Intergenerational differences in social support for the community‐living elderly in Beijing, China

Abstract Background and Aims The combination of the rapid process of social‐economic development, urbanization, and population ageing brings many challenges for care providers and quality of life of the community‐living elderly in Beijing, China. This research aims to understand the intergenerational differences of social support for the elderly in the socio‐cultural context of Beijing. Methods and Results To answer this research question, we collected 30 semi‐structured in‐depth interviews from elders aged 60 and over in three communities in Beijing. The constant comparative method was used for analysis. The results show that the young‐old (people aged 60 to 74) received more formal social support and less informal social support compared to their parents' generation. The formal social support they received was not much different but they received less informal social support compared to the older‐old (people aged 75 and over) living in the same communities. The young‐old expect to receive more formal social support when they become the older‐old, as the informal social support from their children would be reduced due to the one‐child policy and socio‐cultural changes. Conclusions Intergenerational differences of social support for the elderly do exist in the form of instrumental, financial, and emotional support. The findings help us understand how socio‐economic development and urbanization processes affect the daily life and social support of the community‐living elderly from different age groups, and also provides knowledge for improving the quality of life for the elderly in Beijing.

economic reform in China in 1978, the GDP per capita in Beijing was only 1,671 RMB in 1982 and increased to 115,000 RMB in 2016. 4 Around the same period as the economic reform, by the end of 1970s, the Chinese government set up the one-child policy (a population planning policy of China, to limit the great majority of family units to have only one child each) to control the rapid growth of population, a policy which was in place until recently. After the implementation of this policy for more than three decades, it successfully decreased the fertility rate and controlled the population growth. It, however, increased the rate of population ageing and increased the challenges The older parents' care needs will increase in the next few decades, while the family care resources are decreasing.
As a result of these socio-economic changes, the young-old generation (population aged 60 to 74) faces a different situation for ageing compared to the older-old (population aged 75 and over), and the parents' generation of the young-old. Meanwhile, the community care and residential care services are still under development. All of these changes bring challenges for providing social support for the elderly to meet their care needs.
The Chinese government aims to improve the reduced family care resources by increasing more social care resources. The Beijing municipal government has made a series of policies to improve the availability and accessibility of social and health care services for the elderly living in communities. Meanwhile, pension system and health care system have been under reform in China in recent decades. Urban and rural residents receive different pension and health care benefits according to their household registration and status of employment.
The Chinese government has established a universal non-contributory pension plan covering urban non-employed workers and rural residents, combined with an old-age insurance program covering urban employees. 7 However, the benefit amount of national social pension plan is very low, with a country average of 81 RMB (13 US dollars) per month in 2014. By the end of 2013, 95% of the population was covered by one of the medical insurance schemes. There is a significant gap of social welfare benefits between rural and urban residents. 8 This research aims to understand the intergenerational differences in social support between the young-old (the elderly people aged 60 to 74) and the older-old (the elderly people aged 75 and over) in the sociocultural context of Beijing. Thirty elderly, including the young-old and the older-old people living in three communities built in 1950s, 1990s, and 2000s, were interviewed to understand this issue, which contributes knowledge aimed at increasing social support resources and improving quality of live for the elderly in Beijing. The second section describes the conceptual framework that applies in this research. The intergenerational differences of life experiences in the context of the socio-economic changes in the past 30 years in China are explained in the third section.
The methods and results are presented in the fourth and fifth sections.
Conclusions and discussions are drawn in the last section of this paper.

