Date of Award
Doctor of Philosophy
Population aging is accelerating across the globe. A cross-national comparison perspective is imperative and important because such comparison provides an opportunity to contrast experiences of different countries and learn from each other. Promoting healthy aging is one of the ultimate goals of social policies related to older adults. Guided by the integrative theoretical framework based on the social ecological model and life course perspective, this dissertation investigates the relationship of social resources with older adults’ physical, mental, and cognitive health in China, the United States, England, and Mexico using the Harmonized Health and Retirement Study (HRS) dataset and its international sister studies. Four countries were chosen primarily based on their geographic location, different level of economic development, and availability in the Harmonized HRS dataset. The dissertation comprises three projects.The first project explored the relationship between retirement/pension and depressive symptoms of older adults across the life course. Regression models were estimated using Structural Equation Modelling. Results indicated that retirement was associated with higher levels of depressive symptoms for the US and with lower levels of depressive symptoms for Mexico and England. Having a public pension was associated with lower levels of depressive symptoms for Mexico and with higher levels of depressive symptoms for the US and China. Having a private pension was associated with lower levels of depressive symptoms for the US, China, and England. The study showed that continuity theory demonstrates cross-national variation in explaining the association between retirement and depressive symptoms. The second project tested the cross-cultural applicability of the shared resource hypothesis in explaining mental health concordance among older couples. Dyadic data were analyzed to examine the actor and partner effects of demographic, health, and household variables on depressive symptoms using both multilevel model and Structural Equation Model. Results indicated both husbands’ and wives’ depressive symptoms were associated with their own and the spouses’ social and health status. Most couple-level resources were nonsignificant predictors for Chinese and Mexican couples’ concordance, but having more social and financial resources was associated with higher concordance among British and American couples. It is concluded that the shared resource hypothesis was more applicable to depressive symptom concordance within couples in the US and England, but not in China and Mexico. The third project examined health inequalities between genders and countries in the context of Cumulative Dis/Advantage (CDA) and Welfare State theories. Regression models were fitted to examine the moderation roles of country and gender. Health patterns across age groups were cross-examined by linear regression models and negative binomial models. Results indicated older Chinese and Mexican respondents had poorer health status than their British and American counterparts consistently except for Mexicans’ memory. Cumulative health gaps between developing and developed countries existed only for functional ability. However, there is no evidence of gender gaps in health status across age groups. CDA explains the increasing gaps of functional ability across age groups between countries. General health and mental health, however, may depend more on individuals’ intrinsic capacity and human agency. Findings from these interconnected projects corroborate the person-in-environment perspective and suggest older adults’ health is influenced by multilevel factors including micro demographic characteristics, meso household resources, and macro culture/policy contexts across countries. The cross-national comparisons provide a unique perspective on variables associated with older adults’ health in different societal contexts. Suggestions were recommended for clinical practice to work with diverse aging population and for decision makers to improve policy design, with the ultimate goal to promote healthy aging and reduce health disparity in later life.
Lu, Peiyi, "Social resources, pension policy, and older adults’ mental, physical, and cognitive health: A cross-national comparison between China, England, Mexico, and the United States" (2021). Graduate Theses and Dissertations. 18547.