Association between family economic decision-making power and survival outcomes among older adults in China: A population-based longitudinal study

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health Pub Date : 2025-01-04 DOI:10.1016/j.ssmph.2025.101749

Liyong Lu , Ting Chen , Sicheng Li , Tianjiao Lan

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Abstract

Objective

This study examines the association between family economic decision-making power and survival outcomes among older adults.

Methods

Data were drawn from the China Longitudinal Healthy Longevity Survey (CLHLS) from 2005 to 2018. Family economic decision-making power was assessed based on participants’ self-reported influence over household financial matters, categorized as: “making decisions on almost all household expenditures”, “deciding on non-essential spending”, “only deciding on personal expenditures”, and “having no decision-making power over household spending”. Survival status and date of death were determined through interviews with close family members during each survey round. Cox proportional hazards regression models were used to analyze the relationship between family economic decision-making authority and survival outcomes among older adults using longitudinal follow-up data. Subgroup analyses were conducted to identify vulnerable populations.

Results

The study included 10,443 older adults, of whom 5606 (53.68%) died during the follow-up period, with a median survival time of 7 years. Compared to those with full decision-making authority, the hazard ratios (95% CI) were 1.02 (0.87–1.20) for those with authority over non-essential spending, 1.22 (1.07–1.38) for those with authority over personal spending, and 1.24 (1.04–1.47) for those with no decision-making power. The impact of low decision-making authority on survival was modified by factors such as gender, occupation before age 60, household economic status, experience of child loss, and physical labor.

Conclusions

Low family economic decision-making power is associated with an increased risk of mortality. Promoting active participation in financial decisions may enhance health outcomes. However, the study is limited by its focus on Chinese data, challenges in establishing causal relationships, and the measurement of decision-making power at a single point in time.

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来源期刊

Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

2.10%

发文量

298

审稿时长

101 days

期刊介绍： SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.