Demographics in Focus (Asynchronous - Online Only)
Featured Methodological Challenges of Interviewing Older Persons Living in Extreme Poverty View Digital Media
Paper Presentation in a Themed Session Owasim Akram
Interview as a method would continue to remain popular to understand the lived experiences of a vulnerable population. Older persons, as a vulnerable group, require special methodological considerations while interviewing. Experience of interviewing older persons living in extreme poverty can contribute to the methodological innovation for interview-based research. Relying on the experiences of life-history interviews with 37 older persons living in extreme poverty in Bangladesh, this article aims to shed light on the overall experiences and challenges encountered throughout a fieldwork. The research sheds light on several practical, emotional, as well as ethical aspects that impact the interview process. In doing so, the article critically engages in the discussion of power imbalance between researcher and interviewee, informed consent process, dilemmas regarding appropriate mode showing empathy and solidary. Silence of the older persons during interviews found to be innovative if carefully analysed. Recognising that interviews may leave long-lasting emotional scars with researchers, the article stresses having a proper mechanism in place to deal with ethical and emotional concerns equally protecting interviewees and researchers. In conclusion, the research highlights key learning and brings forward crucial questions and concerns to be further debated and investigated.
Engaged and Excluded: The Oldest-old in a Changing-communal Kibbutz View Digital Media
Paper Presentation in a Themed Session Ilana Mizrahi Naor
The communal kibbutz allows its elderly members unique considerable continuity in employment, housing, social activities, economic security, and excellent health and nursing services. However, in recent years ideological and social changes impacting the kibbutz have reduced this continuity. This study focuses on how the oldest-old (aged 80+) members of a changing-communal kibbutz experience and describe their involvement in work and social activities over time. Methodologically, the information was gathered through participant observations and narrative interviews of 37 kibbutz members in a single kibbutz as a case study. This longitudinal study was conducted in two stages, following the participants to the end of life. The findings show that at the first time point most of the oldest-old do not disengage and continue to work and participate in social activities, presenting an anti-aging self. However hidden from public view one sees their aging, their hurt, their exclusion and pain regarding their place in the kibbutz which is no longer a home. At the second time point, 7 years later, some of the "survivors" do not feel committed to work as in the past, but still participate in social activities and family gatherings. They accept their ageing and are proud to remain active without feeling alienated as previously. Towards the end of life there is a period of loss, with no pride in their survival. Nevertheless, they are involved with their families and wish to die at home and not in a nursing home, which is a threat to their independence and selfhood.
Self-Perceived Health, Precarious Employment, Poverty, and Healthy Life Expectancy: Changes in Quality of Life and Life Expectancy in European Countries
Paper Presentation in a Themed Session Aviad Tur Sinai
Advances in medical knowledge and technology have helped to raise both general and healthy life expectancy (HLE), causing a secular upturn in the share of the elderly population and challenging PAYGO systems of Social Insurance (SI) by increasing their default risk. Analyzing the determinants of self-perceived health (SPH) by use of the SHARE longitudinal multi-country database, combined with data on life expectancy and its healthy part, from EUROSTAT, and where missing, from WHO, we find that past and present employment improves health while the gender effect of job quality on SPH is detrimental for women and positive for men. We found that job precarity is particularly widespread among women and that its negative effect on health rises with age, whereas job quality among men is mainly positive and peaks in the mid-fifties. This empirical result has an important implication for the policy of automatically linking retirement age to healthy life expectancy: We argue that it justifies progressive reduction of the linkage, certainly for women, with increasing age. One way to achieve this is to attach weights to the existing and the linked retirement age—a weight increasing with age to the existing RA and a complementarily falling weight with age to the linked RA. This would obviate the front-loading of the linkage of RA to healthy life expectancy as occurs in current typical discretionary RA policies. We conclude that SI sustainability should be linked to healthy LE rather than to general LE.
The Aging Workforce in the Stone Age: Economic Implications of Increased Human Longevity in the Late Pleistocene
Paper Presentation in a Themed Session Kevin Kelly
As conference attendees consider the current economic and demographic impact of aging populations, it may be helpful to reflect on the consequences of aging at a much earlier period in human history, the upper Paleolithic (the Stone Age). I will argue that population aging was an economic driver of First Agricultural Revolution (the Neolithic). This assertion derives from my research (Kelly 1980, n.d. [1982], 1994) and that of others (Weiss 1973; Caspari and Lee 2004, 2006). For example, although not explicitly noted, trends of increasing longevity are evident from a comprehensive view of Weiss’ monograph on paleodemography. More recently, Caspari and Lee have provided additional convincing evidence of increasing numbers of older people during the Pleistocene (Ice Age). Using tooth wear, Caspari and Lee divided fossils into young and older adults. They found a trend of increasing ratio of older to younger adults (OY ratio). That trend accelerated at the beginning of modern human behavior in the Upper Paleolithic (30,000 years ago) suggesting that the behaviors that we associate with anatomically modern humans are a consequence of these demographic changes. I note that an increase in the OY ratio is also an increase in the dependency ratio. An aging Paleolithic workforce would have a direct impact economic needs and outputs. Given continued improvements in longevity, technological changes would be necessary to keep older adults productively in the workforce. I assert those changes are evident in the adoption of agriculture and in later sedentism.