| UNDERSTANDING SOCIAL SUPPORT
Social support has been studied across a wide range of disciplines including psychology, medicine, sociology, and public health, among others. 9 Social support has been defined as the assistance and protection given to others, especially to individuals. 10,11 In recent studies, researchers have conceptualized support in terms of the structural components and the functional components. Based on the actual support received, it can also be divided into perceived support and received support. 12,13 Social support is a multidimensional construct which can be derived from various sources, such as families, friends, neighbors, colleagues, organizations, and governments. 14 It can be tangible in the form of financial support, assistance, and material goods, or intangible as the form of emotional support such as being listened to, understood, and comforted. 9,14,15 Langford et al. 9 reviewed 85 articles and summarized social support as emotional, instrumental, informational, and appraisal support. Emotional support involves the provision of caring, empathy, love, and trust. [16][17][18] Instrumental support refers to the provision of financial assistance, material goods, or services. 17,19 Information support is defined as information provided by others during a time of stress, to solve problems. 17,18,20 Appraisal support refers to the communication of information relevant to self-evaluation instead of problem-solving. 17 Many studies have analyzed the relationship between social support and health focusing on the elderly population. Previous research suggested that having adequate social support was associated with better self-rated health among the elderly people in the context of both the developed and developing countries. 15,[21][22][23] With regard to mental health, Wang, Li, and Chen 24 studied 266 empty-nested elderly in Ningbo, China, and found that social support and mental health status of empty-nested elderly are significantly lower than those in other elderly people. Increasing the social support of empty-nested elderly people is important for improving their mental health.
The social support that elderly people receive is influenced by important events in their life-span, such as retirement and loss of one's spouse. 25 In addition, the quantity and quality of social support, which is called social embeddedness by Langford et al., 9 can also affect elderly people's life satisfaction and subjective well-being. 15,[26][27][28][29] However, little research has been done to understand the intergenerational difference in social support in the context of rapid urbanization and socio-cultural changes in China. Modified conceptual framework is needed to adapt for this case study in Beijing. In this study, we propose the following framework, which categorizes social support as formal support and informal support depending on the source of social support. The former refers to the support from governments, enterprises, organizations, and communities, while the later refers to the support from families, neighbors, and friends. In terms of attributes, social support is categorized as instrumental support, financial support, and emotional support. Instrumental support refers to caregiving and other support to manage one's daily life, such as shopping, cleaning, laundry, and cooking activities. Financial support refers to the financial and material support. Emotional support refers to mental support, such as listening, talking, consulting, and caring ( Figure 1).

| INTERGENERATIONAL DIFFERENCES IN LIFE EXPERIENCES
As the socio-economic environment has changed rapidly in China since the socio-economic reform in the late 1970s, the intergenerational differences have dramatically increased. People's perceptions on filial piety are also changing. The elderly's expectation on receiving care from their children is decreasing, while the young generation's willingness to provide care for their parents is still strong. 30 However, many of the younger generation provide financial support and emotional support to their older parents to compensate the limited instrumental care that they can provide. 30 In the young-old's generation, the urban youth during the Cultural Revolution (1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975)(1976) were sent to live and work in agrarian areas to be re-educated by the peasantry, which is referred to as "up to the mountains and down to the countryside movement". During the movement, many urban youths at that time lost their opportunity for higher education. 31 When they returned to the cities after the Cultural Revolution, the economic reform from central planning to market economy started. Meanwhile, the one-child policy was introduced in 1979 to encourage the young generation to marry at later ages and urban families to have only one child. This policy was formally phased out in 2015. 32 From the mid-1990s to 2004, the Chinese central government restructured the state-owned enterprises (SOEs) sector to increase the efficiency of industry and be more competitive in the global economy. The middle-aged and older workers (40-60 age groups), those with low educational levels, and females were more likely to be laid-off during the reform. 33 The state-owned sector before the reform provided medical care, pensions, housing, and child education and continuing job training. 28 After the reform, the danwei system (danwei refers to a place of employment in the context of state-owned sector during the planned economy of China) gradually collapsed. The laid-off workers lost their employment and some of the welfare they used to have, which resulted in many of them living under the poverty line. 34 Together with the economic reform, China has also gone through a reform in social welfare systems, including a health care and pension reform as well as the commercialization of housing in urban areas. With the rapid economic development in China, the young generation has been able to take advantages of market opportunities through education and training, while the laid-off workers were facing economic hardship.
Many of the laid-off are entering their old age and their disadvantageous position in the socio-economy challenges the social support they can receive. Together with the rapid urbanization process, the living distance between the older parents and the adult children increases, which also has an impact on the family support they can receive, especially among the parents of the one-child generation. Therefore, with limited educational opportunity, one-child policy, SOEs reform, social welfare reform, commercialization of housing, collapse of danwei system, and rapid urbanization process overlap, which is the case for the young-old generation, those who are at disadvantageous positions are less likely to receive social support.
With regard to the older-old, they were born before the foundation of People's Republic of China and suffered during the World War II.
They survived the "ThreeYears of Natural Disasters", between the years of 1959 and 1961, characterized by widespread famine national-wide. 35 The majority of them were either not employed or retired before the SOEs reform. The socio-economic reform has improved people's quality of life, but at the same time, the older-old are not the population who enjoy the most benefits from the reform. Their adult children play an important role in providing various forms of social support for them.

