 around here)
7.3 Reasons behind the minimal effects of home ownership
The fact that the majority of people in Japan, the United States, and China
already own their own homes, as seen in Table 4, may explain the homeownership results in these countries. Likewise, the fact that few people own
their own homes in India may be the reason behind the results there. Moreover,according to the Knight Frank Global House Price Index (2010, 2011), realestate prices in Japan, the United States, and China have been either
decreasing or trending toward step-down (Table 8). With these trends, homeownership does not necessarily make people feel secure about the future. On
the other hand, real estate prices in India have been increasing. Thus, realestate facts and trends seem to explain why home ownership significantly
lessens anxiety only in India.
(Insert Table 8 around here)
7.4 Reasons why living with children did not lessen anxiety
Many parents, contrary to common expectations, may not expect their children
to provide long-term care. According to a Japanese survey of 1,092 adults,
conducted by Daiichi-Life Insurance (2012), there is a huge gap between
parents and children in terms of their beliefs and opinions about who shouldbe the caregivers (Figure 4). About 30 % of children think that they should
provide their parents with long-term care, whereas only 2.8 % of parents thinkthat way. Parents in Japan do not expect their children to take care of them,even though their children may think they do. This gap might have influenced
the unexpected outcome for Japan in this category. However, no such data are
available for other countries. This warrants further investigation of differencesin family dynamics, expectations, attitudes towards children, and differencesin the values placed on independence, compliance, and obligation.

12

(Insert Figure 4 around here)
8. Conclusions
In order to respond to the social security needs of increasingly aging
populations, many governments need to focus their limited resources on the
direct causes of people’s anxieties about aging. Using an ordered probit model,
this study investigated the causes of people’s anxieties about life after the ageof 65 years using household data from countries with different social contexts:
Japan, the United States, China, and India. In addition, a generalized structural
equation model was used to check the robustness of the results. The research
uncovered three major findings. First, levels of anxiety about life at an older
age partly depend on people’s general views about the future. The generalapathetic attitude to the future in China explains why people in China were notvery concerned about their lives in old age, despite expectations that the nation
will face rapid population aging without a corresponding improvement in thedevelopment of social security. The precautionary saving theory requires
people to have a considerable amount of interest in the future. Second, highfinancial status lessens anxiety only if prices are stable. In Japan and theUnited States, where the CPI has been stable, high financial status effectively
reduced anxiety, whereas high financial status did not work to reduce anxiety
in China or India, where the CPI has been unstable. Unless the CPI remains
the same for several years, people will not feel secure because of their current
financial status. A similar principle can be applied to home ownership. Homeownership did not significantly reduce anxiety in Japan, the United States, or
China, where housing prices were declining (or off their peak) at the time ofthe survey, whereas it effectively lessened anxiety in India, where housing
prices were increasing steadily at the time of the survey. Third, living withchildren did not necessarily lessen people’s concerns about life after 65 years.
Many parents, contrary to common expectations, did not expect their children
to provide them with long-term care.
This research has several limitations. First, only the major cities in
China and India were surveyed, whereas the data for Japan and the UnitedStates were based on nationwide surveys. The results for China and India
might have been different if the data had covered rural areas. Second,13

self-reported subjective anxiety levels might be influenced by culture. In some
cultures, people tend to make extreme choices (i.e., 1 or 5 choices on a 5-point
scale), whereas in other cultures, people like to make moderate choices (i.e., 3).
The differences we found might have been influenced by culture, and notnecessarily economic context. Third, the variable “exercise” might be subject
to reverse causation. Some people might exercise regularly because they feelanxious about the future‡. Fourth, the data collection method involves mailing
respondents in the United States, which could affect the results.
Nonetheless, this research adds contextual aspects to the literature onsocial security and precautionary savings. Aging-related anxiety is affected bypeople’s general views about the future and economic trends, such as trends in
the CPI and housing prices. Governments need to take these factors into
account in order to identify the causes of aging-related anxiety.
The research results provide the platforms to investigate further thedifferent causes of aging-related anxieties in these four countries, or to expand
research into other contributing factors and/or the unique political, social, andeconomic contexts of other countries. Ultimately, such research could
contribute to the improvement of people’s lives as they move into their later
years.

