The development of China’s community care services and its impact on older adults' health and subjective wellbeing: 1998 -2018
Creators: name: Yan, Shibin
Publisher: name: No Publisher Supplied
Year: 2025

description: As China has experienced rapid population aging, the demand for elder care services has increased dramatically. The gap in service demand has become concerning because the traditional provision of eldercare heavily relies on informal care provided by the family. Social and demographic transformations have made the family-reliant care model unsustainable. Community care has become a reasonable and practical option to balance the care demand. Despite the crucial role of community care in elder care provision, the focus of many scholars has predominantly been on state, market, or family-provided care, with less attention given to community-based services.This dissertation examines the evolution and impact of community care services on the health and subjective well-being (SWB) of older adults in China. Utilizing data from four waves of the Chinese Longitudinal Healthy Longevity Study, the study employs person fixed-effect regression analysis to assess community care influence on the broader population of older adults, including subpopulations such as the childless and disabled.Key findings indicate a significant disparity between the provision and needs of community care, with unmet needs having a notable negative impact on both health and SWB,especially pronounced in urban areas. The research reveals that while community care services significantly enhance SWB and health, the impact varies depending on the type of service, place of residency, disability status, and financial sufficiency. Specifically, cultural and social services were found to have a more significant effect on health outcomes, whereas medical care services notably influenced SWB. Importantly, the study also found that community care services might more directly influence older adults' subjective well-being than their objective health outcomes.The dissertation highlights the critical need for policies that foster an integrated care model combining community and family care to effectively support aging in place. This approach not only leverages the strengths of both care systems but also addresses the unique needs of the aging population, thereby enhancing their quality of life and well-being. The study advocates for future research to incorporate more objective health measures and to examine the influence of degree of urbanicity on the effectiveness of community care services.
description: 随着中国人口老龄化速度的加快，老年人养老服务的需求急剧增加。传统养老服务依赖着家庭提供的非正式护理，但社会和人口结构的变化使得这种护理模式已不可持续。社区养老服务因此成为了平衡养老需求的一个合理且实际的选择。尽管社区养老在老年护理提供中扮演着关键角色，但许多学者的研究重点主要集中在国家、市场或家庭提供的护理上，对基于社区的服务关注较少。本论文研究了社区养老服务在中国的发展及其对老年人健康和主观幸福感的影响。利用中国健康长寿纵向研究的四个波次数据，本研究采用个体固定效应回归分析，评估社区养老对包括无子女和残疾人群在内的广泛老年人群的影响。主要发现表明，社区养老的提供与需求之间存在显著差异，未满足的需求对健康和SWB有明显的负面影响，特别是在城市地区更为突出。研究揭示，虽然社区养老服务显著提高了观幸福感和健康，但其影响因服务类型、居住地、残疾状态和经济状况而异。具体来说，文化和社会服务对健康结果的影响更大，而医疗保健服务则显著影响观幸福感。重要的是，研究还发现社区养老服务可能对老年人的主观幸福感影响比对客观健康结果更直接。论文强调了制定政策的迫切需要，以促进结合社区和家庭护理的综合护理模式，有效支持老年人在原居住地安老。这种方法不仅利用了两种护理模式的优势，还解决了老年人群独特的需求，从而提高了他们的生活质量和幸福感。研究呼吁未来的研究应纳入更多客观健康指标，并检验城市化程度对社区养老服务效果的影响。