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Abstract

The purpose was to examine the relationship between intergenerational support, perceived health and subjective wellbeing (SWB) of the elderly’ s in China, and what role perceived health played in this study. Based on data from Chinese General Social Survey (CGSS) in 2017 (N = 1,373), regression analysis was employed to test the mediation effects by software STATA17.0 and Macro PROCESS3.50. The regression results showed that intergenerational support including intergenerational support received and provided had a positive relationship with the elderly’s SWB. And perceived health was positively related to the elderly’s SWB in all models. Providing intergenerational support had a positive impact on the perceived health of elders, but receiving intergenerational support cannot significantly influence it. And the mediating role of perceived health was played in the relationship between the providing intergenerational support and the elderly’s SWB, rather than between the receiving intergenerational support and the elderly’s SWB. Although some limitations were there, the findings contributed to addressing theoretical gaps and giving references for the improvement of policies. Attention should be paid to the effect of intergenerational support on the elderly’s SWB.

Keywords

intergenerational support perceived health subjective wellbeing the elderly China

Introduction

The total population exceeded 1.4 billion in 2021 in China, and the percentage of people over 60 years old took up 18.70% (National Bureau of Statistics of China [NBSC], 2021). According to the United Nations’ definition of aging countries (i.e. more than 10% of the total population is over 60 years old), China has become an aging country, which has promoted the acceleration of the global aging process. Securing the subjective well-being (SWB) of old adults that refers to an individual’s subjective feelings of evaluating life, such as happiness or life satisfaction (Diener et al., 1999; Larsen et al., 1985), is the key to building an active aging society (Y. Zhu, 2019).

Based on ensuring the material life of senior adults, problems they faced, including care services (Pangaribowo et al., 2020), mental health (Shang, 2020), etc., urgently need to be solved. Early studies revealed that perceived health was more likely to predict the SWB status than objective health (Hunt et al., 1980; Rajabi Gilan et al., 2021). And in Chinese society where filial piety is a central concept in Confucianism (Mao & Chi, 2011), families are the main supporter of the elderly. Intergenerational support from children is closely connected with the elderly’s SWB (C. Peng et al., 2019). Additionally, the elderly should be regarded as a valuable human resource for societal development. Providing intergenerational support for their children is also a way to achieve self-worth enhancing psychological happiness (Chang & Huang, 2020). Thus, intergenerational support can closely influence the elderly’s SWB whether receiving or providing support.

However, there are still gaps in the literature that comprehensively discusses bidirectional intergenerational support, perceived health and the elderly’ SWB. On the one hand, most studies have explored the direct effects of intergenerational support on SWB in the elderly, rather than the indirect pathways (Chang & Huang, 2020; Courtin & Avendano, 2016; Silverstein et al., 2013). The research content needs to be updated. China’s domestic-related research mainly focused on the theoretical level, with insufficient empirical data support. Additionally, the intergenerational exchange model has been popularly used in the relationship between intergenerational support and the elderly’s SWB (C. Peng et al., 2019). In view of the intergenerational exchange model with perceived health addition, it is therefore worth developing to better adapt to the current aging situation.

This paper thus selected aged people (over 60 years old) as the research object from the 2017 Chinese General Social Survey (CGSS). We divided intergenerational support into receiving and providing intergenerational support among seniors to answer the following questions. How does intergenerational support influence the elderly’s SWB in Mainland China? Does intergenerational support received and provided have different effects on their SWB? What role can the perceived health play in the relationship between intergenerational support and the elderly’s SWB? The conclusions are able to contribute to the theoretical and practical development. On the one hand, the results can provide new empirical evidence for research enrichment and develop a theoretical model for reference in related studies. On the other hand, based on the research findings, we can put forward suggestions for optimizing senior service policies that improve the elderly’s SWB to build an active aging society.

Literature Review and Hypotheses

Intergenerational Support and the Elderly’s SWB

Intergenerational support refers to the mutual support between parents and children, involving the reciprocity and conversion of intergenerational support (Mutran & Reitzes, 1984; Ofstedal et al., 1999). In this study, intergenerational support mainly included emotional support (caring, comfort, and company), instrumental support (life care, and the supply of clothing and food), and financial support (financial assistance for children or parents) between adult children and elderly parents (Tian, 2014).