Conflict of interest This author declares that he has no conflict of interest.

‡

However, I have not found any literature that suggests anxiety may cause people to exercise.

14

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Norasakkunkit, V., & Kalick, S. M. (2009) Experimentally detecting how
cultural differences on social anxiety measures misrepresent culturaldifferences in emotional well-being. Journal of Happiness Studies, 10,313–327.
OECD. (2006) Long-term care for older people. Paris, France: Organisation
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Okazaki, S. (1997) Sources of ethnic differences between Asian-American andwhite American college students on measures of depression and social
anxiety. Journal of Abnormal Psychology, 106(1), 52–60.
Starr-McCluer, Martha. (1996) Health insurance and precautionary saving.
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http://esa.un.org/wpp/unpp/panel_population.htm. Accessed 3
September 2013.
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U.S. community: The application of research diagnostic criteria to aresurveyed community sample. Acta Psychiatrica Scandinavia, 62,
99–111.

17

Appendix 1
Details of the Data Collection Method
Japan
In the Japan study, nationwide visit-placement surveys of individuals andhouseholds were conducted from January to March 2012. The target
respondents were between 20 and 69 years. Two-stage stratified random
sampling was applied. First, the prefectures of Japan were divided into 10
regional blocks: Hokkaido, Tohoku, Kanto, Koshinetsu, Hokuriku, Tokai,
Kinki, Chugoku, Shikoku, and Kyushu. Then, each of the 10 regions was
sub-divided into the following four strata: government-designated major cities,
cities with populations of more than 100,000, cities with populations of lessthan 100,000, and towns and villages. From this dataset, 2,579 observations
were chosen covering 40–64-year olds with no missing answers.
The United States
In the United States study, mail surveys were sent to individuals andhouseholds all over the nation, except to the states of Alaska and Hawaii,
between January and March 2012. The target respondents were 18 years orolder. Multi-stage sampling was applied. The population was split into 36
different sample universes based on age group, gender, and race ethnicity.
From this dataset, 1,190 observations were chosen. The observations covered
40–64-year olds with no missing answers.
China
In the China study, face-to-face interviews were conducted in six major
cities—Beijing,
Shanghai,
Guangzhou,
Chengdu,Wuhan,andShenyang—from December 23, 2011 to January 21, 2012. The target
respondents were adults between 20 and 70 years of age. A multi-stage
sampling and allocation method was used. First, numbers of responses werepredicted based on the target population in each district using the Statistical
Yearbook. Then, an area in each district was selected randomly. Finally, using
the Kish Grid method, individuals were chosen to be interviewed. From thisdataset, 735 observations were chosen covering 40–64-year olds with no
missing answers.

18

IndiaIn the India study, face-to-face interviews were conducted in six major
cities—Delhi,
Mumbai,Bangalore,
Chennai,Calcutta,
andHyderabad—between January and March 2012. The target respondents were
adults between 20 and 69 years of age. A multi-stage sampling and allocation
method was used. Each city was divided into four quadrants (north, south,
west, and east) and each section was stratified into separate categories bygender, age group, and socioeconomic characteristics. Finally, the numbers of
responses were set to be collected randomly within each stratum. From thisdataset, 493 observations were chosen. The observations covered 40–64-year
olds with no missing answers.

19

Figure 1: LevelLof anxxiety by agge group
Responses indicating thet degree oof anxiety raanging fromm 1 (least annxious) to 5
(most anxioous).

Figure 2: Views
Vabou
ut the futurre by age grroup
Responses to the questtion “Since the future isi uncertain,, is it a wastte to think
about it?” rangingr
fromm 1 (compleetely disagrree) to 5 (completely aggree).

