Family capital and the self-rated health of older adults in rural China: an intergenerational perspective

Abstract

Background: Self-rated health is an important predictor of adverse health outcomes (e.g. mortality) and health service use. While intergenerational family capital has been considered as one of the most important social determinants of self-rated health, the role of grandparent-grandchild dyads in self-rated health has not been fully investigated. Further, little is known about the patterns of change in trajectories of the self-rated health of older rural Chinese adults, who constitute the largest ageing population in the world.

Objectives: This study investigated the association between grandparent-grandchild family capital and the self-rated health of older adults in rural China, as well as the mediation role of the grandparent-parent relationship in the association between grandparent-grandchild family capital and self-rated health. The present study also examined the development trajectories of the self-rated health of older rural Chinese adults from the point of view of intergenerational relationship and socio-economic status.

Methods: Data for this study are derived from the Well-Being of the Elderly in Anhui Province survey. A random sample of 1,715 adults aged 60 and older were interviewed in the rural Chaohu region in 2001. A total of 1391 and 1067 respondents participated in the 2003 wave and 2006 wave respectively. New respondents were recruited for the 2009 wave and 1224 respondents were interviewed in 2009. Based on the 2009 wave of the Chaohu survey, structural equation modeling was used to examine the direct effect of grandparent-grandchild family capital on the self-rated health of older adults and the mediation role of the grandparent-parent relationship. Based on the 2001, 2003 and 2006 waves of the Chaohu survey, general growth mixture modeling was used to examine the multiple underlying trajectory patterns of self-rated health as well as the antecedents of the latent class memberships.

Results: The results showed that grandparent-grandchild family capital had a direct effect on the self-rated health of older adults in rural China. The results also showed that the grandparent-parent relationship played a partial mediation role in the association between grandparent-grandchild family capital and self-rated health. Further, a two-class model was chosen to interpret the underlying trajectory classes. The two trajectories were labeled “good but declining SRH class” and “poor and declining SRH class”.

Discussion: The findings enriched our theoretical understanding of intergenerational family capital and its effects in a cultural context that emphasizes collectivism and intergenerational exchanges. The mediator role of the grandparent-parent relationship was also highlighted in the findings, which confirmed “grandchild-as-linkage” theory. Further, there are underlying multiple trajectory patterns of the self-rated health of rural older adults. Intergenerational relationship was an important antecedent of the latent classes of self-rated health trajectories in rural China.