Social exchange theory and equity theory were used in the early literature to explain the relationship between intergenerational support and the elderly’s SWB (Davey & Eggebeen, 1998; H. J. Lee et al., 2014). The former believed that exchange is of considerable significance for maintaining relationships. When the benefit exceeds the cost of the exchange, the recipient is considered the beneficiary, to some extent, the individual prefers to be the beneficiary during the interaction (Homans, 1958; H. J. Lee et al., 2014). Consequently, intergenerational support from children can benefit the elderly recipients’ SWB (C. Peng et al., 2019), which has been supported by international research. For instance, Courtin and Avendano (2016) demonstrated that seniors living with their children in Europe could receive more life-caring and emotional support, which resisted the risk of depression. Some studies in Southeast Asia showed that financial, instrumental, and emotional support from children was associated with higher life satisfaction for older parents, despite the different needs (Teerawichitchainan et al., 2015; Thanakwang, 2015). Furthermore, the research in mainland China also confirmed that receiving instrumental support from children can positively affect the life satisfaction of the elderly, whether in urban or rural areas (Wu, 2022). C. Peng et al. (2019) using 504 samples found that the elderly in Hong Kong were less satisfied with life when they lacked support in daily life, but when they lacked financial support or benefit from too much emotional support, they were happier in life. However, Silverstein et al. (2013) found that in Israel, instrumental support lowered positive emotion among older Arabs, which made it regionally controversial. Thus, it is necessary to find further results in China for debates.

The equity theory believed that the relationship with equality and reciprocity contributes to achieving a high level of SWB (Walster et al., 1973). In order to maintain self-dignity and reasonable acceptance of intergenerational support, elderly parents usually expect to achieve an equal exchange of support by raising their children in their early years, which is in exchange for their children’s support for their later lives. Additionally, identity theory emphasized that allowing space for self-ability in social interaction can promote the adaptation of individual roles and social structures, and realize self-determination (Stryker, 2007). In intergenerational exchanges, being merely regarded as the recipient will greatly diminish the self-affirmation of elders and bring about role conflict, which lessens their SWB (Mutran & Reitzes, 1984). Old parents will feel confident in the balanced relationship by providing intergenerational support (Thomas, 2010). Therefore, compared to those who receive only support, seniors also as providers who exchange support are happier (Litwin, 2004). Chinese scholars found that providing intergenerational support for children such as giving money and emotional support and caring for grandchildren, which could also enrich the self-esteem of the elderly, was positively correlated with their SWB (Chang & Huang, 2020; H. Peng et al., 2015; Tian, 2014). Because in the process of intergenerational exchanges, the senior man was seen as a valuable person instead of an old and useless person. The research in Korea suggested that older parents who financially supported offspring exhibited high levels of psychological well-being (H. J. Lee et al., 2014). Because the elderly were able to fulfill the role of parents (as providers) and maintain their identity and dignity when their young children accepted intergenerational support. In a sense, this is two-way reciprocity for elderly parents and adult children. However, there were conclusions with no association between providing intergenerational support and the elderly’s SWB that needed further confirmation (Schwarz et al., 2010; Silverstein et al., 2006). To address the above research gaps, the hypotheses were given in the Chinese context.

H1. Intergenerational support is likely to have a positive relationship with the elderly’s SWB.

H1-1. Receiving intergenerational support may have a positive relationship with the elderly’s SWB.

H1-2. Providing intergenerational support may have a positive relationship with the elderly’s SWB.

Perceived Health and the Elderly’s SWB

Perceived health is a subjective assessment of individual health status (Hunt et al., 1980), and is a sum of the medical health status and its functional consequences (Røysamb et al., 2003). According to World Health Organization (WHO, 1996), health is not only free from disease, but also is satisfaction with mental health, social relationships, and others. Traditional health measurement methods are based on the medical evaluation of physical functions but ignore subjective feelings, and the factors that affected physical health do not completely affect perceived health (Bryant et al., 2000; Hunt et al., 1980), such as socioeconomic status, lifestyle, and social networking (Hirve et al., 2014). Health status is not even associated with health literacy and feelings (Vozikis et al., 2014).

The health belief model with self-efficacy theory was used to explain the relationship between perceived health and SWB. Self-efficacy is a crucial component of social cognitive theory, scilicet, the belief that one has the ability to accomplish something (Bandura, 1986). Hence, when people are perceived to be healthy, they don’t think they can live a negative life troubled by diseases (Rosenstock et al., 1988). The health belief model contains several core concepts: perceived susceptibility, severity, benefits, and barriers. An individual’s perception of self-health will influence health behaviors and mental health (Henshaw & Freedman-Doan, 2009; Rosenstock, 1974). Good health perception will resist the negative psychology to heighten life satisfaction (B. A. Lee & Oh, 2013).

Perceived health has been used in gerontological research as an energetic indicator of predicting the elderly’s SWB (Dumitrache et al., 2017; López et al., 2020). Studies demonstrated that compared with poor-health elders, good-health ones could actively participate in daily leisure and social activities, thereby obtaining relatively rich social resources, their independent ability was stronger (Koolhaas et al., 2014; Lobos et al., 2016). They positively paid attention to health literacy, which could improve self-care behaviors and increase self-efficacy. They were better to address life problems and disease risks (Y. J. Lee et al., 2016; Pangaribowo et al., 2020). Therefore, the elderly with good perceived health may live happier. Conversely, poor perceived-health elders were often reluctant to participate in activities, accompanied by a series of negative beliefs, such as loneliness and depression, lower self-care capacity, and lower satisfaction with life (Etxeberria et al., 2019). To some extent, it can be speculated that the level of happiness will also escalate if the individual’s perceived health is satisfactory. Therefore, the second hypothesis was proposed.

