The More Engagement, the Better? A Study of Mortality of the Oldest Old in China

  • Rongjun Sun
  • Yuzhi Liu
Part of the Demographic Methods and Population Analysis book series (PSDE, volume 20)


This chapter investigates the role of social engagement in mortality among the oldest old in China. Adopting the convoy networkmodel, we differentiate engagement with close social ties (spouse and children) from other social activities. Weibull hazard models were employed to analyze the mortality risk of those aged 80 or above within a 2-year period between 1998 and 2000. While the results of the whole sample show significant effects of marital status and number of children alive on mortality without the interaction effect, the beneficial effect of social activities on mortality gradually diminished with age and was reversed at very old ages, when health status, health behaviors, and socio-demographic characteristics were controlled. But the results vary by place of residence and gender. The findings seem to suggest that more social engagement may not necessarily be better for the well-being of the elderly at very old ages.


Beneficial effect Convoy network model Disengagement theory Identity accumulation hypothesis Interaction Mortality Normal aging Oldest-old Social engagement Social network Socioemotional selectivity theory Survival analysis Weibull hazard models 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Agresti, A. and B. Finlay (1997), Statistical methods for the social sciences. 3rd ed. New Jersey: Prentice HallGoogle Scholar
  2. Anstey, K.J., M.A. Luszcz, and L.C. Giles (2001), Demographic, health, cognitive, and sensory variables as predictors of mortality in very old adults. Psychology and Aging, 16 (1), pp. 3–11CrossRefGoogle Scholar
  3. Atchley, R.C. (1989), A continuity theory of normal aging. The Gerontologist 29 (2),pp. 183–190Google Scholar
  4. Balters, M.M. and L.L. Carstensen (1996), The process of successful aging. Ageing and Society 16 (4), pp. 397–422Google Scholar
  5. Baltes, P.B. (1997), On the incomplete architecture of human ontogeny. American Psychologist 52 (4), pp. 366–380CrossRefGoogle Scholar
  6. Baltes, M.M. and L.L. Carstensen (1996), The process of successful aging. Ageing and Society 16(4), pp. 397–422Google Scholar
  7. Belloc, N.B. (1973), Relationship of health practices and mortality. Preventive Medicine 2 (1), pp. 67–81CrossRefGoogle Scholar
  8. Berkman, L.F. and L. Breslow (1983), Social networks and mortality risk. In: L.F. Berkman and L. Breslow (eds.): Health and ways of living. New York: Oxford University Press, pp. 113–160Google Scholar
  9. Berkman, L.F., L. Breslow, and D. Wingard (1983), Health practices and mortality risk. In: L.F. Berkman and L. Breslow (eds.): Health and ways of living. New York: Oxford University Press, pp. 61–112Google Scholar
  10. Berkman, L.F., T. Glass, I. Brissete, and T.E. Seeman (2000), From social integration to health: Durkheim in the new millennium. Social Science and Medicine 51 (6), pp. 843–857Google Scholar
  11. Bygren, L.O., B.B. Konlann, and S. Johansson (1996), Attendance at cultural events, reading books or periodicals, and making music or singing in a choir as determinants for survival: Swedish interview survey of living conditions. British Medical Journal 313 (21),pp. 1577–1580Google Scholar
  12. Carstensen, L.L. (1991), Selectivity theory: Social activity in life-span context. Annual Review of Gerontology and Geriatrics 11, pp. 195–217Google Scholar
  13. Carstensen, L.L. (1992), Social and emotional patterns in adulthood: Support for socioemotional selectivity theory. Psychology and Aging 7 (3), pp. 331–338CrossRefGoogle Scholar
