Subjective well-being indicators

Chapters 5 and 6 examine factors associated with subjective well-being of older people, focusing on the role of living arrangement concordance, and intergenerational support, respectively. Subjective well-being is captured by three indicators, including self-rated health, life satisfaction, and psychological well-being. These indicators have been used in previous research to measure subjective well-being (Chen & Jordan, 2018; Gaymu & Springer, 2010; Hoang, 2015; Katz, 2009; Williams, Zhang, & Packard, 2017).. Using multiple indicators to conceptualize well-being offers a more comprehensive view of psychological health (George, 2006). Although life satisfaction and depression may represent the extreme ends of the psychological well-being continuum, there is growing evidence that they are distinct constructs and could be the result of different processes (see Cheshire, Barlow, & Powell, 2010, p. 1676). A recent study also shows that they capture different aspects of life for older adults (Williams et al., 2017). Depression assesses depressive symptoms (negative affect, lack of negative affect, feelings of marginalization, and somatic problems), while life satisfaction assesses cognitive judgment on the present quality of life (Silverstein et al., 2006). Hence, both constructs are examined in this study.

a. Self-rated health

Self-rated health is a widely used indicator to measure and monitor the health of the population (Zimmer, Natividad, Lin, & Chayovan, 2000). It is not only simple and easy to capture, but it has also been found to be a better predictor of mortality than the patient’s medical records or their report of medical conditions (DeSalvo, Bloser, Reynolds, He, & Muntner, 2006; Idler &

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Benyamini, 1997; Mossey & Shapiro, 1982). It can also reflect dimensions of health not captured in other single health indicators (Tareque et al., 2015).

Self-rated health is used as a subjective well-being indicator rather than as a physical health indicator because it reflects more than physical health and includes overall well-being. Although self-rated health can capture the impact of physical health indicators, it cannot be exactly located in the continuum of the disablement process. To measure self-rated health the following question was asked: “In general, how would you describe your state of health?”. The available responses were: ‘very healthy’, ‘healthier than average’, ‘of average health’, ‘somewhat unhealthy’ ‘very unhealthy’ and ‘not sure’. Following previous research (Chan & Jatrana, 2007; Sereny, 2011; Zunzunegui, Beland, & Otero, 2001) those who answered ‘very healthy’ and ‘healthier than average’ were coded as 1 (healthy), while ‘of average health’, ‘somewhat unhealthy’ and ‘very unhealthy’ were coded as ‘0’ (unhealthy/average health). Those who answered not sure were excluded from the analysis.

b. Life satisfaction

Life satisfaction refers to the cognitive component of subjective well-being (Kim, Hisata, Kai, & Lee, 2000; Pinquart & Sorensen, 2000). Life satisfaction of older people in this study was measured by a single-item question. Assessing life satisfaction through a single-item indicator is one of the most common approaches in measuring subjective well-being (George, 2010), but it does not necessarily mean that it is less inferior than the multi-item measures in terms of validity and reliability (Diener et al., 1999). Life satisfaction was measured in the current study by asking the respondents whether they are satisfied with their present life. The possible responses to this question were: (1) Yes, very satisfied, (2) Yes, somewhat satisfied, (3) No, not satisfied. These three categories were used in the analysis rather than combining them into satisfied and not satisfied because doing so would result in a lack of variability in the responses, as about 90 percent of the respondents will be classified as satisfied. Sensitivity analysis also shows that those who are somewhat satisfied and very satisfied are significantly different from each other in terms of education, perceived socioeconomic status and physical health conditions, providing a compelling reason to treat them separately rather than grouping them together.

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c. Psychological well-being

Psychological well-being was measured in the study by using 12 depressive symptoms that were based from the 20-item CES-D scale developed by the Centre for Epidemiological Studies to screen for depressive symptoms among the community-dwelling population (Radloff, 1977). The entire CES-D scale is comprised of items designed to represent three domains: positive and negative emotional states and depressive symptoms (Cruz, Natividad, Gonzales, & Saito, 2016; Suthers et al., 2003). The 12-item version of the scale has been tested and was found to be as valid as the 20-item version in depression screening (Cruz et al., 2016). The short version was used in PSOA because the latter takes a considerable amount of item in the survey (Cruz et al., 2016). The 12-item CES-D was also used in comparable surveys in Japan and Singapore. The items are as follows:

1. My appetite was poor 2. I felt depressed

3. I felt that everything I did was an effort 4. My sleep was restless

5. I felt happy 6. I felt lonely

7. I felt that people were unfriendly 8. I enjoyed life

9. I felt sad

10.I felt that people disliked me 11.I could not get going

12.I felt hopeful about the future

Each item was read to the respondent, who was then asked if he/she felt that rarely/not at all (1), sometimes (2), or often (3). The negatively worded items were reverse coded so that higher scores mean higher levels of psychological well-being. The possible score ranges from 14 to 36. The 12 items registered a Cronbach’s Alpha of 0.73, indicating good internal consistency. Respondents who were too ill or too incapacitated and hence required a proxy (169 cases) to answer the survey questions were not asked the questions on life satisfaction and psychological well-being.

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Factors associated with these different indicators of health and well-being outcomes are examined separately in each chapter of this thesis. Chapter 4 examines the role of children's education in the physical health of older people, while chapters 5 and 6, examine the role of living arrangement concordance and exchange of intergenerational support, respectively in older Filipinos' well-being. The next section describes the operationalization of these main independent variables.