H2. Perceived health may have a positive association with the elderly’s SWB.

Intergenerational Support and Perceived Health

According to social support theory (Johnsen, 2001), intergenerational support, as a kind of social support, is a beneficial resource, which can help people obtain tangible or intangible support in solving stress and difficulties, influencing individual health and mental health outcomes. Previous studies have shown a certain correlation between intergenerational support and perceived health among older recipients (Liang et al., 2014). For example, the research found that for the Chinese American elderly, their access to personal help from children can improve self-rated health and reduce the risk of depression (Mao et al., 2021). Meanwhile, the positive relationship between receiving children’s instrumental support and the perceived health of older parents in rural China also was confirmed in a longitudinal study (Mao et al., 2020). However, 11-year data showed that receiving care harmed the self-rated health of the Chinese elderly because it meant that the health status of elderly parents decreased over time (Mao et al., 2019). Han et al. (2021) using logistic regression found that being looked after by their children and helping them with agricultural work were not beneficial to the perceived health of left-behind elders. Heinze et al. (2015) showed that the elderly in America were more dependent on the support of their friends and neighbors rather than their children to avoid being a burden to their children. Hence, there were debates on the correlation between receiving intergenerational support and the perceived health of elders in needing to respond.

Additionally, some different voices can be listened to the relationship between intergenerational support and perceived health for elderly providers. For instance, Abolfathi et al. (2014) suggested that giving support such as advice and emotional support was a positive indicator of the perceived health of older Malaysian. A South Korean empirical study displayed that grandmothers who provided long-term care for their grandchildren reported better self-rated health than those who do not (Choi & Zhang, 2018). This relationship also was supported by the early Chinese study. Zhou et al. (2017) found that assisting in the care of babies for their sons and daughters could positively affect the self-worth and perceived health of Chinese elders. However, there was no substantive evidence holding this correlation relationship in Chile, although intergenerational relationships’ quality and content were strongly linked to SWB in old age (Herrera et al., 2022). To address the above theoretical gaps, we gave the following hypotheses in the Chinese context.

H3. Intergenerational support perhaps has a positive relationship with the perceived health of elders.

H3-1. Receiving intergenerational support perhaps has a negative relationship with the elderly’s perceived health.

H3-2. Providing intergenerational support perhaps has a positive relationship with the elderly’s perceived health.

The Mediating Role of Perceived Health

Based on the above-mentioned content, studies about the indirect effect of IS on the elderly’s SWB were insufficient even if the direct effect had been well known. While the mediating effect of perceived health has been detected in the relationship between related factors and the elderly’s SWB (Palomo-Vélez et al., 2020; Weech-Maldonado et al., 2017). So we would like to know whether perceived health can play a mediating role between intergenerational support (including receiving and providing intergenerational support) and the elderly’s SWB in China.

In accordance with prior studies, intergenerational support exchange can influence old adults’ perceived health, because intergenerational support changed the self-rated health through access to caring resources (Han et al., 2021; Liang et al., 2014; Mao et al., 2020; J. Zhou et al., 2017). For example, the provision of intergenerational support reflects the self-ability and value of seniors, and giving instrumental support, such as life care and housework services, requires the elderly to have the behavioral ability and good physical status, all of which will be positively beneficial to evaluate their health (Abolfathi Momtaz et al., 2014; Choi & Zhang, 2018). Due to the emotional support and life care from children, old parents can reduce loneliness and depression to increase health perception (Mao et al., 2021; C. Peng et al., 2019). Furthermore, perceived health based on subjective assessment, as a type of individual health, is closely related to the individual’s internal psychological well-being (Etxeberria et al., 2019). On the one hand, good perceived health is conducive to promoting the active engagement of the elderly in social activities, increasing tangible or intangible social capital, and promoting life satisfaction (Lobos et al., 2016; López et al., 2020). On the other hand, it is also conducive to improving individual psychological well-being, and enhancing self-confidence and happiness in life (Dumitrache et al., 2017; Y. J. Lee et al., 2016; Pangaribowo et al., 2020).

To sum up, it can be seen that there is a certain potential connection between intergenerational support, perceived health and SWB among the elderly. Intergenerational support maybe has an indirect impact on the elderly’s SWB through perceived health. Nevertheless, the intermediary role of perceived health in the relationship between intergenerational support and SWB is still blank. Thus, combined with the above hypotheses, we gave hypothesis 4 to supplement the gaps and the conceptual framework was shown in Figure 1.