  14. Cerhan, J.R., C. Chiu, R.B. Wallace, J.H. Lemke, C.F. Lynch, J.C. Torner, and L.M. Rubenstein (1998), Physical activity, physical function, and the risk of breast cancer in a prospective study among elderly women. Journal of Gerontology53A (4), M251–M256Google Scholar
  15. Cumming, E. and W.E. Henry (1961), Growing old: The process of disengagement. New York: Basic BooksGoogle Scholar
  16. DiPietro, L. (2001), Physical activity in aging: changes in patterns and their relationship to health and functions. Journals of Gerontology 56A (Special Issue II), pp. 13–22Google Scholar
  17. Glass, T.A., C. Mendes de Leon, R.A. Marottoli, and L.F. Berkman (1999), Population based study of social and productive activities as predictors of survival among elderly Americans. British Medical Journal 319 (8), 478–483Google Scholar
  18. Gove, W.R. (1972), The relationship between sex roles, mental illness and marital status. Social Forces, 51, 34–44CrossRefGoogle Scholar
  19. Gove, W.R. (1973). Sex, marital status and mortality. American Journal of Sociology 70,45–67CrossRefGoogle Scholar
  20. Ho, S.C. (1991), Health and social predictors of mortality in an elderly Chinese cohort. American Journal of Epidemiology 133 (9), pp. 907–921Google Scholar
  21. House, J.S., R.C. Kessler, A.R. Herzog, R.P. Mero, A.M. Kinney, and M.J. Breslow (1992), Social stratification, age, and health. In: K.W. Schaie, D. Blazer, and J.S. House (eds.): Aging, health behaviors, and health outcomes. Hillsdale, NJ: Lawrence Erlbaum Associates, pp. 1–32Google Scholar
  22. Johnson, C.L. and B.M. Barer (1992), Patterns of engagement and disengagement among the oldest old. Journal of Aging Studies 6 (4), pp. 351–364CrossRefGoogle Scholar
  23. Johnson, C.L. and B.M. Barer (1997), Life beyond 85 years. New York: SpringerGoogle Scholar
  24. Kahn, R.K. and T.C. Antonucci (1980), Convoys over the life course: Attachment, roles, and social Support. In: P.B. Baltes and O.G. Brim (eds.): Life-span development and behavior. New York: Academic Press, pp. 253–286Google Scholar
  25. Kaplan, G.A. (1992), Heath and aging in the Alameda County Study. In: K.W. Schaie, D. Blazer, and J.S. House (eds.): Aging, health behaviors, and health outcomes. Hillsdale, NJ: Lawrence Erlbaum Associates, pp. 69–88Google Scholar
  26. Kaplan, G.A., M.N. Hann, S.L. Syme, M. Minkler, and M. Windeby (1987a), Socioeconomic status and health. In: R.W. Amler and H.B. Dull (eds.):Closing the gap: The burden of unnecessary illness. New York: Oxford University Press, pp. 125–129Google Scholar
  27. Kaplan, G.A., T.E. Seeman, R.D. Cohen, L.P. Knudsen, and J. Guralnik (1987b), Mortality among the elderly in the Alameda County Study: Behavioral and demographic risk factors. American Journal of Public Health 77 (3), pp. 307–312CrossRefGoogle Scholar
  28. Lang, F.R. and L.L. Carstensen (1994), Close emotional relationships in later life: Further support for proactive aging in the social domain. Psychology and Aging 9 (2), pp. 315–324CrossRefGoogle Scholar
  29. Lee, E.T. (1992), Statistical methods for survival data analysis. New York: WileyGoogle Scholar
  30. Lennartsson, C. and M. Silverstein (2001), Does engagement with life enhance survival of elderly people in Sweden? The role of social and leisure activities. Journal of Gerontology 56B (6), pp. S335–S342Google Scholar
  31. Liang, J., J.F. McCarthy, A. Jain, N. Krause, J.M. Bennett, and S. Gu (2000), Socioeconomic gradient in old age mortality in Wuhan, China. Journal of Gerontology 55B (4), pp. S222–S233Google Scholar
  32. Liu, X., A.I. Hermalin, and Y.L. Chuang (1998), The effects of education on mortality among older Taiwanese and its pathways. Journal of Gerontology 53B (2), pp. S71–S82Google Scholar
  33. Mookherjee, H.N. (1997), Marital status, gender, and perception of well-being. The Journal of Social Psychology 137, 95–105CrossRefGoogle Scholar