200Figure 3: Trend
Tof CP
PI in subjecct nations

Source: Minisstry of Internaal Affairs and Communicatiions, Governm
ment of Japan (2010)
CPI: Consum
mer Price Indexx

Figure 4: Answers
Ato the questioon “Who shhould take care of an oldparent?” inn Japan

Source: Daiicchi-Life Insuraance (2012)21
1

Table 1. Cross-country differences in context
Speed of
Public long-term care
AgingprogramJapan

Very fast

UnitedStates

Fast

China
India

Very fast
Moderate

Long-Term Care
Insurance (Universal)
Medicaid(Means-tested)
Medicare (Limited
Means-tested)
Underdeveloped
Underdeveloped

Coverage of mandatory
pension schemes by labor
force (%)
95.2
92.1

20.7
9.2

Sources: Data on the speed of aging are from the United Nations (2010). The OECD (2005)
provides data on the nature of public long-term care programs in Japan and the United States.
Data on the percentage of the labor force covered by mandatory pension schemes are from theOECD (2012).

Table 2. Variables
Variable(Dependent
Variable)anxiety(Independent
Variables)
male
age
educ
asset_1000usd

ownhousing
security
spousechildlt
exercise

Definition

How much do you agree with the following sentence?
(5 being the maximum and 1 the minimum)
I have anxieties about my “life after I turn 65”**(For those who are already 65 or older, “future life.”)
1= male, 0 = female
Years of education
Balance of financial assets (savings, stocks, bonds,
insurance, etc.) of the entire household (the value wasconverted to US dollars using the exchange rates as ofFebruary 2012: 1 JPY = 0.0128 USD; 1CNY= 0.159
USD; and 1 INR = 0.018 USD).
1= own, 0 = otherwise
Expected social security (pension) income for total
living expenses after retirement (%)
1= married, 0= otherwise
1= living with child(ren), 0= otherwise
1= exercising at least once a week, 0 = otherwise.

22

Table 3. Scale of expected coverage of social security for living expenses
after retirement
Scale used in data
Medium value
collection
0–9%
0.045
10–19%
0.145
20–29%
0.245
30–39%
0.345
40–49%
0.445
50–59%
0.545
60–69%
0.645
70–79%
0.745
80–89%
0.845
90% or more
0.950
No social security*
0.000*This choice was available only in China and India.

23

Table 4. Descriptive statistics
Japan
Variable
age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exercise
United States
age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exercise
China
age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exercise
India
age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exercise

Obs
2579
2579
2579
2579
2579
2579
2579
2579
2579

Mean
52.59364
0.464133
13.34781
148.9013
0.898410.483562
0.856534
0.654130.354401

Std. Dev.
7.259945
0.498809
2.017237
219.6319
0.302167
0.253654
0.350616
0.475744
0.478424

Min
40
0
9
0.001267
0
0.045
0
0
0

Max
64
1
21
1280
1
0.95
1
1
1

1190
1190
1190
1190
1190
1190
1190
1190
1190

52.55882
0.473109
13.6584
189.8424
0.839496
0.397916
0.727731
0.368908
0.687395

6.733006
0.499486
1.687133
254.4606
0.367227
0.262250.445315
0.482712
0.46375

40
0
9
12.5
0
0.045
0
0
0

64
1
18
1000
1
0.95
1
1
1

735
735
1093
735
735
735
735
735
735

52.17687
0.480272
10.8920415.97712
0.794558
0.368157
0.922449
0.657143
0.670748

7.44105
0.499951
2.786884
21.50263
0.40430.244093
0.267646
0.474988
0.470262

40
0
0
0
0
0
0
0
0

64
1
16
159
1
0.95
1
1
1

493
493
493
493
493
493
493
493
493

53.88438
0.448276
8.543611
12.54504
0.63286
0.076045
0.776876
0.675456
0.263692

9.295555
0.497823
4.846487
28.09773
0.482515
0.172661
0.416764
0.46868
0.441082

40
0
0
0
0
0
0
0
0

71
1
18
477
1
0.95
1
1
1

24

Table 5. Estimation results
Ordered probitJapananxiety

United States
anxietyChinaanxietyIndia
anxiety-0.0160***(-4.89)0.00174(0.34)-0.00718(-1.11)0.0143**(2.48)

male

0.0310(0.73)

0.0412(0.67)-0.0688(-0.86)

