Caregiving services are currently the weakest part of China’s social security system for the elderly. It is well needed to investigate the fac-tors affecting the unmet care needs of the elderly with disabilities. Based on the Behavioral Model of Health Services Use (BMHSU), this paper explores the needs and influencing factors of care services for the disabled elderly in urban and rural areas using data from the 2018 Project of Social Policy Support System for Disadvantaged Families in China. The demand for care services of the disabled elderly in central and western areas is significantly higher than that in eastern, along with that in rural areas significantly higher than that in urban areas. The demands for care services of the disabled elderly in urban and rural areas are significantly affected by tendency factors, resource factors, and need factors. Urban and rural attributes, worried pension and LCI are the common influencing factors for the care service demand of the disabled elderly from economically disadvantaged families and ordinary families. The demands for care services of the disabled elderly were associated with tendencies, resources, and needs, increased chronic disease prevention and mental health services benefit caregivers.

Objective: Caring for the disabled elderly is a source of stress for family caregivers, and the lack of social support and the pressure of social exclusion might aggravate family caregiver burden. The purpose of this study was to examine the association between caring load and family caregivers’ burden, as well as the mediating effects of social support and social exclusion.Methods: Data used in this study derived from the nationally representative database of aged population in China, and 3125 households with family caregivers for the home-bound disabled elderly were eventually selected into this analysis. Regression methods and mediation analysis methods were employed in this study.Results: The results indicated that there was a significant positive association between caring load and the caregiver burden, and specifically, social support intensity (rather than social support breadth) and passive social exclusion (rather than active social exclusion) played partial mediating effects. Furthermore, the contributions of mediating effects of social support intensity and passive social exclusion were 13-15% and 27%-29%, respectively, and the total contribution of mediating effects was about 35%-38%.Conclusion: Family caregivers’ burden should be paid more attention in the large population with rapidly aging speed like China, and more guidance services as well as support should be provided to family caregivers. In addition, it is crucial to focus on the social support and social exclusion in community in the public policy innovation.

Purpose: Hearing loss (HL) is prevalent and relates to social health in old age. This study aims to examine the association between functional HL and social well-being (SWB) in older adults and to investigate whether psychological resilience mediates this association. Method: The analytical sample of 4,531 older adults aged ≥ 60 years was from the Sample Survey on Vulnerable Populations from Poor Families in Urban/Rural China (2018). SWB was measured by social networks and social engagement using the Lubben Social Network Scale and Index of Social Engagement Scale, respectively. Functional hearing impairment was defined by a dichotomized measure of self-perceived hearing difficulty. Psychological resilience was assessed by a 25-item Connor-Davidson Resilience Scale. Structural equation modeling was performed to determine associations of HL with SWB and the mediating roles of psychological resilience. Results: Functional HL was associated with reduced SWB among older adults living in low-income households. Hearing-impaired individuals were more likely to be socially isolated and less socially engaged compared to those with normal hearing. The association persisted in gender subsamples and in non–low-income households but not in older adults aged ≥ 70 years. Psychological resilience partially mediated the association of hearing impairment with SWB, accounting for 50.9% of the variance in the change of SWB. Conclusions: Functional hearing impairment may be a modifiable risk factor for social restrictions and downstream older adults' health. Promotion of hearing health care and accessibility to coping resources including psychological support may improve social wellness among the older adults and benefit healthy aging. Supplemental Material: https://doi.org/10.23641/asha.22750736

BackgroundCompression and expansion of morbidity are two critical hypotheses to analyze the relationship among morbidity, disability, and mortality. This study aims to analyze the global distribution of the compression and expansion of morbidity and to investigate its relationship with income inequality. MethodsData was from the Global Burden of Disease Study 2016 and Standardized World Income Inequality Database, version 8.2. Seven types of health changes were de ned. Income inequality was measured with Gini coe cient index. Binary logistic regression was used to analyze the association of income inequality with the compression and expansion of morbidity. ResultsAll the seven types of the compression and expansion of morbidity exist in the world, despite their uneven distribution. The relative expansion of morbidity with increased or constant life expectancy (Type 6) was the most popular type occurring to more than half of populations in the last quarter of century, which was followed by the relative compression of morbidity with increased or constant LE (Type 3, 30.71%). The income inequality was signi cantly associated with the health changes, which still held after controlling a variety of confounders and in robustness tests. Those societies with lower income inequality were more likely to incur Type 3. ConclusionsIt is necessary to distinguish the positive and negative changes in life expectancy when examing the compression and expansion of morbidity. The increasing popularity of Type 6 implies higher needs for health and social care. Measures to reduce income inequality or mitigate its negative in uence on health changes might promote the occurrence of Type 3.