TY - JOUR
T1 - Evolution in intergenerational exchanges between elderly people and their grandchildren in Taiwan; Data from a multiple round cross-sectional study from 1993 to 2007
AU - Tsai, Feng Jen
AU - Motamed, Sandrine
AU - Elia, Nadia
AU - Rougemont, André C.
N1 - Funding Information:
The health care system is one of the important social welfare policies, especially for elderly people. Health care in Taiwan is administrated by the Department of Health, which introduced National Health Insurance on 1st March, 1995. Before NHI, there were several health insurance systems such as health insurance for government officers, farmers and laborers, but only 57% of the population was covered in 1994 [23]. With strong political backing, NHI was introduced in 1995 and the coverage rate then rapidly reached 97.62% for females and 94.11% for males in 1999 and then 99% by the end of 2004 [24]. As a single-payer compulsory social insurance plan, mainly financed through premiums based on a payroll tax, the insurance fee of NHI was controlled by the government and remained relatively low priced. As a compulsory insurance with a low insurance premium, NHI provided a possibility of an affordable non-employer based health insurance and a safe health environment for elders’ future. This was supported by the old people’s great satisfaction and feeling of security toward NHI (Table 1). With previous findings that older adults were more likely to work less or retire after receiving access to non-employer based insurance [24,25], the implementation of NHI and its comprehensive coverage rate might give the elderly more leeway to make their retirement decision and work-family balance. Therefore, elders might tend to retire to improve their family life, including taking care of their grandchildren. The significantly decreased elderly employment rate from 1993 to 1999 might also be supporting evidence for this explanation. Also, the result that mainlanders provided significantly more grandchild care might also support the argument. The term ‘mainlanders’ refers those who migrated with the Kuomintang (KMT) to the island of Taiwan from mainland China between 1945 and 1950, following the Chinese civil war. Because these elders had comparatively less family support in Taiwan, they had to work more for their future life security. Therefore, they might have felt less necessity to work after the implementation of NHI and so have a greater chance to devote more time to their family.
PY - 2011
Y1 - 2011
N2 - Background: This study aimed to evaluate social evolution in Taiwan in recent decades using the changing pattern of care provided by grandparents for their grandchildren as an indicator. Methods. Data from the second, fourth and sixth wave surveys of the Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan were used for the analysis. This survey collected individual characteristics, including age, gender, education, ethnicity, dwelling place, living with partners, co-resident with children, employment status, self-reported health status and their provision of care for their grandchildren. Information about the attitudes toward National Health Insurance (NHI) was further collected in a questionnaire of 1999 following the implementation of NHI in 1995. By elders, we mean persons 60 or more years old. By grandchildren, we mean persons under 16 years of age. First, changes in individual characteristics were compared during these study periods (chi-square test). Then the logistic regression was performed to determine how significantly elders' grandchild-care behavior was associated with their individual characteristics. Results: The percentage of elders providing grandchild care increased from 7.7% in 1993 to 13.6% in 1999, and then to 19.4% in 2007. By analysis, significant association was found between behavior in taking care of grandchildren and individuals of lower age, grandmothers, those living with partners or co-residing with children, those unemployed and those with better self-reported health status. And the effect of year was confirmed in the multivariable analysis. Conclusions: This study pointed out the changing pattern of elders' behavior in taking care of their grandchildren as the main indicator and their related individual characteristics. We argue the need for improving social security policies in an ageing society. We suggest that the interaction between population policies and those of social welfare, including policies for health care and childcare, should be carefully evaluated.
AB - Background: This study aimed to evaluate social evolution in Taiwan in recent decades using the changing pattern of care provided by grandparents for their grandchildren as an indicator. Methods. Data from the second, fourth and sixth wave surveys of the Study of Health and Living Status of the Middle-Aged and Elderly in Taiwan were used for the analysis. This survey collected individual characteristics, including age, gender, education, ethnicity, dwelling place, living with partners, co-resident with children, employment status, self-reported health status and their provision of care for their grandchildren. Information about the attitudes toward National Health Insurance (NHI) was further collected in a questionnaire of 1999 following the implementation of NHI in 1995. By elders, we mean persons 60 or more years old. By grandchildren, we mean persons under 16 years of age. First, changes in individual characteristics were compared during these study periods (chi-square test). Then the logistic regression was performed to determine how significantly elders' grandchild-care behavior was associated with their individual characteristics. Results: The percentage of elders providing grandchild care increased from 7.7% in 1993 to 13.6% in 1999, and then to 19.4% in 2007. By analysis, significant association was found between behavior in taking care of grandchildren and individuals of lower age, grandmothers, those living with partners or co-residing with children, those unemployed and those with better self-reported health status. And the effect of year was confirmed in the multivariable analysis. Conclusions: This study pointed out the changing pattern of elders' behavior in taking care of their grandchildren as the main indicator and their related individual characteristics. We argue the need for improving social security policies in an ageing society. We suggest that the interaction between population policies and those of social welfare, including policies for health care and childcare, should be carefully evaluated.
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U2 - 10.1186/1471-2458-11-639
DO - 10.1186/1471-2458-11-639
M3 - Review article
C2 - 21835009
AN - SCOPUS:80051506445
SN - 1471-2458
VL - 11
JO - BMC Public Health
JF - BMC Public Health
M1 - 639
ER -
