The Impact of Family Network and Intergenerational Transfers of Financial Support On Self-Rated Health Among Aging Parents in Urban China: Accounting for Socio-Cultural Factors

Background and Purpose: The protective effects of social networks and social support on health outcomes have been recognized in diverse cultural contexts. Cultural norms, roles, and relationships shape how people interact with one another. China provides a unique context for studying how social networks and social support influence health status among older adults. Family networks and intergenerational support have been shown to be central to the well-being of older adults in Chinese societies characterized by filial piety. This study explores culturally relevant correlates of self-rated health with a specific focus on direct and indirect effects of family network and intergenerational transfers of financial support on self-rated health among aging parents in urban China. Previous studies in the Chinese context have been limited in terms of cultural factors considered, sample representativeness, and examination of interrelationships among correlates. Methods: Data came from the nationally representative study Sample Survey on Aged Population in Urban and Rural China in 2006, collected by the China Research Center on Aging. A subsample of parents aged 60 and older in urban China (N=7,898) was included in path analysis using Mplus 5.1. Self-rated health was measured by one item “How do you assess your current health condition?” on a 5-point scale and higher value means better health. Robust validity of the single-item global assessment of health status has been consistently demonstrated in aging Chinese populations. Family network was measured using the translated and abbreviated version of the family subscale of the Lubben Social Network Scale (LSNS-6). A summated score for family network was calculated, ranging from 0 to 15.The Chinese version of LSNS has been previously tested and used among older Chinese adults. Received financial support from children was measured by a single item—“Did you receive money from children during the previous year?”—with yes or no (referent) as the response set. Provided financial support to children was captured by a single item asking whether aging parents provided any money to their children during the previous year with yes or no (referent) as the response categories. Socio-cultural factors included age, gender, years of education, marital status, economic security, coresidence status with children (married sons, unmarried sons, married daughters, and unmarried daughters), perceived filial piety, number of children, friend network, depressive symptoms, functional capacities, and chronic disease status. Results: Model fit was good (χ2/df=19.807/1; p=0.000; CFI=0.997; RMSEA=0.049). Gender, chronic disease status, functional capacities, years of education, coresidence with married sons, depressive symptoms, perceived filial piety, and financial support from children were significantly directly associated with self-rated health. The effects of family network on self-rated health were fully mediated by receiving financial support from children. Conclusions and Implications: In order to better promote health status among aging parents in urban China, the direct effects of coresidence with married sons, perceived filial piety, and depressive symptoms on self-rated health should be taken into consideration. Besides encouraging and maintaining the family network, interventions should take into account of the mediating effects of financial support received from children.