Featured Social Well-being and Utilisation of Health and Social Care Services in Older Age: Results of a Systematic Review of Reviews View Digital Media
Paper Presentation in a Themed Session Sarah Assaad
With increasing trends in loneliness and social isolation, more attention has been given to understanding the role of social factors in decreasing the burden on health and social care systems. The aim of this paper is to systematically identify reviews that investigated associations of social factors with health and social care service utilisation in older age. Following PRISMA guidelines, nine databases were searched from inception to October 2019, yielding 4197 unique records. Screening and quality appraisal were conducted by two independent reviewers. A total of 36 reviews, mostly from high-income countries were included in a narrative synthesis. Those studied varied from people with specific diseases (such as dementia and cardiac disorders) to outpatients and those in the community. Social support was the main social factor investigated, and all reviews focused on healthcare services utilisation (including re-hospitalisation, institutionalisation, and physician visits) except for one (integrative) review examining adult day service centres. Low social support, being unmarried and living alone were associated with an increased risk of re-hospitalisation and emergency department visits. Volunteering showed no evidence for nursing home admission prevention or reduction. While associations between social support and frequent attendance in primary care, and social relationships and physician visits were inconsistent. This paper highlights the need for more investigations drawing on longitudinal studies with more diversity (like ethnic groups in high-income countries). The findings suggest caution in assuming interventions aimed at strengthening social factors reduce health care utilisation.
Changes in Health Attitudes During the Pandemic : Salud Percibida en la Población Extremeña Ante la COVID-19 View Digital Media
Paper Presentation in a Themed Session María José Lopez Rey, Mar Chaves Carrillo, Manuela Caballero Guisado
The data presented here are part of a broader investigation on active population aging. The work was carried out in November 2020, in a region of southern Spain. It was carried out by a sociology research team from the University of Extremadura, within the framework of the R + D + I project: Sceneries of active aging in Extremadura: intervention proposals, which was supported by the Government of Extremadura and the European Regional Development Fund. Here, we focus on aspects that have to do with the experience of health, especially during the COVID-19 pandemic, and how this has affected the population related to the main sociodemographic variables. In an exercise of methodological triangulation, thus providing robustness to the analysis, primary data, obtained from the survey designed ad hoc, are combined with other secondary data from various sources and studies carried out in Spain (Sociological Research Centre, and National Institute of Statistics). The survey was carried out on a representative sample of population over 55 years old, coming from Extremadura. Among the findings, we must highlight the practical invariability of perceptions based on the main sociodemographic variables, as well as some subtle differences indicated by the variables sex and age.
Living Arrangements of Older People in Flanders, Belgium: The Importance of the Neighborhood and Distance View Digital Media
Paper Presentation in a Themed Session Wesley Gruijthuijsen, Veerle Draulans, Jakob D'herde, Dominique Vanneste
Healthcare policies in most European countries aim at aging-in-place combined with a socialization of care that appoints a larger role to care and support from the family and local community. Even though most older people express the wish to remain in their own dwelling, it remains largely unknown whether their immediate physical and social environment support this desire. During the summer of 2021, 41 interviews (still ongoing) were carried out with older people (64 – 93) living independently in Flanders (Belgium). We focused on their living situation and their immediate (social – physical) surrounding, with special attention for distance to facilities, family members and social contacts. Furthermore, we discussed future living preferences and the ideal neighborhood to get old. While most research focuses either on urban or rural areas, we carried out a cluster analysis to select 15 neighborhoods across Flanders, based on demographic data, the level of urbanization, and the level of facilities in the municipality. The first results show that most people indeed aspire to remain in their current dwelling and are satisfied with their neighborhood. However, approximately 20- 25% of the respondents moved recently or expressed the wish to move in the future, mostly because of practical considerations, like home or garden maintenance, or distance to facilities. Distance to family members seems to be less important, as most respondents plan to use formal (home) care, and do not plan to ask for help from the family and local networks, other than in emergencies, questioning the healthcare policies.