| DATA AND METHODS
This study collected 30 semi-structured in-depth interviews from the elderly aged 60 and over in three communities in Beijing. The three stud-   people like to gather together for chatting or excising, to recruit participants. Only the elderly with Beijing household registration, and those who were willing and capable to communicate were enrolled in this study. Purposive selecting in the community considering the age and sex, and snowball sampling by recommendation from the participants were used for recruiting participants. Five young-old aged 60 to 74 and five older-old aged 75 and over were interviewed in each community, with 30 participants in total in the three communities (Table 1). As the older people were cautious about conducting interviews at their private homes, they were interviewed in public spaces such as the benches in the green space or parks in the communities with which they were familiar. Interviewers started the interviews based on the question list after obtaining oral informed consent from the interviewees. The young-old were asked about their care experiences for their older parents, the social support their parents received, their own care needs and social support received, and the perceptions on their future care and social support. The olderold were asked about their current situation of health status, care needs, and social support they received. The interviewer took notes, and the interviews were audio recorded at the same time. Mandarin was the language used during the interviews because it is the official and everyday language in Beijing. The total time for interviewing was 904 minutes, with around 30 minutes for each participant. Ethics approval for the research project was obtained from Beijing Normal University in China. All participants in the present study gave their informed consent before their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted and all data collected were de-identified.
Analysis of the data is based on the constant comparative method. 36 The content of the audio recordings was fully transcribed.
The transcripts were read line-by-line several times in order to mark the key points with a series of codes, and similar codes were grouped into a concept. As concepts accumulated and their descriptions became more detailed, similar concepts were rearranged by common themes, and thematic categories were developed. Finally, the thematic categories were used to define concepts and find associations between themes. The thematic categories, concepts, and resulting associations were used to provide explanations for the findings. 37 We are the most unlucky generation. When we were at the age of studying, the Cultural Revolution started, then we had to go to the countryside to work. After we came back to the cities, the one-child policy was implemented, and we were laid-off due to the economic reform. Our generation, the ones born in the 1950s, was the unluckiest people as we suffered all these challenges. (B-01, 60 years old) It was common for the young-old's generation to view themselves as the unlucky generation. After the collapse of the old Danwei work unit system at the end of 1990s, the new Community system has been under reconstruction to pull together resources from various sectors to provide formal support for the older residents. The availability and accessibility to formal support varies among the three communities due to the lack of regulations and standards for community services.
The participants expressed their expectations of the government to play a crucial role in monitoring the quality of services, including housekeeping work and food services for the elderly. The following parts explain the intergenerational differences from the perspectives of instrumental support, financial support, and emotional support in detail.

| Instrumental support
The formal instrumental support includes practical support and health care services provided by communities, such as food service, housekeeping service, and home care services. The young-old reported that there was a lack of formal instrumental support in the community they live. They mainly do the housekeeping work by themselves, as most of them are independent at this stage. The informal instrumental support from family members was reduced compared to their parent's

