How Childlessness Affects the Quality of Life of Chinese Elders: Mediating Effects of Social Support and Lifestyle

Background/Purpose: Adult children played a primary role in support and caregiving for the fast-growing older population in China because of the core value of “filial piety” and underdeveloped formal services in the country. However, an increasing amount of Chinese people will end up with having no children in their later years, either non-parental or no children survived. Limited studies focused on the Chinese childless elders, and little is known about the mechanisms through which childlessness influences the lives of elders. It is important to understand that how the absence of children affects the health and well-being to better serve this growing vulnerable older population.The purpose of the study is to explore the factors mediating the effect of childlessness on quality of life among older people in China.

Methods: Data of this study were from the 2008-09 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS). The sample size was N=13,897 including older adults aged 65 and above who had no non-biological children (e.g., adopted children and stepchildren). The dependent variable was the self-rated quality of life (good/poor), and the independent variable was childlessness (yes/no). The mediators included social support, participation in social and leisure activities, and health behaviors. Covariates included demographics (gender, marital status, age, ethnicity) and socioeconomic status (education, poverty, rural/urban residence). Multivariate logistic regression was used to estimate the coefficients, which will be standardized to calculate the indirect effects. The standard errors and confidence intervals were computed from a bootstrap resampling approach testing the significance of the indirect effects.The statistical analyses were conducted by Stata 13.

Results: The analysis revealed that childless elders were less likely to report a good quality of life than those who had children alive controling for the covariates (OR= 0.381; p < 0.01). The mediation tests showed that being childless affects the quality of life for elderly through social support (direct effect = -0.082; indirect effect = -0.024, 95% CI: -0.049 to -0.008; total effect = -0.106) and participation in social and leisure activities (direct effect = -0.107; indirect effect = -0.010, 95% CI: -0.024 to -0.001; total effect = -0.117). Being childless did not influence the quality of life by altering the health behaviors of people in their later life (direct effect = -0.116; indirect effect = 0, 95% CI: -0.008 to 0.007; total effect = -0.116)). 

Conclusion and Implications: The findings suggest that being childless had more influences on the social dimensions of life for elders. Future studies should further explore the different paths of the effect for people who became childless due to different reasons. Social policies and practices in China need to address the psych-social needs of childless elders apart from financial/material needs. More serious efforts are needed to expand the provision of the social and leisure facilities and events in different settings and to foster the support and caregiving from informal social networks for childless elders.