H4. Perceived health may have a partial mediating impact on the relationship between intergenerational support and the elderly’s SWB.

H4-1. Perceived health may partly mediate the relationship between receiving intergenerational support and the elderly’s SWB.

H4-2. Perceived health may partly mediate the relationship between providing intergenerational support and the elderly’s SWB.

Figure 1.

Conceptual framework.

Method

Data

The Chinese General Social Survey (CGSS) launched by the National Survey Research Center at Renmin University of China in 2003, is the earliest national representative continuous survey project run by the academic institution in Mainland China. The targeted population of the CGSS is civilian adults aged 18 and above. CGSS used a multi-stage stratified random sampling method to obtain a nationally representative sample all over Mainland China, involving residents in 31 provinces, autonomous regions, and direct municipalities (Hong Kong SAR, Macao SAR, and Taiwan were excluded). 2017CGSS including 4,372 elderly samples was released in 2020. It provided the survey data of intergenerational support, which was consistent with this research content and more reflective of the current status than prior waves. Deleting missing values and invalid data, this study had 1,373 valid elderly data from 2017CGSS (aged 60–96, M = 69.26, SD = 7.38).

Measures

Control Variables

Several questions were used to reflect controls in the 2017CGSS, and recoded values, including age (2017 minus the year of birth), gender (0 = male, 1 = female), household registration (0 = agricultural household, 1 = non-agricultural household, including resident Hukou, military Hukou, non-registered and others), marital status (0 = non-married status, including single, cohabitation, divorce or widowed, 1 = married status, referring to first marriage with a spouse, the remarried with a spouse and the separated without divorce), educational level (0 = uneducated, 1 = private schools and literacy classes, 2 = primary school, 3 = middle school, 4 = high school or vocational high school, 5 = technical secondary school or technical school, 6 = college/university and above).

Independent Variable: Intergenerational Support

In this research, intergenerational support with the exchanges between older parents and children mainly included three dimensions, namely, emotional support, instrumental support, and financial support (Mutran & Reitzes, 1984; Ofstedal et al., 1999). Providing intergenerational support was reflected by this question in 2017CGSS. “Then, did you often provide the following help for your child in the past year?,” with 3 items: (1) Give money. (2) Help with housework (such as cleaning, preparing dinner, shopping, doing chores, or looking after children or other family members). (3) Listen to his/her ideas or thoughts. Recorded the original options from “1 = not at all” to “5 = very often.” The scores ranged from 1 to 15. The larger the average values, the more they provided intergenerational support. And intergenerational support received was incarnated by the question “Then, did the adult child often provide the following help for you in the past year?,” with the same items and scoring method as the intergenerational support provided. The means of all indicated intergenerational support with the identical standard. Larger overall means were associated with higher levels of intergenerational support (Cronbach’s α = .7).

Dependent Variable: SWB

In this study, SWB referred to an individual’s subjective evaluation of life happiness, which was also supported (Diener, 2006; Diener et al., 1999; Veenhoven, 1996). In 2017CGSS, it was measured by the question and its options: “In general, how happy do you think you are?,” with possible responses of “1 = very unhappy” to “5 = very happy.” Lower scores were associated with lower levels of SWB. This single measurement has been employed in related studies (J. Zhu et al., 2020).

Intermediary Variable: Perceived Health

In this text, perceived health was regarded as a mediation. It was measured by the question in 2017CGSS “Do you think how your current health does?,” and the options from 1 to 5 respectively were “very unhealthy” to “very healthy.” Higher scores were associated with better-perceived health. The single-measurement method has been effectively used by scholars (e.g., Hirve et al., 2014; Mao et al., 2021; Weech-Maldonado et al., 2017).

Analysis

Software STATA17.0 and Macro program PROCESS3.50 written by Hayes (2017) were utilized to run the model. STATA17.0 conducted the descriptive analysis of sociodemographic variables in the sample, such as frequency analysis, central tendency analysis and dispersion degree, and correlation analysis. Then, regression analysis run by PROCESS3.50 verified whether the models can support hypotheses in this research. The Bootstrapping method was used to repeat sampling 5,000 times with the 95% unbiased correction confidence interval (CI), and the data processing and model testing were performed. If CI excluded zero, the effect was significant (Preacher & Hayes, 2008). The regression equations were as follows.

$M_{PH} = β_{0} + β_{1} X_{i} + λ_{0} Z_{i} + ε$ (1)

$Y_{SWB} = η_{0} + η_{1} X_{i} + η_{2} M_{PH} + λ_{1} Z_{i} + ε$ (2)

Where, M_PH represented the mediating role of perceived health. Y_SWB was the dependent variable SWB. X_i was an independent variable, including IS, providing IS and receiving IS. Z_i was the controls in this study. ε represented the errors. i was the individuals. And β₀ and η₀ denoted constants, and β₁, η₁, η₂, λ₀, λ₁were regression coefficients. η₁ was the direct effect of X_i on Y_SWB. The indirect effect of X_i on Y_SWB through M_PH was estimated as β₁η₂. The total effect of X_i on Y_SWB through M_PH was equal to $η 1 + β 1 η 2$ .

