College for Health, Community and Policy
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Browsing College for Health, Community and Policy by Department "Sociology"
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Item Are Religious Teens Nice Kids? Faith and Congeniality among American Adolescents(2018-10-26) Fondren, Kristi M.; Bartkowski, John P.; Xu, Xiaohe; Levin, Martin L.One body of extant research has documented the social contours and positive effects of teen religiosity, while another has explored the religious sources of social congeniality (“niceness”) among adult Americans. This study integrates these parallel bodies of scholarship by examining the religious bases of niceness among American teens. Using post-hoc interviewer ratings from wave 1 of the National Longitudinal Study of Adolescent Health (Add Health), we examine the degree to which religious teens are perceived more positively than their nonreligious peers. Associations linked to six dimensions of teen religiosity are considered. Select facets of teen religiosity are associated with more positive interviewer ratings, particularly for interpersonal warmth, thereby providing modest support for hypothesized patterns. Findings are interpreted in light of current theories of religious involvement, interpersonal dispositions, and social competencies.Item Buddhism and Depressive Symptoms among Married Women in Urban Thailand(2020-01-25) Xu, Ting; Xu, Xiaohe; Sunil, Thankam; Sirisunyaluck, BangonA growing body of research has documented salutary associations between religious involvement and poor mental health outcomes, such as depressive symptoms and psychological distress. However, little scholarly attention has been given to the association between Buddhism, a non-Western religious faith, and depressive symptomatology in Thailand. Using random survey data collected from urban Thailand, this study examines the association between religious involvement and depressive symptoms among married women in Bangkok. Findings from multiple linear regression models reveal that (1) Buddhist respondents report significantly lower levels of depressive symptoms than their non-Buddhist counterparts, (2) the frequency of participation in religious activities is significantly and inversely associated with the level of depressive symptoms, and (3) the inverse association between religious participation and depressive symptoms is more salient for Buddhists who frequently practice their faith (i.e., significant interaction effect). Research limitations and directions for future research are discussed.Item Comparing same- and different-sex relationship dynamics: Experiences of young adults in Taiwan(Max Planck Institute for Demographic Research, 2019-03-05) Lin, Zhiyong; Yu, Wei-hsin; Su, Kuo-HsienBackground: Few studies of same-sex relationships are able to capture the dynamics of these relationships from formation to dissolution, and even fewer provide evidence on these dynamics in a non-Western context. Objective: Using retrospective relationship history data collected from a nationally representative sample of young adults, this study compares the processes of forming and terminating relationships between same- and different-sex couples in Taiwan, an Asian society featuring both strong parental influences on children’s mate selection and an ongoing legislative effort to legalize same-sex marriage. Results: Results from event history models show that factors associated with relationship formation and dissolution are largely similar for same- and different-sex unions and that same-sex relationships do not have higher dissolution rates. Nevertheless, premarital coresidence with parents, which is likely to amplify parental influences on children’s mate selection, deters the entry into and accelerates the dissolution of same-sex relationships more than it does different-sex relationships. Moreover, same-sex relationships are more heterogamous in family economic background, but more homogamous in age and education level, than different-sex ones. Contribution: This study is among the first to provide evidence on the dynamics of same- and different-sex relationships in a non-Western context. Aside from a few differences between same- and different-sex relationships related to parental influences, our study provides strong evidence that same- and different-sex couples experience intimacies in similar ways – even in a relatively conservative cultural context like Taiwan.Item The Contribution of Sociocultural Factors in Shaping Self-Reported Sickness Behavior(Frontiers Media, 2020-01-24) Shattuck, Eric; Perrotte, Jessica K.; Daniels, Colton; Xu, Xiaohe; Sunil, ThankamSickness behavior is an evolutionarily conserved phenomenon found across a diverse range of animals involving a change in motivational priorities to theoretically maximize energetic investment in immune function and recovery. Typical components of sickness behavior include reduced sociability and activity, changes in diet, and depressed affect. Importantly, however, sickness behavior appears to be subject to other demands of life history in animal models, including reproduction and offspring survival. Thus, “feeling sick” is often context dependent with possible effects on morbidity and mortality. While humans may not always face the same life history trade-offs, sociocultural norms and values may similarly shape sickness behavior by