| Financial support
Both the young-old and the older-old reported that formal financial support increased due to the pension reform. The young-old also reported that the formal social support their parents received was tied to their former workplace. Employees worked in SOEs, and public institutions received different welfare in terms of pension and health care in their parents' generation. There were great differences between the elderly who were unemployed, workers in factories, and employees in public institutions.
My father was teaching in a college … When he was diagnosed with cancer (in the 1980s), his college sent a staff to care for him during the daytime … My mother was working in the hospital. After the diagnose of my father, the hospital provided him with a single room. My mom was able to care for him without quitting her job. All the health care expenses were reimbursed. There was no financial burden for us at that time. (C-01, 65 years old) The young-old expect their financial security to be improved as they become the older-old. They expect the increase in formal financial support will be able to cover all of their expenses and the cost of their increasing demands for instrumental support and health care services. As the parents of the one-child generation, they do not have much expectation on the increase in informal financial support from their children. The older-old reported that they receive informal financial support from their adult children in the form of money, clothing, food, and daily necessities.
My wife and I both have pensions. We are quite healthy and don't go to see the doctor often... We have only one child and don't want to put too much pressure on him … It would be great if the community care services are improved. I hope the services include food service, housekeeping service, and home care … The residential care facilities with good service are quite expensive, over 5000 RMB per month. We cannot afford to it … We hope the formal support increases to help us access these services. (C-02, 68 years old)

| Emotional support
The formal emotional support for the young-old comes from various social activities, such as gatherings, lectures, outgoing, singing, and dancing groups organized by the communities and their former workplace.
The young-old reported that the formal emotional support increased Informal emotional support from former colleagues was important for the elderly. Gathering, group tour, and phone calls were the ways through which they maintain their friendships. Some participants reported that they had a stronger sense of belonging to the former workplace than the community, and kept a strong social network with their former colleagues even though they did not live in the same community. However, as their mobility decreases, the elderly become more dependent on their families for emotional support.
The social welfare policy, family planning policy, and urban relocation compensation policies all affect the social support that the elderly receive. The survey in 2010 showed that 93.7% of the urban older residents received pensions. 39 Pensions enable the elderly to gain more financial independence and discourse in decision making. The improvements in providing community services including food service, housekeeping service, and social activities are important for providing formal instrumental and emotional support for the elderly.
Social changes have great impacts on the life course of the elderly by affecting their educational level, family structure, household size, and economic status, which further influence the social support that the elderly receive. The experiences of going to countryside losing educational opportunities, having only one child in each family, being laid-off from the state-owned enterprises, being relocated due to urbanization, and undergoing the social reform of pension and health care systems have dramatic impacts on the socio-economic status, family structures, and social welfare of the young-old's generation. All of these impacts will bring more challenges for the elderly in one or two decades, when the health status of the young-old's generation declines and they need more social support for elderly care.
Many old buildings were tore down for commercial use or building expensive apartment buildings in the central city during the urbanization process. The elderly whose residence has been demolished were Previous literature in English-speaking countries have reported similar findings to those reported in this study. First, older people with disadvantaged socio-economic status experience reduced social support. 40,41 Secondly, geographical separation from family and friends may increase the risk of isolation, depression, and loneliness, and reduce the social support that older people receive. [42][43][44] Thirdly, the change of living environment such as gentrification challenges the social support older people receive. Gentrification may result in forced physical relocation, increased housing costs, and homeownership exclusion. These changes threaten neighborhood social spaces, sense of belonging, and social cohesion. 44,45 There are also similarities to the situation in other developing countries. A study in Thailand 46 found that the migration of young adults to urban areas creates a geographic mismatch in the locations of older individuals and their children, which affect the social support the older people receive.
Emotional and financial support can be provided remotely through modern communication technology. However, meal preparation, personal care, and transportation require regular and frequent services, and, thus, closer proximity makes the services easier. In the future, children may no longer be able to be the main support and caregivers for parents due to demographic changes. 46 There is, however, limited research on the intergenerational difference of social support that older people receive. The findings of this research contribute understanding of the change in social support in terms of instrumental, financial, and emotional support from the formal and informal sources in the context of developing country.
There are some limitations of this study. All of the participants in this study are older-people with Beijing household registration. Older migrants are increasing in Beijing due to various reasons such as caring for grandchildren or relocating closer to their family members. They are ineligible to receive some social welfare and social services due to the household registration. This study is unable to provide information on social support received by the floating older population in Beijing. In future studies, this group of older population should be considered.

FUNDING
This work was supported by the National Natural Science Foundation of China (NO. 41301164 and NO.41671497).

CONFLICTS OF INTEREST
None declared.