Results

Descriptive Statistics and Correlation

Sociodemographic descriptive statistics of the data (N = 1,373) showed that 633 males (46.1%) and 740 females (53.9%) were in the sample. Concerning the distribution of household registrations, the agriculture register accounted for 49.9%, non-agricultural register accounted for 50.1%. The majority of people were in marriage (71.4%), and 28.6% of the elderly were non-married status. In terms of the educational level, the literacy level of the elderly was low with significantly individual differences. The number of people at the primary level was the largest (29.9%), followed by the level of middle school (24.3%). The uneducated took up 24%. The full results were shown in Table 1.

Table 1.

Socio-demographic Characteristics (N = 1,373).

		N	%	M	SD	Range
Age		1,373		69.26	7.376	60–96
Gender	Male	633	46.1	0.54	0.499	0–1
Gender	Female	740	53.9
Household registration	Agriculture	685	49.9	0.50	0.500	0–1
Household registration	Non-agriculture	688	50.1
Marital status	Non-married status	393	28.6	0.71	0.452	0–1
Marital status	Married status	980	71.4
Educational level	Uneducated	329	24	2.33	1.727	0–6
	Literacy class	28	2
	Primary school	410	29.9
	Middle school	333	24.3
	High school or vocational high school	115	8.4
	Technical secondary school or technical school	61	4.4
	College/university and above	97	7.1

Note. M = means; SD = standard deviation; N = frequency; % = percent.

The average values of SWB (M = 3.88, SD = 0.862), intergenerational support (M = 2.62, SD = 0.714) and perceived health (M = 2.98, SD = 1.042) were higher than the ideal means, indicating that the overall levels of the elderly’s SWB, intergenerational support and perceived health were relatively high, but the differences were there. Receiving intergenerational support (M = 2.87, SD = 0.882) for the elderly was more than providing intergenerational support (M = 2.38, SD = 0.854). Pearson correlation results suggested that intergenerational support had a positive correlation with the elderly’s SWB (r = .129, p < .01). A positive correlation can also be found between providing intergenerational support and the elderly’s SWB (r = .094, p < .01), receiving intergenerational support and the elderly’s SWB (r = .118, p < .01). And perceived health also correlated positively with the elderly’s SWB (r = .292, p < .01), intergenerational support (r = .085, p < .01), and intergenerational support provided (r = .115, p < .01), respectively. But a positive correlation between intergenerational support received and perceived health was not found (r = .028, p > .05). Details were shown in Table 2.

Table 2.

Correlation Coefficients and Descriptive Statistics (N = 1,373).

	M	SD	1	2	3	4	5	6	7	8	9	10
1	2.38	0.854	1
2	2.87	0.882	.352**	1
3	2.62	0.714	.816**	.828**	1
4	2.98	1.042	.114**	.028	.085**	1
5	3.88	0.862	.094**	.118**	.129**	.292**	1
6	69.26	7.376	−.206**	.055*	−.089**	−.067*	.058*	1
7	0.54	0.499	.088**	.085**	.106**	−.074**	.017	−.017	1
8	0.50	0.500	.181**	−.002	.107**	.197**	.164**	.064*	−.011	1
9	2.33	1.727	.177**	−.054*	.073**	.233**	.137**	−.116**	−.227**	.513**	1
10	0.71	0.452	.095**	−.077**	.009	.082**	.045	−.309**	−.188**	.029	.179**	1

Note. M = means; SD = standard deviation. 1 = provide intergenerational support. 2 = receive intergenerational support. 3 = intergenerational support. 4 = perceived health. 5 = subjective wellbeing. 6 = age. 7 = gender. 8 = household registration. 9 = educational level. 10 = marital status.

p < .05, **p < .01 (two-tailed tests).

The Results of Regression Analysis

According to the results in Table 3, intergenerational support was regarded as independence, intergenerational support had a positive relationship with the elderly’s SWB (β = .099, p < .001, 95% CI = [0.059, 0.180]), supporting H1. Namely, old parents with more intergenerational support were more likely to be higher levels of SWB. Meanwhile, perceived health had a positive correlation with the elderly’s SWB (β = .265, p < .001, 95% CI = [0.173, 0.265]), that is, the better-perceived health was associated with the higher levels of SWB among seniors. H2 was supported. And H3 also got supported because the high level of intergenerational support was positively related to perceived health (β = .063, p < .05, 95% CI = [0.013, 0.172]), namely, intergenerational support positively affected the perceived health of elder persons. And in this model, 11.7% and 7.1% variances of SWB and perceived health, respectively, can be explained.

