Fear scarcity but also inequality: Imbalanced upstream support and older parents' self-reported health in China

Given the rapidly aging population in China, the health of older individuals is increasingly reliant on support from their adult children. This study aims to investigate how imbalances in this support, referred to as imbalance in upstream transfer, impact the reported health status of older adults.

We employed the generalized propensity score weighting regression and causal mediation analysis to reveal the impact of imbalance in upstream transfer on older individuals' self-reported health, illustrating both transactional and norm-based mediation mechanisms.

Imbalance in upstream transfer is predominantly evident in daily caregiving tasks, such as household chores assistance, while financial support for elders is more evenly distributed among adult children. Irrespective of the type of support provided, imbalance in upstream transfer demonstrates a significantly negative impact on the self-reported health status of older parents. This finding remains robust across various empirical measures and modeling strategies. The Causal mediation analysis reveals that imbalance in upstream transfer increases the average level of support provided to older parents, indirectly mitigating its direct adverse effects on their reported health. However, imbalance in upstream transfer is also associated with discrepancies in older parents' perceived sufficiency of caregiving from adult children, which in sequence detrimentally affects their health status.

The "global" characteristics jointly manifested by supports provided by all caregivers significantly impact the wellbeing of older individuals, highlighting the importance of addressing a special kind of "domestic" resource disparities in societies with a collectivist culture like China.