Table Of ContentHandbook of
Asian Aging
Edited by
Hyunsook Yoon
Hallym University
and
Jon Hendricks
Oregon State University
CRC Press
Taylor & Francis Group
Boca Raton London New York
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First published 2006 by Baywood Publishing Company, Inc.
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Library of Congress Catalog Number:
Library of Congress Cataloging-in-Publication Data
Handbook of Asian aging / edited by Hyunsook Yoon and Jon Hendricks,
p. cm.
Includes bibliographical references and index.
ISBN 0-89503-316-X (cloth)
1. Older people—Asia. 2. Older people—Govemment policy--Asia. 3. Older
people—Services for—Asia. 4. Aging—Asia. I. Yoon, Hyunsook. II. Hendricks, Jon,
1943-
HQ1064.A78H35 2005
305.26’095—dc22
2005048001
Dedication
To Dr. Samuel Aroni, Professor Emeritus of UCLA, who, through his initial
enthusiasm and motivation for a worthwhile project on global aging, brought
together some of his well-known colleagues from the United States, Israel, and
Australia. His faith, encouragement, and support make him, in essence, the
godfather of this book. This book affirms the philosophical belief that people
joining forces can achieve great things that one person acting alone cannot do.
KON SIK
&
HAZEL O’REAR REEVES
Table of Contents
Foreword:............................................................................................................ vii
Mapping Intersections in the Atlas of Asian Aging
Jon Hendricks and Hyunsook Yoon
Acknowledgments................................................................................................ xv
Introduction:......................................................................................................... 1
The Sweep of Asian Aging: Changing Mores, Changing Policies
Jon Hendricks and Hyunsook Yoon
PART I: ASIAN AGING IN SOCIAL CONTEXT
1. Demography of Aging Across A sia.......................................................... 25
Andrew Mason, Sang-Hyop Lee, and Gerard Russo
2. Economic Resources: Implications for Aging Policy in Asia................ 67
Yung-Ping Chen and John Turner
3. The Politics and Policies of Aging, Asian Style....................................... 91
Laura Katz Olson
4. Culture as the Context of Aging................................................................117
John van Willigen and Denise C. Lewis
PART II: ECONOMIC STATUS, WORK, AND RETIREMENT
5. Economic Status, Work, and Retirement in China...................................145
Peng Du
6. Economic Resources of the Elderly Within the Japanese Family . . . . 165
Nobuko Nagase
7. Empowering Older Adults as Key Resources in Development
in Malaysia...................................................................................................195
Poo Chang Tan and Nai Peng Tey
8. Economic Status, Work, and Retirement Among Korean Elders . . . . 211
Sung-Jae Choi
v
vi / HANDBOOK OF ASIAN AGING
PART III: LIVING ARRANGEMENTS, FAMILY CAREGIVING,
AND SOCIAL SUPPORT
9. Living Arrangements and Social Support for Older Adults
in India.........................................................................................................237
Phoebe Liebig and P. V. Ramamurti
10. Living Arrangements and Social Interaction of the Elderly
in Taiwan......................................................................................................261
Te-hsiung Sun and Ming-cheng Chang
11. Intergenerational Support Mechanisms for Filipino Elderly...................293
Mercedes B. Concepcion and Aurora E. Perez
12. Welfare Policy for Older Adults and Caregiving Burden
in South Korea.............................................................................................319
Ka-Oak Rhee
PART IV: HEALTH AND LONG-TERM CARE
13. Health Insurance in South Korea................................................................339
Sang-soo Bae and Tae-jin Lee
14. Long-Term Care Insurance in Japan..........................................................355
Koichi Hiraoka
15. Healthcare and Long-Term Care Financing in Singapore......................383
Kai Hong Phua
PART V: COMMUNITY SOCIAL SERVICES
16. Family Support and Community Services for Older Adults
in China: Integration and Partnership......................................................405
Joe C. B. Leung
17. Community Services for Older People in Australia................................431
Hal Kendig and Susan Quine
18. Community-Care Services in Japan..........................................................453
Daisaku Maeda and Hisanori Ishikawa
Contributors.........................................................................................................469
Index 477
FOREWORD
Mapping Intersections in the
Atlas of Asian Aging
The 20th century was marked not just by technological and medical breakthroughs
but also by striking increases in life expectancy and a shrinking of the world stage
(Hendricks and Cutler, 2002). By the dawn of the 21st century, these shifts had
encircled the globe and were being felt in all quarters. Many people, regardless of
where they live, can now anticipate up to three or more decades beyond the point at
which the formal economic sector moves them into retirement, and there can be
little doubt that the quality of their lives will be influenced by events well beyond
their horizon.
In many respects, population aging in developing countries in Asia repre
sented a “gray dawn” to the new century, just as it had earlier in what are now
thought of as developed countries. At the same time, worldwide commerce has
brought unprecedented changes in custom and traditions long established across
the continent (Peterson, 1999). Providing insight into how those transformations
are playing out, along with giving Asian experts their own voice in describing
the experience of aging, were abiding priorities for us as this Handbook of
Asian Aging took shape.
Given the vast reach of the Asian landscape, making hasty generalizations
from one to another country is an endeavor fraught with drawbacks and missteps.