Table 3.

The Regression Results of the Mediation Model With Intergenerational Support as the Independent Variable (N = 1,373).

Outcomes	Indicators	B	β	SE	t	BootLLCI, BootULCI (95%)	R/R-sq	F(df)
PH	IS	0.091	.063	0.039	2.362*	[0.013, 0.172]	.267/.071	17.453 (6)***
	Age	−0.006	−.042	0.004	−1.487	[−0.014, 0.002]
	Gender	−0.083	−.04	0.058	−1.429	[−0.20, 0.033]
	Household registration	0.238	.114	0.065	3.678***	[0.109, 0.365]
	Marital status	0.076	.033	0.065	1.185	[−0.056, 0.207]
	Educational level	0.09	.15	0.019	4.656***	[0.053, 0.127]
SWB	IS	0.12	.099	0.031	3.829***	[0.059, 0.180]	.342/.117	25.851 (7)***
	PH	0.219	.265	0.022	10.04***	[0.173, 0.265]
	Age	0.012	.102	0.003	3.752***	[0.006, 0.018]
	Gender	0.085	.049	0.047	1.833	[−0.008, 0.176]
	Household registration	0.12	.07	0.053	2.293*	[0.020, 0.225]
	Marital status	0.102	.054	0.052	1.968	[0.000, 0.205]
	Educational level	0.023	.046	0.016	1.457	[−0.008, 0.053]

Note. IS = intergenerational support; SWB = subjective wellbeing; PH = perceived health; B = the unstandardized path coefficient; β = the standardized path coefficient; SE = the standard error; = the significance test of the regression equation; t = the significance test value of the regression parameter. R² statistic relates to variation between individuals. BootLLCI = the lower bound of the bootstrap 95% CI; BootULCI = the upper bound of the bootstrap 95% CI.

***

p < .001. **p < .01. *p < .05.

The total effect in this mediation path was 14%. The direct effect of intergenerational support on SWB was 12%, accounting for 85.63% of the total effect. And the indirect effect was 2%, taking up 14.3% of the total effect. And 95% CI = [0.003, 0.039] didn’t include zero in this indirect path, which confirmed the mediating role of perceived health. It indicated that intergenerational support can indirectly influence the elderly’s SWB through the mediating effect of perceived health, supporting H4 (see Table 6).

Intergenerational support received was taken as the independent variable in Table 4. The standardized regression results confirmed that receiving intergenerational support was positively associated with the elderly’s SWB (β = .109, p < .001, 95% CI = [0.055, 0.159]), that is, the more the intergenerational support received, the higher the elderly’s SWB level. Hypothesis 1-1 was supported. And H2 was also valid in this model. This positive relationship was found between perceived health and the elderly’s SWB (β = .266, p < .001, 95% CI = [0.174, 0.266]). Surprisingly, receiving intergenerational support cannot significantly influence perceived health (β = .045, p > .05, 95% CI = [−0.011, 0.114]), which made H3-1 unsupported. And this model can explain 6.9% and 11.9% variances of perceived health and SWB, respectively.

Table 4.

The Regression Results of the Mediation Model With Intergenerational Support Received as the Independent Variable (N = 1,373).

Outcomes	Indicators	B	β	SE	t	BootLLCI, BootULCI (95%)	R/R-sq	F(df)
PH	RIS	0.053	.045	0.031	1.719	[−0.011, 0.116]	.264/.069	16.984(6)***
	Age	−0.007	−.049	0.004	−1.76	[−0.015, 0.001]
	Gender	−0.074	−.036	0.058	−1.293	[−0.185, 0.040
	Household registration	0.249	.12	0.065	3.853***	[0.123, 0.379]
	Marital status	0.079	.035	0.065	1.224	[−0.047, 0.208]
	Educational level	0.093	.154	0.019	4.781***	[0.055, 0.130]
SWB	RIS	0.106	.109	0.025	4.240***	[0.055, 0.159]	.345/0.119	26.381(7)***
	PH	0.22	.266	0.022	10.109***	[0.174, 0.266]
	Age	0.01	.089	0.003	3.284**	[0.004, 0.017]
	Gender	0.092	.053	0.046	1.976*	[0.002, 0.181]
	Household registration	0.133	.077	0.052	2.551*	[0.029, 0.231]
	Marital status	0.109	.058	0.052	2.101*	[0.006, 0.216]
	Educational level	0.027	.054	0.016	1.696	[−0.003, 0.059]

Note. RIS = receive intergenerational support; SWB = subjective wellbeing; PH = perceived health; B = the unstandardized path coefficient; β = the standardized path coefficient; SE = the standard error; F = the significance test of the regression equation; t = the significance test value of the regression parameter. R² statistic relates to variation between individuals; BootLLCI = the lower bound of the bootstrap 95% CI; BootULCI = the upper bound of the bootstrap 95% CI. *** p < .001. **p < .01. *p < .05.

