214 GENDER SOCIETY /April 2003 on the relative influences of the cultural value of xiao,family structure,and eco- nomic resources on gendered patterns of parent care. Guiding Model for Analysis For this analysis,family size and economic resources are viewed as structural factors that are influenced by the societal changes that have been introduced in China as part of globalization,economic reform,and the one-child policy.Conse- quently,our analyses serve as an initial assessment of the likely effect of these struc- tural changes on women's role as caregivers for elders in interior China in the con- text of current cultural values To accurately assess the impact of the structural factors on care patterns,we first analyze the gendered nature of care task performance and of cultural values.Next, we include the gender of the caregiver and the care recipient in our regression mod- els along with control variables for the level of physical need of the elder and the marital status of the care recipient.In addition,we have included two measures of the cultural value of xiao in the models.In this way,we are able to examine the influence of structural factors after taking into account the influence of elder need and cultural beliefs. The data for this study were obtained through structured interviews in interior China with 110 urban-dwelling familial caregivers who were assisting an elderly parent or parent-in-law.A snowball method was used to identify the caregivers in Yiyang City,Hunan Province,and Baoding City,Hebei Province.Both Yiyang and Baoding are medium-sized cities located in the interior of China.They were selected because they are smaller cities,which are not often studied but are repre- sentative of the places where the majority of the interior urban population reside and work.It is in cities like these that most Chinese who have experienced privatiza- tion and globalization of their economy still live in a relatively traditional style and where cultural norms and practices ofelder care are more likely to remain relatively stable.Hence,our sample provides an excellent opportunity to assess the dual impacts of economic reform and traditional cultural values. Within the context of our available resources,it was not possible to obtain a rep- resentative sample of caregivers.However,an effort was made to select a sample that was sufficiently diverse in terms of the key independent variables including gender,employment status,and health care benefits.To maximize the variation of class status within the sample,the snowball process was initiated in four district cat- egories:factory,school,government,and residential.As most families still lived in apartments assigned by work units,though purchased by employees in the mid- 1990s,this method facilitated the inclusion of individuals with very diverse back- grounds.There was little variation in ethnicity because the vast majority of urban dwellers in these two cities are Han Chinese,as is true for most Chinese cities.To be included in the study,caregivers had to be providing financial,physical,or emo- tional assistance to parents or parents-in-law on a regular basis,and the care Downloaded from gas.sagepub.com at UCSF LIBRARY CKM on January 27.2015
on the relative influences of the cultural value of xiao, family structure, and economic resources on gendered patterns of parent care. Guiding Model for Analysis For this analysis, family size and economic resources are viewed as structural factors that are influenced by the societal changes that have been introduced in China as part of globalization, economic reform, and the one-child policy. Consequently, our analyses serve as an initial assessment of the likely effect of these structural changes on women’s role as caregivers for elders in interior China in the context of current cultural values. To accurately assess the impact of the structural factors on care patterns, we first analyze the gendered nature of care task performance and of cultural values. Next, we include the gender of the caregiver and the care recipient in our regression models along with control variables for the level of physical need of the elder and the marital status of the care recipient. In addition, we have included two measures of the cultural value of xiao in the models. In this way, we are able to examine the influence of structural factors after taking into account the influence of elder need and cultural beliefs. The data for this study were obtained through structured interviews in interior China with 110 urban-dwelling familial caregivers who were assisting an elderly parent or parent-in-law. A snowball method was used to identify the caregivers in Yiyang City, Hunan Province, and Baoding City, Hebei Province. Both Yiyang and Baoding are medium-sized cities located in the interior of China. They were selected because they are smaller cities, which are not often studied but are representative of the places where the majority of the interior urban population reside and work. It is in cities like these that most Chinese who have experienced privatization and globalization of their economy still live in a relatively traditional style and where cultural norms and practices of elder care are more likely to remain relatively stable. Hence, our sample provides an excellent opportunity to assess the dual impacts of economic reform and traditional cultural values. Within the context of our available resources, it was not possible to obtain a representative sample of caregivers. However, an effort was made to select a sample that was sufficiently diverse in terms of the key independent variables including gender, employment status, and health care benefits. To maximize the variation of class status within the sample, the snowball process was initiated in four district categories: factory, school, government, and residential. As most families still lived in apartments assigned by work units, though purchased by employees in the mid- 1990s, this method facilitated the inclusion of individuals with very diverse backgrounds. There was little variation in ethnicity because the vast majority of urban dwellers in these two cities are Han Chinese, as is true for most Chinese cities. To be included in the study, caregivers had to be providing financial, physical, or emotional assistance to parents or parents-in-law on a regular basis, and the care 214 GENDER & SOCIETY / April 2003 Downloaded from gas.sagepub.com at UCSF LIBRARY & CKM on January 27, 2015