Yet, as Liang (2004) and others have long observed, cross-cultural comparisons
are invaluable for double-checking inferences and causal mechanisms for
whatever aspect of aging the professional community examines. Adding to the
complexities of such analyses is the fact that the experience of aging is itself
paradoxical: Individuals are convinced their lives are like no one else’s, whereas
gerontologists are intent on making generalizations reflecting identifiable
patterns. Obviously there is undeniably validity to both positions. As nation
states experience economic change, population aging is a simultaneous occurrence
foreshadowing consequences for governments as well as for individuals. The
processes are inextricably interwoven. As developing nations move toward
being countries of the old (Hendricks, 1980), they have to create policies that
provide some semblance of balance between what are often less than parallel
vii
viii / HANDBOOK OF ASIAN AGING
priorities. Complicating the process even further, they must do so in the midst
of competing claimants.
In Asia, where market economies took root somewhat later than in other
quarters of the globe, populations are aging at staggering rates, and economic
growth is hard-pressed to keep pace. Add in the undeniable healthcare crises posed
by population aging, and we see national governments being forced to make hard
choices as to where to put their scarce resources. No single scenario is likely to
carry the day. As will be seen in the chapters to follow, few solutions provide a
cure-all—and just as few are indemnified in the face of economic setbacks. Each
prospective strategy affects differing constituency in conflicting ways; subvention
and redirection are abiding facts of life. Policies firmly supported today may fall
prey to new priorities tomorrow.
Arbitrating the Conflict Between Economic
Security and Old-Age Security
So how do states arbitrate between conflicting social priorities in order to
adequately sustain all citizens, young and old? Hudson-Rodd (2001) reiterated a
familiar admonition as she noted that an equitable and just society is the best
chance for creating a healthy old age, especially a healthy old age for women.
But what constitutes equitable and just? Such tenets are based on underlying
moral and ethical principles that have evolved in every culture. In times of
plenty and relative stability, a given set of values can be espoused, despite some
differences of opinion. These moral precepts provide the social adhesive that
nurtures communality across members of a group despite various centrifugal
tendencies. However, when surrounding conditions are altered in any significant
way, values are redefined as the terms of the social contract are written, rewritten,
and amended again, depending on macro-level circumstances well beyond the
ken of the individuals whose lives are affected (Hendricks and Leedham, 1991;
Thompson, 1971).
Of course it is essential to ensure a sense of social solidarity and belonging
under any circumstances—but especially as social and economic development
take place. Nowhere is this any more apparent than in Asian nations moving
rapidly from overarching traditional values of filial piety, communal harmony,
and self-subjugation to Westernized notions of materialism, personal happiness,
and individualism. The shift is having a palpable effect across generations, leading
to an increasingly fractured existence in which generations have come to hold
dramatically different worldviews and in which global economic trade is also
bringing distinct values, priorities, and material interests. Townsend (1981) spoke
of the structured dependence of the elderly in addressing exactly these sorts of
alterations wherein societal-level redefinitions play out by creating what may be
described as asymmetrical dependencies accruing to the aged. In this fashion, the
social meaning of aging is shaped as a social status, based on what are ostensibly
FOREWORD / ix
earned credits and entitlements is redefined. How individuals experience their
later years is in no small measure a product of circumstances encountered in
earlier stages of life—on both an individual level and on a structural level—and
what is regarded as their “due” is a reflection of the socioeconomic contexts in
which they find themselves when they are old.
For example, in a prophetic analysis of changes accompanying the market-
ization of China, Liu (2002) highlighted the effect structural changes have on
the everyday life and subjectivity of individuals bom in an earlier era. Though
Liu’s emphasis is not restricted to aging perse, the discussion helps contextualize
the impact of changes in China insofar as individuals are concerned. In a nutshell:
Imagine anticipating a life script focused on one definition of productivity, filial
responsibility, community, individualism, and temporality—then becoming old
under the auspices of a different script. What is true of China is pretty much
true in all developing nations: One series of generations has internalized one set
of values and expectations, but their younger cohorts, on which they now depend,
operate with slightly to very different expectations.
The Sword of Damocles
Greek legend has it that the courtier Damocles was seated beneath a sword
hanging by a single hair as an object lesson for how precarious entitlements can
become. With dramatic growth in the aged populations of developing countries,
resources are squeezed between riding the economic tide or tending to those who
have given what they could and are now defined as old.
Add in some persistent disadvantages—education, rurality, and gender come
readily to mind—and the situation becomes even more tentative. China and
India are two places where quality of life for the elderly, and especially the oldest
old, older rural residents, and old women, is anything but heartening. As will
be seen in several of the chapters to follow, the new economy in Asia is an
urban economy, and to the extent that social insurance is made available to those
in need, it is frequently an urban policy. Wage labor is normally an urban
phenomenon in modem economies, so it should not be too surprising that benefits
follow suit. The consequences of these shifts for older people, growing old as
the world changes around them, can be profoundly unsettling.
Dependence on the benevolence of others, regardless of normative expecta
tions and whether they are family members, can yield a delicate hold on any
elder’s sense of well-being or quality of life. Add in local gender-based disparities,
ethnic favoritism, changing employment patterns of younger workers competing
in a market economy, episodic scarcity, or any of a myriad of local circumstances
or structural arrangements, and the prospect of adequate old-age security does
not necessarily grow any brighter. As Yung-Ping Chen and John Turner point
out in chapter two, actual benefits accruing to the elderly reflect the invisible
hand of market forces, the invisible handshake of tradition and custom, and the