In terms of the path results in Table 6, the total effect was 11.8%, and the direct effect of receiving intergenerational support on the elderly’s SWB was 10.61%, accounting for 90.07% of the total effect. However, the indirect effect of receiving intergenerational support on the elderly’s SWB through perceived health was only 1.17%. And 95% CI in the bootstrap test included zero (95% CI = [−0.003, 0.026]), which suggested the insignificant indirect path in this model. Due to the above, H4-1 was also unsupported. It revealed that intergenerational support received did not influence indirectly the elderly’s SWB through the mediating effect of perceived health.

The findings with the independent variable of providing intergenerational support in Table 5, it was positively related to the elderly’s SWB (β = .055, p < .05, 95% CI = [0.001, 0.11]), which supported H1-2. The old parents with more intergenerational support provided were likely to have a higher SWB level. Likewise, H2 was also held in this model. Perceived health was positively associated with the elderly’s SWB (β = .222, p < .001, 95% CI = [0.176, 0.267]). H3-2 was supported because the more providing intergenerational support was related to the higher level of perceived health (β = .061, p < .05, 95% CI = [0.009, 0.143]). In other words, providing intergenerational support positively influenced the elderly’s perceived health. 11% of SWB variances and 7.1% of perceived-health variances can be explained in this model.

Table 5.

The Regression Results of the Mediation Model With Intergenerational Support Provided as the Independent Variable (N = 1,373).

Outcomes	Indicators	B	β	SE	t	BootLLCI, BootULCI (95%)	R/R-sq	F(df)
PH	PIS	0.075	.061	0.033	2.226*	[0.009, 0.143]	.266/.071	17.342(6)***
	Age	−0.005	−.036	0.004	−1.256	[−0.013, 0.003]
	Gender	−0.083	−.04	0.058	−1.429	[−0.196, 0.032]
	Household registration	0.232	.112	0.065	3.572***	[0.104, 0.359]
	Marital status	0.071	.031	0.065	1.097	[−0.061, 0.203]
	Educational level	0.088	.146	0.02	4.525***	[0.051, 0.125]
SWB	PIS	0.055	.055	0.027	2.038*	[0.001, 0.110]	.332/.11	24.168(7)***
	PH	0.222	.268	0.022	10.125***	[0.176, 0.267]
	Age	0.012	.104	0.003	3.74***	[0.006, 0.019]
	Gender	0.094	.054	0.047	2.004*	[0.004, 0.183]
	Household registration	0.122	.071	0.053	2.312*	[0.020, 0.223]
	Marital status	0.097	.051	0.052	1.851	[−0.005, 0.197]
	Educational level	0.022	.044	0.016	1.384	[−0.009, 0.054]

Note. PIS = provide intergenerational support; SWB = subjective wellbeing; PH = perceived health; B = the unstandardized path coefficient; β = the standardized path coefficient; SE = the standard error; F = the significance test of the regression equation; t = the significance test value of the regression parameter. R² statistic relates to variation between individuals; BootLLCI = the lower bound of the bootstrap 95% CI; BootULCI = the upper bound of the bootstrap 95% CI.

***

p < .001. **p < .01. *p < .05.

And in the results of path effects (see Table 6), the indirect effect of intergenerational support provided on the elderly’s SWB through perceived health was significant, which supported H4-2. Because the 95% CI = [0.002, 0.032] in the bootstrap test excluded zero. That is to say, the perceived health can partially mediate the relationship between intergenerational support provided and the elderly’s SWB. The indirect effect was 1.65%, accounting for 22.98% of the total effect (7.8%) in this mediation model. And the direct effect took up 77.02% of the total.

Table 6.

The Results of Path Effects in Mediating Models.

Independent variables		Path	Effect (%)	SE	BootLLCI, BootULCI (95%)	RE (%)
IS	Total		13.99	0.032	[0.076, 0.203]
	Direct		11.98	0.031	[0.059, 0.181]	85.63
	Indirect	IS→PH→SWB	2.00	0.009	[0.003, 0.039]	14.30
RIS	Total		11.78	0.026	[0.067, 0.169]
	Direct		10.61	0.025	[0.057, 0.155]	90.07
	Indirect	RIS→PH→SWB	1.17	0.007	[−0.003, 0.026]	11.03
PIS	Total		7.18	0.028	[0.017, 0.127]
	Direct		5.53	0.027	[0.002, 0.109]	77.02
	Indirect	PIS→PH→SWB	1.65	0.008	[0.002, 0.032]	22.98

Note. IS = intergenerational support; RIS = receiving intergenerational support; PIS = providing intergenerational support; SWB = subjective wellbeing; PH = perceived health; SE = the standard error; BootLLCI = the lower bound of the bootstrap 95% CI; BootULCI = the upper bound of the bootstrap 95% CI; RE = the relative effect.