establishing internalized parameters for “socially appropriate sickness.” We explore the role of these factors in shaping sickness behavior by surveying a national U.S. sample (n = 1,259). Self-reported and recalled sickness behavior was measured using the SicknessQ instrument, which has previously been validated against experimentally induced sickness behavior. After post-stratification weighting and correction for Type I error, generalized linear models showed that sickness behavior is significantly affected by various factors across sex and racial/ethnic groupings. Income below the national mean (b = 1.85, adj. p = 0.025), stoic endurance of pain and discomfort (b = 1.61, adj. p < 0.001), and depressive symptomology (b = 0.53, adj. p < 0.001) were each associated with greater sickness behavior scores. Familism (b = 1.59, adj. p = 0.008) was positively associated with sickness behavior in men, but not women. Endurance of pain and discomfort was associated with greater sickness behavior in Whites only (b = 1.94, adj. p = 0.002), while familism approached significance in African Americans only (b = 1.86, adj. p = 0.057). These findings may reflect different social contexts of sickness across demographic groups, which may in turn have important implications for pathogen transmission and recovery times, potentially contributing to health disparities.Item Double Burden for Women in Mid and Later Life: Evidence from Time Use Profiles in Cebu, the Philippines(Cambridge University Press, 2017-07-10) Chen, Feinian; Bao, Luoman; Lin, Zhiyong; Zimmer, Zachary; Gultiano, Socorro; Borja, Judith B.Using data from the Cebu Longitudinal Health and Nutrition Survey (1994, 1998, 2002, 2005, 2007, 2012), we utilise latent class analysis to develop time-use class membership to characterise the degree to which women in Cebu are subject to the double burden of work and family responsibilities in mid- and later life. Results suggest that close to a third of the sample are engaged in high-intensity work for pay (either outside or home-based), while combining it with a substantial amount of household chores and with a low level of personal time in a span of 18 years. Our latent transition analysis also shows that, with the addition of grandchildren into the household, some women experience a shift in time-use class membership by becoming high-intensity care-givers or by completely transitioning out of the work arena, while others remain double-burdened with active involvement in both work and family responsibilities.Item The Emergence of Educational Hypogamy in India(Duke University Press, 2020-06-10) Lin, Zhiyong; Desai, Sonalde; Chen, FeinianWith rising education among women across the world, educational hypergamy (women marrying men with higher education) has decreased over the last few decades in both developed and developing countries. Although a decrease in hypergamy is often accompanied by increasing homogamy (women marrying men with equal levels of education), our analyses for India based on a nationally representative survey of India (the India Human Development Survey), document a considerable rise in hypogamy (women marrying partners with lower education) during the past four decades. Log-linear analyses further reveal that declining hypergamy is largely generated by the rise in education levels, whereas hypogamous marriages continue to increase even after marginal distributions are taken into account. Further multivariate analyses show that highly educated women tend to marry men with lower education but from more privileged families. Moreover, consanguineous marriages, which exemplify strong cultural constraints on spousal selection in certain parts of India, are more likely to be hypogamous than marriages not related by blood. We argue that the rise in hypogamous marriage by education paradoxically reflects deep-rooted gender scripts in India given that other salient social boundaries are much more difficult to cross.Item Evaluating the Impact of a Clinician Improvement Program for Treating Patients with Intellectual and Developmental Disabilities: The Challenging Case of Mississippi(2018-01-10) Bartkowski, John P.; Kohler, Janelle; Escude, Craig L.; Xu, Xiaohe; Bartkowski, StephenIn recent years, people with intellectual and developmental disabilities (IDD) have moved from institutionalized settings to local community residences. While deinstitutionalization has yielded quality of life improvements for people with IDD, this transition presents significant health-related challenges. Community clinicians have typically not been trained to provide sound medical care to people with IDD, a subpopulation that exhibits unique medical needs and significant health disparities. This study reports the results of a comprehensive evaluation of an IDD-focused clinician improvement program implemented throughout Mississippi. DETECT (Developmental Evaluation, Training and Consultative Team) was formed to equip Mississippi’s physicians and nurses to offer competent medical care to people with IDD living in community residences. Given the state’s pronounced health disparities and its clinician shortage, Mississippi offers a stringent test of program effectiveness. Results of objective survey indicators and subjective rating barometers administered before and after clinician educational seminars reveal robust statistically significant differences in clinician knowledge and self-assessed competence related to treating people with IDD. These results withstand controls for various confounding factors. Positive post-only results were also evident in a related program designed specifically for medical students. The study concludes by specifying a number of implications, including potential avenues for the wider dissemination of this program and promising directions for future research.Item Evaluating the Impact of the Synar Program: Tobacco Access and Use among Youth in Mississippi, the South, and the U.S.