0.0430(0.42)

educ-0.0117(-1.08)0.00194(0.10)-0.0289*(-1.70)-0.00311(-0.28)asset_1000usd-0.000920***(-9.24)-0.000366***(-2.78)0.00514***(2.79)-0.0000112(-0.01)ownhousing-0.116(-1.63)0.0299(0.34)

0.172*(1.73)-0.317***(-3.13)security-0.332***(-3.83)-0.0163(-0.13)-0.215(-1.33)-0.0603(-0.20)

spouse-0.316***(-4.79)-0.137*(-1.83)0.0227(0.15)-0.0977(-0.74)childlt

0.0417(0.84)-0.0660(-0.92)0.00253(0.03)

0.00765(0.07)

exercise-0.0818*(-1.85)-0.148**(-2.21)0.125(1.42)

0.118(1.06)-3.509***(-14.13)-0.765**(-2.07)-2.335***(-4.93)-0.895**(-2.38)-2.648***(-10.83)-0.208(-0.56)-0.885*(-1.90)-0.420(-1.13)-1.826***(-7.53)0.514(1.39)-0.0552(-0.12)0.586(1.58)

1.273***(3.43)
1190

1.055**(2.25)
735

1.468***(3.91)
493

anxiety
age

cut1
_cons
cut2
_cons
cut3
_cons
cut4
_cons

-0.690***(-2.86)N2579
t statistics in parentheses*
p < 0.1, ** p < 0.05, *** p < 0.01

25

Table 6. Estimation results to check robustness
Japan-0.01595(-4.87)***0.031004(0.73)-0.01168(-1.06)-0.00092(-9.44)***-0.11631(-1.62)-0.33165(-3.77)***-0.31572(-4.96)***
0.041691(0.85)-0.08177(-1.86)*

UnitedStates.001739(0.34).0412337(0.67).001944(0.11)-.0003658(-3.14)***.0298913(0.31)-.0162509(-0.13)-.1372901(-1.84)*-.0660098(-0.94)-.148337(-2.19)**China-.0071834(-1.12)-.068825(-0.85)-.0289111(-1.74)*.0051416(3.31)***.1716625(1.74)*-.2147011(-1.47).0226523(0.13).0025267(0.03).1245074(1.38)

India.0143335(2.26)**.0430048(0.43)-.00311(-0.26)-.0000112(-0.01)-.3167527(-3.30)***-.0603341(-0.19)-.0976962(-0.75).0076523(0.06).1175404(1.08)

2579

1190

735

493

Pseudo R2
0.0324t statistics in parentheses*
p < 0.1, ** p < 0.05, *** p < 0.01

0.00590.00880.0129

age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exercisen

26

Table 7. GSEM results to check robustness against endogeneity problem

age
male
educ
asset_1000usd
ownhousing
security
spousechildlt
exerciseJapan-0.0159(-4.89)***0.0310(0.73)-0.0116(-1.08)-0.0009(-9.24)***-0.1163(-1.63)-0.3316(-3.83)***-0.3157(-4.79)***0.04169(0.84)-0.0817(-1.85)*

UnitedStates0.0017(0.34)
0.0412(0.67)
0.0019(0.10)-0.0004(-2.78)***0.0298(0.34)-0.0162(-0.13)-0.1372(-1.83)*-0.0660(-0.92)-0.1483(-2.21)**China-0.0071(-1.11)-0.0688(-0.86)-0.0289(-1.70)*0.0051(2.79)***
0.1716(1.73)*-0.2147(-1.33)0.0226523(0.15)
0.0025(0.03)
0.1245(1.42)

1190

735

n
2579
t statistics in parentheses*
p < 0.1, ** p < 0.05, *** p < 0.01

India
0.0143(2.48)**
0.0430(0.42)-0.0031(-0.28)-0.00001(-0.01)-0.3167(-3.13)***-0.0603(-0.20)-0.0976(-0.74)0.0076(0.07)
0.1175(1.06)
493

Table 8. House price indexes
Q1 2010–Q1 2011
Japan
−3.6%
United States−4.9%
China (Beijing and Shanghai) 8.4%
India
21.9%
Source: Knight Frank (2010, 2011)

Q1 2009–Q1 2010
−4%
2.3%
68%
8.4%

27