Men’s Health and Co-residence with Older Generations in Russia
With the increasing housing prices and the need to take care of an ageing population, many young generations are living together with their parents, parents-in-law or grandparents (here forth, older generations). Previous research confirms the importance of intergenerational living arrangements (ILAs) for health, but it is still unclear whether ILA is beneficial or detrimental for one’s health. When living in the same household, older generations can have a positive influence on the health habits of their adult children by controlling their dietary intake, alcohol consumption or smoking frequency. At the same time, such living arrangements can be stressful for younger generations because of the burden of having multiple roles (such as caregiving for elders), which can be detrimental for both physical and mental health. These previous findings are mainly based on cross-sectional analysis and can be contradictory due to selection into and out of ILA. To overcome this limitation, Permyakova & Billingsley (2017) assessed the health effect of ILA by using data from the Russian Longitudinal Monitoring Survey (1994-2015). The authors focused on men in the Russian context because this country has a unique combination of a high share of ILAs (1/3) and one of the lowest male life expectancy in Europe (65-years-old).
A cross-sectional model not only confirmed previous findings of the significant association between ILA and health, but also showed that the direction of this association differed depending on the health status of a co-residing older generation. In other words, men were more likely to report fine health if they were living with healthy older generations and less likely to be healthy when living with at least one unhealthy parent/grandparent/parent-in-law. However, the cross-sectional approach does not allow us to conclude whether ILA has a positive effect on men’s health or whether men who are healthier are the ones who are more likely to co-reside with an older generation in fine health. As one of the ways to reduce the selection bias, the authors applied a fixed-effects approach, which confirmed the significance of the negative association between co-residing with an unhealthy older generation and men’s health. To further isolate the effect of ILA on men’s health from the potentially unobserved selection of men into and out of ILA, the authors observed the within-person changes in men’s health only after transitioning into or out of ILA. The first model included men who were not living with an older generation in the first wave of participation and showed that their odds of reporting fine health significantly decreased after a transition into co-residence with an unhealthy older generation. The second model was based on the sub-sample of men living with an older generation when the observation began, which confirmed a detrimental health effect not only when continuously living with an unhealthy older generation (men’s odds of reporting fine health decreased by half), but also when transitioning out of living with a healthy older generation (men’s odds of reporting fine health decreased by 63%).
To conclude, Permyakova & Billingsley (2017) revealed a health interlinkage between co-residing generations and confirmed a detrimental health effect of co-residing with an unhealthy older generation in the cases where the authors attempted to isolate the selection bias. A health-damaging effect of ILA might be explained by the burden on one’s health when providing informal caregiving and the multiple roles when living with an unhealthy older generation. Although women are often expected to be the primary caregivers, men could also experience stress from living with ill family members, particularly in terms of the burden of a financial provision as the primary breadwinners. Country-specific policies related to health, economic prosperity and ageing may contribute to the high prevalence of ILA and lead to poor health. In the Russian context, a combination of several factors such as high unemployment rates, high housing prices, low pensions and one of the worst health outcomes among men and elders in comparison to the European countries, may compound the stress of having an unhealthy older generation with the added obligation for the older generation’s wellbeing. Therefore, it is important to account for the possible country-specific selection of younger generations into and out of ILA by looking at such factors as employment, pensions, and availability of housing, formal care and care institutions in the future research.