(2019-12-22) Avery, Jerri S.; Bartkowski, John P.; Xu, Xiaohe; Kohler, Janelle; Mason, Melissa(1) Background: This study examines the impact of Synar policy adoption on youth commercial access to tobacco products in Mississippi, the South, and the remaining U.S. The principal focus on youth commercial access is complemented by analyses of Synar's impact on minors' non-commercial access to tobacco and tobacco use patterns. Mississippi has been especially aggressive in implementing Synar, as evidenced by its unusually low retailer violation rates (RVRs). Synar, a mandatory, enforceable regulation meant to limit youth's retail access to tobacco, was implemented nationwide in 1997. This study is governed by a combination of conceptual insights from a diffusion of health innovation perspective and structuration theory. (2) Methods: Repeated cross-sectional data from 1995 to 2011 from the CDC Youth Risk Behavior Survey are analyzed using a pre/post-implementation, quasi-experimental analytic strategy. Tobacco access and use in the pre-Synar era (1995–1997) are compared with two post-Synar periods (1999–2005 and 2007–2011), thereby highlighting diffusion effects related to this policy innovation within Mississippi, the South, and the remaining U.S. (3) Results: Analyses of temporal trends reveal that Mississippi and other study regions effectively restricted commercial access to tobacco. Positive outcomes associated with Synar adoption were observed several years after initial implementation, thus supporting a diffusion of innovation perspective. However, results also reveal that Mississippi youth were more inclined than their counterparts elsewhere to gain access to tobacco through non-commercial means after Synar implementation, and that declines in tobacco use among Mississippi youth were less robust than those observed elsewhere. Such variegated effects are in line with expectations linked to structuration theory. (4) Conclusions: Synar policy implementation has been generally effective at deterring youth access to tobacco and, in many cases, has yielded declines in tobacco use. However, there is no evidence that especially aggressive retailer compliance checks in Mississippi have yielded distinctive benefits for youth in this state.Item Evolving parent–adult child relations: location of multiple children and psychological well-being of older adults in China(Elsevier, 2018-05) Lin, Zhiyong; Chen, FeinianObjective: This study examines the interplay among intergenerational emotional closeness, location of multiple children, and parental depressive symptoms in the context of massive migration in rural China. Study design: This study is based on a longitudinal survey. Methods: Longitudinal data were collected from a stratified random sample of age 60 and over living in rural townships within Chaohu, a primarily agricultural municipal district with massive out-migration in China. In 2009, 1224 individuals completed the survey, and 977 (79.8% of the original participants) were followed up in 2012. We estimate fixed-effects models to examine how changing collective emotional cohesion and the total composition of children’s location affect parents’ depressive symptoms. Results: Descriptive analyses show that both the composition of children’s location and intergenerational emotional closeness are subject to changes during a three-year survey interval. Results from fixed-effect models further demonstrate that collective emotional closeness and psychological well-being are positively associated with each other. This association is the strongest when all children are local but it becomes less prominent when there are more migrant than local children. Conclusions: This study has provided important evidence that both intergenerational cohesion and location of multiple children evolve over time and jointly influence parents’ psychological well-being in later life. The left-behind older adults are not necessarily the most vulnerable group in rural China. Those with most adult children living close by could also suffer from a deficit in psychological well-being if the emotional bond between them is weak.Item Fear God, Not COVID-19: Is Conservative Protestantism Associated with Risky Pandemic Lifestyles?