Zhan,Montgomery GENDER AND ELDER CARE IN CHINA 215 recipient had to be in need of assistance with one or more activities of daily living (ADL)or instrumental activities of daily living(IADL).Although some secondary caregivers were interviewed,only data for primary caregivers are included in this analysis. Data Collection Process Structured interviews with the 110 caregivers were conducted in Chinese by the senior author during the fall of 1997 and 1998.Most of the interviews were con- ducted in the caregiver's home,although a few were conducted in the caregiver's workplace during lunch break or in an agreed-on public meeting place.Each partic- ipant was given a questionnaire written in Chinese and asked to either complete the questionnaire or allow the investigator to read the questions and complete the form for the participant.Only 18 caregivers chose to complete the form themselves. Information collected through the interview process included basic demographic data,the health and functional status of the elder and the caregiver,caregivers'atti- tudes and beliefs about caregiving responsibilities,and the type and extent of assis- tance that the caregiver was providing to the parent or parent-in-law. Sample Description Caregiver characteristics.The demographic characteristics for both the elders and the caregivers included in the sample are shown in Table 1.The majority(68 percent)of the caregivers in the sample were women.The caregivers ranged in age from 27 to 60.with the vast majority(86 percent)being between the ages of 30 and 49.All but seven of the caregivers were married.Fifty-six of the caregivers were daughters assisting parents,19 were daughters-in-law assisting parents-in-law,33 were sons assisting their parents,and 2 sons-in-law were primary caregivers for their fathers-in-law. Coresidence with parents or parents-in-law in this sample did not occur as fre- quently as in other studies,which have reported rates greater than 80 percent (Lavely and Ren 1992).Nearly half of the caregivers(46 percent)did not live with their care recipients.About a third (31 percent)of the caregivers lived with parents, while 23 percent lived with parents-in-law.One of the major reasons for this differ- ence in patterns of coresidence was that caregivers in this sample resided in urban interior China where elders were more likely to own apartments and live by them- selves than is the case among rural elders. The large majority (86 percent)of the caregivers had at least a middle school education,and their mean income was between 200 to 300 yuan(or $25 to $35)per month.Nearly half(43.6 percent)of the interviewees reported that they were not working full-time.Most of these caregivers were laid off;however,a few reported going to their former workplace to register their presence,but they rarely obtained work.While most caregivers(66.4 percent)received no reimbursement for medical Downloaded from gas.sagepub.com at UCSF LIBRARY CKM on January 27.2015
recipient had to be in need of assistance with one or more activities of daily living (ADL) or instrumental activities of daily living (IADL). Although some secondary caregivers were interviewed, only data for primary caregivers are included in this analysis. Data Collection Process Structured interviews with the 110 caregivers were conducted in Chinese by the senior author during the fall of 1997 and 1998. Most of the interviews were conducted in the caregiver’s home, although a few were conducted in the caregiver’s workplace during lunch break or in an agreed-on public meeting place. Each participant was given a questionnaire written in Chinese and asked to either complete the questionnaire or allow the investigator to read the questions and complete the form for the participant. Only 18 caregivers chose to complete the form themselves. Information collected through the interview process included basic demographic data, the health and functional status of the elder and the caregiver, caregivers’attitudes and beliefs about caregiving responsibilities, and the type and extent of assistance that the caregiver was providing to the parent or parent-in-law. Sample Description Caregiver characteristics. The demographic characteristics for both the elders and the caregivers included in the sample are shown in Table 1. The majority (68 percent) of the caregivers in the sample were women. The caregivers ranged in age from 27 to 60, with the vast majority (86 percent) being between the ages of 30 and 49. All but seven of the caregivers were married. Fifty-six of the caregivers were daughters assisting parents, 19 were daughters-in-law assisting parents-in-law, 33 were sons assisting their parents, and 2 sons-in-law were primary caregivers for their fathers-in-law. Coresidence with parents or parents-in-law in this sample did not occur as frequently as in other studies, which have reported rates greater than 80 percent (Lavely and Ren 1992). Nearly half of the caregivers (46 percent) did not live with their care recipients. About a third (31 percent) of the caregivers lived with parents, while 23 percent lived with parents-in-law. One of the major reasons for this difference in patterns of coresidence was that caregivers in this sample resided in urban interior China where elders were more likely to own apartments and live by themselves than is the case among rural elders. The large majority (86 percent) of the caregivers had at least a middle school education, and their mean income was between 200 to 300 yuan (or $25 to $35) per month. Nearly half (43.6 percent) of the interviewees reported that they were not working full-time. Most of these caregivers were laid off; however, a few reported going to their former workplace to register their presence, but they rarely obtained work. While most caregivers (66.4 percent) received no reimbursement for medical Zhan, Montgomery / GENDER AND ELDER CARE IN CHINA 215 Downloaded from gas.sagepub.com at UCSF LIBRARY & CKM on January 27, 2015