  34. Morgan, D.L. (1988), Age differences in social network participation. Journal of Gerontology 43 (4), pp. S129–S137Google Scholar
  35. Morgan, K. and D. Clarke (1997), Customary physical activity and survival in later life: A study in Nottingham, UK. Journal of Epidemiology and Community Health 51 (5), pp. 490–493Google Scholar
  36. Morgan, K., H. Dallosso, E.J. Bassey, S. Ebrahim, P.H. Fenten, and T.H.D. Arie (1991), Customary physical activity, psychological well-being and successful aging. Ageing and Society 11 (4), pp. 399–415Google Scholar
  37. Parker, M.G., M. Thorslund, and M. Nordstrom (1992), Predictors of mortality for the oldest old. a 4-year follow-up for community-based elderly in Sweden. Archives of Gerontology and Geriatrics 14, pp. 227–237CrossRefGoogle Scholar
  38. Pienta, A.M., M.D. Hayward, and K.R. Jenkins (2000). Health consequences of marriage for the retirement years. Journal of Family Issues 21 (5),559–586CrossRefGoogle Scholar
  39. Rowe, J.W. and R.L. Kahn (1998), Successful aging. New York: Pantheon BooksGoogle Scholar
  40. Sabin, E.P. (1993), Social relationships and mortality among the elderly. The Journal of Applied Gerontology 12 (1), pp. 44–60CrossRefGoogle Scholar
  41. Settersten, R.A. Jr. (2006), Aging and the life course. In: R.H. Binstock and L.K. George (eds.):Handbook of aging and the social sciences. 6th ed. New York: Academic Press, pp. 3–19Google Scholar
  42. Shek, D.T. (1995), Gender differences in marital quality and well-being in Chinese married adults. Sex Roles 32, pp. 699–715CrossRefGoogle Scholar
  43. Simon, R.W. (2002). Revisiting the relationships among gender, marital status, and mental health. American Journal of Sociology 107 (4), 1065–1096CrossRefGoogle Scholar
  44. Suzman, R.M., K.G. Manton, and D.P. Willis (1992), Introducing the oldest old. In: R.M. Suzman, D.P. Willis, and K.G. Manton (eds.):The oldest old. New York: Oxford University Press, pp. 3–14Google Scholar
  45. Thoits, P.A. (1983), Multiple identities and psychological well-being: A reformulation and test of the social isolation hypothesis. American Sociological Review 48 (2), pp. 174–187CrossRefGoogle Scholar
  46. United Nations (2001), World population ageing: 1950–2050. Department of Economic and Social Affairs, Population Division. New York: United NationsGoogle Scholar
  47. Waite, L.J. (1995), Does marriage matter? Demography 32, 483–507CrossRefGoogle Scholar
  48. Welin, L., B. Larsson, K. Svardsudd, B. Tibblin, and G. Tibblin (1992), Social network and activities relation to mortality from cardiovascular diseases, cancer and other causes: A 12 year follow up of the study of men born in 1913 and 1923. Journal of Epidemiology and Community Health 46 (2), pp. 127–132Google Scholar
  49. Yu, E.S.H., Y.M. Kean, D.J. Slymen, W.T. Liu, M. Zhang, and R. Katzman (1998), Self-perceived health and 5-year mortality risks among the elderly in Shanghai, China. American Journal of Epidemiology 147 (9), pp. 880–890Google Scholar
  50. Zeng, Y. and J.W. Vaupel (2002), Functional capacity and self-evaluation of health and life of oldest old in China. Journal of Social Issues 58 (4), pp. 733–748CrossRefGoogle Scholar
  51. Zeng, Y., J.W. Vaupel, Z. Xiao, C. Zhang, and Y. Liu (2002), Sociodemographic and health profiles of the oldest old in China. Population and Development Review 28 (2),pp. 251–273CrossRefGoogle Scholar
  52. Zunzunegui, M., B.E. Alvarado, T.D. Ser, and A. Otero (2003), Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. Journal of Gerontology 58B (2), pp. S93–S100Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Rongjun Sun
    • 1
  • Yuzhi Liu
  1. 1.Department of SociologyCleveland State UniversityClevelandUSA

Personalised recommendations