(2023-02-15) Bartkowski, John P.; Klee, Katherine; Hill, Terrence D.; Garcia-Alexander, Ginny; Ellison, Christopher G.; Burdette, Amy M.Previous research has established attitudinal and behavioral health variations in relation to the COVID-19 pandemic, but scholarship on the religious antecedents associated with these outcomes has only recently gained momentum. Rhetoric from some leading conservative Protestants in the U.S. has underplayed the threat of the pandemic and may have contributed to unhealthy pandemic behaviors within this faith tradition. Moreover, previous inquiries have revealed that conservative Protestantism's otherworldly focus can thwart personal and community health. We use nationally representative data to test the hypotheses that, compared with other religious groups and the non-religious, conservative Protestants will tend to (1) perceive the pandemic as less threatening and (2) engage in riskier pandemic lifestyles. These hypotheses are generally supported net of confounding factors. We conclude that affiliation with a conservative Protestant denomination can undermine public health among this faith tradition's adherents and may therefore compromise general health and well-being during a pandemic. We discuss the implications of these findings, offer recommendations for pandemic health promotion among conservative Protestants, and delineate promising avenues for future research on this important topic.Item Gender Role Discrepancy Stress and COVID-19 Prevention Behaviors Among Men in the United States(SAGE Publications, 2023-01-17) Sileo, Katelyn M.; Luttinen, Rebecca; Muñoz, Suyapa; Hill, Terrence D.Purpose: To examine the associations between gender role discrepancy (non-conformity to socially prescribed masculine gender role norms) and discrepancy stress (distress arising from this discrepancy) on COVID-19 prevention behaviors among men, and the potential moderating effects of race/ethnicity, sexual orientation, and income on these relationships. Design: A national online survey was conducted between May and June 2021. Setting: The United States. Subjects: 749 adult men residing in the United States. Measures: A scale measured gender role discrepancy and discrepancy stress. COVID-19 prevention outcomes were constructed and included self-reported vaccination status/intentions, social distancing, mask-wearing, and hand-sanitizing. Analysis: Multivariate generalized linear models were performed in SPSS. Results: Gender role discrepancy associated with greater odds of vaccination (AOR = 1.35, 95% CI = 1.02-1.78, P = .04), while discrepancy stress associated with lower odds of vaccination (AOR = .48, 95% CI = .35-.68, P < 0. 001) and mask-wearing (AOR = .54, 95% CI = .37-.79, P = .001) for men overall. Discrepancy stress’s negative effect on specific COVID-19 prevention behaviors was only apparent or was amplified for men in lower income brackets (vaccination, social distancing, mask-wearing), racial/ethnic minority men (vaccination), and sexual minority men (social distancing). Conclusion: This study demonstrates that gender role discrepancy stress negatively affects men’s engagement in COVID-19 prevention, particularly for men in marginalized populations.Item Good Things in Small Packages? Evaluating an Economy of Scale Approach to Behavioral Health Promotion in Rural America(2018-06-26) Bartkowski, John P.; Xu, Xiaohe; Avery, Jerri S.; Ferguson, Debbie; Johnson, Frankie J.Rural American youth exhibit pronounced health disparities. This study enlists insights from an economy of scale paradigm to determine the relative effects of serving smaller versus larger client groups in an assembly-style school-based behavioral health promotion program. Evaluation results are reported from a three-year intervention delivered to eighth-grade and tenth-grade rural Mississippi students from 2012 to 2015. The program, I Got U: Healthy Life Choices for Teens, coupled a day-long intensive immersion in youth risk prevention and mental health promotion with school-based information dissemination. Results reveal robust effectiveness in program years 1 and 2, during which caps of 175 attendees per event were imposed. Salutary results were no longer evident during year 3, when larger venues were used to serve over three times the number of students per event. This program teaches valuable lessons about the potential for diminishing returns yielded by an economy of scale approach to implementation.Item Housing Conditions, Neighborhood Physical Environment, and Secondhand Smoke Exposure at Home: Evidence from Chinese Rural-to-Urban Migrant Workers(2020-04-11) Xiao, Chenghan; Yang, Yang; Xu, Xiaohe; Ma, XiaoOver the past two decades, health-related issues among rural-to-urban migrant workers in China have been widely discussed and documented by public health scholars. However, little, if any, scholarly attention has been paid to migrant workers’ secondhand smoke (SHS) exposure at home. This study aims to explore the contours of SHS exposure at home and investigate the effects of inadequate housing conditions and poor neighborhood physical environments on such in-home exposure among Chinese migrant workers. A respondent-driven sampling method was employed to interview 1854 rural-to-urban migrant workers from the period June 2017 to June 2018 in Chengdu, China. The results indicate that Chinese migrant workers are at high risk of SHS exposure at home. Migrant workers who live in homes with inadequate conditions, such as substandard housing and crowdedness, are especially at high risk of SHS exposure at home. Moreover, poor neighborhood physical environments are significantly and positively associated with SHS exposure at home. These findings suggest that strategies that can help improve housing conditions and neighborhood physical environments should be developed and promoted to protect rural-to-urban migrant workers from SHS exposure at home.Item Intergenerational Exchange of Resources and Elderly Support in Rural China(Sage, 2016-05-09) Lin, Zhiyong; Pei, XiaomeiThis study examines how parental investments on children affect elderly support, and how this effect is contingent on emotional closeness or parental authority. Data collected from 770 elderly parents residing in rural China were analyzed. We gathered dichotomous data for (a) whether parents invested on their children via financial or instrumental means (i.e., parental investments) and (b) whether parents reported closeness to their children (i.e., emotional closeness) and whether children respected them (i.e., parental authority). We examined the relation between these variables and children’s elderly support (financial, instrumental, and emotional). We tested models in two ways, one examining the direct effect of investments, and another testing the interactions between investments and closeness or authority. We first found that investments were not directly associated with elderly support, although the closeness and authority were. Additionally, the association between investments and support was found within parents who reported authority or closeness with their children.Item A latent profile analysis of the link between sociocultural factors and health-related risktaking among U.S. adults(BMC, 2021-03-19) Shattuck, Eric; Daniels, Colton; Xu, Xiaohe; Sunil, Thankam; Perrotte, Jessica K.Background: Research suggests that health/safety behaviors (e.g., drinking heavily) and medical behaviors (e.g., donating blood) may be perceived as inherently risky, and further suggests there is substantial variation in the likelihood of engaging in a particular health-related risk behavior across people. Research examining demographic and sociocultural factors related to both health/safety and medical risk-taking is highly limited. Importantly, with very few exceptions the literature examining health risks characterized by potentially hazardous health behaviors (e.g, heavy alcohol use, driving without a seatbelt) is kept separate from the literature examining health risks characterized by potentially beneficial medical behaviors (e.g., donating blood, taking medication). In the interest of health promotion, it is critical for researchers to identify – and describe – individuals who are less inclined to engage in health-harming behaviors while at the same time being more inclined to engage in health-benefiting behaviors. Identifying such a subtype of individuals was the guiding aim for this study. Method: A national sample of adults in the United States responded to a survey on sociocultural and demographic correlates of health behaviors. Health-related risk-taking indicators were measured using the items from the health/safety and medical subscales of the DOSPERT-M. Subtypes of risk-takers were identified using latent profile analysis (LPA). Follow-up analyses to describe subtype demographic characteristics were conducted. Results: LPA identified four subtypes of risk-takers, including a subtype (n = 565, 45% of the sample; labeled “divergent”) that was comprised of individuals who highly endorsed medical risk-taking (e.g., taking medicine, giving blood) and minimally endorsed health/safety risk-taking (e.g., drinking heavily, unprotected sex). Subsequent analyses suggested that, among other findings, divergent profile members were likely to be married, endorse familial interdependence, and orient toward masculinity rather than femininity. Conclusion: By examining potentially modifiable factors related to individuals’ inclinations to engage in health protective behaviors, this study is an important step toward improving current health behavior interventions among U.S. adults.Item Male Sexual Dysfunction and the Perpetration of Intimate Partner Violence(SAGE Publications, 2023-05-21) Hill, Terrence D.; Garcia-Alexander, Ginny; Sileo, Katelyn; Fahmy, Chantal; Testa, Alexander; Luttinen, Rebecca; Schroeder, RyanWe contribute to our understanding of the social epidemiology of intimate partner violence (IPV) by developing a mediation model that frames IPV as an outcome of male sexual dysfunction (performance anxiety and erectile dysfunction) and the mechanisms of masculine discrepancy stress (the perceived failure to conform to internalized normative expectations of masculinity) and anger. Our mediation analyses of recently collected data from the 2021 Crime, Health, and Politics Survey (CHAPS), a national probability sample of 792 men, confirmed that sexual dysfunction was indirectly associated with the perpetration of any IPV, physical IPV, and sexual IPV through the compound path of masculine discrepancy stress and anger.Item Mechanisms Linking Masculine Discrepancy Stress and the Perpetration of Intimate Partner Violence Among Men in the United States(SAGE Publications, 2022-08-26) Sileo, Katelyn M.; Luttinen, Rebecca; Muñoz, Suyapa; Hill, Terrence D.Although studies show that masculine discrepancy stress (i.e., the intrapsychic strain associated with failing to meet internalized masculine ideals) is associated with intimate partner violence (IPV) perpetration, little is known about the processes underlying this association. There may be other social psychological constructs at play that explain this relationship further. The present study uses recently collected data from a national survey of men living in the United States (n = 711) to formally test whether the effects of discrepancy stress on three different forms of IPV perpetration are mediated by anger, self-esteem, and perceived powerlessness. We find that discrepancy stress is directly associated with higher levels of anger, lower levels self-esteem, a sense of powerlessness, and a greater odds of perpetrating any physical IPV and severe physical IPV resulting in injuries, but not sexual IPV perpetration in our sample of men. Our mediation analyses confirms that masculine discrepancy stress is indirectly associated with perpetrating all three forms of IPV through the mechanism of anger. Self-esteem and perceived powerlessness are not supported as mediators. These findings add to our understanding of the link between masculinity and violence perpetration and can inform IPV reduction interventions. Gender transformative interventions that reduce discrepancy stress among men by shifting men’s adherence to traditional masculine norms, and that integrate anger management strategies, should be explored in future research.Item Minding Mental Health: Clinicians' Engagement with Youth Suicide Prevention(2022-05-11) Klee, Katherine; Bartkowski, John P.Suicidal ideation and deaths among children and adolescents have seen an unprecedented rise over the last ten years, recently further exacerbated by the COVID-19 pandemic. This research explores mental health professionals' approaches to delivering suicide prevention treatment services. Using insights from Giddens' structuration theory, the study examines licensed mental health professionals' (1) reflections on suicide prevention trainings for those in their profession, (2) appraisals of available treatment options, and (3) assessments of postvention services provided to professionals who encounter a client suicide. Additional attention was given to the structural impacts of the COVID-19 pandemic on intervention services. Data were collected through qualitative interviews with youth mental health clinicians in the state of Texas. Results underscore the interplay between structural influences and practitioner innovations in the delivery of these essential services to a vulnerable population. This study underscores the agency of mental health professionals in navigating the demands of a difficult profession.Item Mixed Blessing: The Beneficial and Detrimental Effects of Religion on Child Development among Third-Graders(2019-01-09) Bartkowski, John P.; Xu, Xiaohe; Bartkowski, StephenPrevious research has linked parental religiosity to a number of positive developmental characteristics in young children. This study introduces the concept of selective sanctification as a refinement to existing theory and, in doing so, adds to a small but growing body of longitudinal research on this topic. We explore how parents' religious attendance (for fathers, mothers, and couples) and the household religious environment (parent–child religious discussions, spousal conflicts over religion) influence child development among third-graders. Analyses of longitudinal data from the Early Childhood Longitudinal Study (ECLS)-Kindergarten Cohort reveal a mix of salutary (beneficial) and adverse (detrimental) developmental outcomes based on teachers' ratings and standardized test performance scores. Third-graders' psychological adjustment and social competence are enhanced by various religious factors, but students' performance on reading, math, and science tests is hampered by several forms of parental religiosity. We discuss the implications of these findings and suggest several avenues for future research.Item Moving beyond living arrangements: the role of family and friendship ties in promoting mental health for urban and rural older adults in China(Taylor and Francis, 2019-04-12) Tang, Dan; Lin, Zhiyong; Chen, FeinianObjective: This study examines the interplay among living arrangements, social networks, and depressive symptoms among Chinese older adults. Methods: Data are derived from the 2014 baseline survey of the China Longitudinal Aging Social Survey (CLASS), which provides a sample of older Chinese who had been married and had children (N = 7,662). This study examines the association between living arrangements and depressive symptoms (measured as CES-D scale, 0–18) of older adults, and addresses the moderating role of social networks (measured as family ties and friendship ties, 0–15) on this perceived association. Results: Our results show that older adults who live both with a spouse and adult children report superior mental health than those living alone (β = 1.240, p < 0.001), but no differences are seen from those living only with a spouse or children. Older adults living alone in rural areas are also more disadvantaged in comparison to those living alone in urban places (β = 0.535, p < 0.05). However, we find that the undesirable consequences associated with depression of older adults living alone can be reduced or even eliminated when older adults have strong friendship ties in rural China (β = −0.145, p < 0.01). We also find that for rural older adults living only with children, their mental health is highly contingent on their family ties, that is, they are extremely disadvantaged when having weak family ties, but benefit most significantly from strong family ties (β = −0.137, p < 0.05). Conclusions: Associations between living arrangements and mental health in later life are contingent on older adults’ social networks, and these moderating effects vary between rural and urban China.
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