Discussion and Conclusion

The results from 2017CGSS revealed that there was a positive correlation between variables. The partial mediating role of perceived health for elders was played in the relationship between providing intergenerational support and SWB, intergenerational support and SWB. The windfall was that intergenerational support received cannot insignificantly impact perceived health, thus perceived health can mediate the relationship between receiving intergenerational support and the elderly’s SWB. In accordance with the full findings, we conducted in-depth discussions as follows and gave a comprehensive structure diagram (see Figure 2).

Figure 2.

The standardized coefficients plot of mediating models.

Firstly, intergenerational support including receiving and providing intergenerational support had a positive relationship with the elderly’s SWB, which was consistent with the previous findings (C. Peng et al., 2019; Silverstein et al., 2013; Tian, 2014). This can be explained by the theory of social exchange and equality. Because the relationship of equality and reciprocity was conducive to long-term maintenance, which also made providing and accepting support rational in the intergenerational support exchanges (Cong & Silverstein, 2014). The elderly gained a sense of self-worth by providing support to children and a sense of respect by receiving support from children, which was also in line with the social background of Chinese Confucian filial piety culture (Mao & Chi, 2011). The elderly fully appreciated value, equality, and dignity in the exchange process, and received long-term payback. Hence, seniors with more intergenerational support were more likely to be happier, regardless of the intergenerational support provided or received. Specifically, intergenerational support received was positively associated with the elderly’s SWB. This was inconsistent with the previous findings. Some studies illustrated that the financial support (H. J. Lee et al., 2014), and instrumental support (Merz & Consedine, 2009) provided by children were significantly unrelated to gerontology wellbeing. Over-benefiting even weakened the mental health of older parents (Davey & Eggebeen, 1998). This also enabled social exchange theory to be controversial in explaining this relationship. The reason may be the differences in social culture. Because of Chinese Confucianism filial piety culture, this was not only a return for providing early support to old parents but also legal and moral obligations for children. Family-oriented thinking also made intergenerational support very meaningful for the elderly’s SWB (Mao & Chi, 2011; C. Peng et al., 2019). For Chinese elderly parents, the old-age stage without children support was a failed life. On the contrary, intergenerational support received can improve dignity and meet psychological needs, which was conducive to improving happiness (Dong et al., 2012). And due to old age, seniors would face such as physical loss, retirement, widowhood and other threats to SWB (Steptoe et al., 2015), which decreased their survivability. They needed children to care for life in old age. Therefore, receiving intergenerational support was both a manifestation of children’s respect for the elderly and a predominant way to ensure the later life quality. The elderly who received more intergenerational support were likely to have a high level of SWB.

From the perspective of older providers, they provided intergenerational support to children that positively correlated with SWB. As stated in the identity theory, providing support was a way for the elderly to interact and communicate with their children, as well as a way to affirm their dignity and self-efficacy (Litwin, 2004; Mutran & Reitzes, 1984; Thomas, 2010). In order not to be seen as a burden, the role conflict is alleviated by providing IS for children. Howbeit, it was contradictory to Silverstein et al. (2006) and Schwarz et al. (2010). They showed that life satisfaction was not associated with the provision of intergenerational support to children among rural older parents, especially mothers in China. This may be due to different research perspectives and research scenarios. The perceived-health variable was included in this study, which highlighted the significance of self-efficacy reflected by providing intergenerational support. In China, elderly parents prefer the pragmatic principle to pure altruism. When seeking support, they often give priority to the child who has given support rather than those who have not. Children who have received parental support are also more likely to provide support to their parents (Lin & Wu, 2014). By providing early assistance and support to children, it is more reasonable and acceptable to expect children’s feedback on the elderly life (Cong & Silverstein, 2014). The elderly providers are proud people who have contributed to the family, which has a positive psychological effect on them. Thus, SWB can be positively related to providing IS, which has been also supported in existing studies (H. J. Lee et al., 2014; H. Peng et al., 2015).

Secondly, perceived health had a positive relationship with the elderly’s SWB in this study. This result was supported by Dumitrache et al. (2017) and López et al. (2020). The reason may be that perceived health was also a health indicator, and it had an important impact on SWB like physical health (Weech-Maldonado et al., 2017). Better perceived health is helpful to overcome the risk of depression, improving mental health (Etxeberria et al., 2019). Elders with good perceived health can also actively participate in enjoying life, which is conducive to advancing self-efficacy and life expectancy, all of which are protective factors in SWB. So higher levels of perceived health were associated with higher SWB levels in this study.

Thirdly, we found that intergenerational support positively affected the elderly’s perceived health, which agreed with previous research (Abolfathi Momtaz et al., 2014; Choi & Zhang, 2018; Mao et al., 2021). As suggested by social support theory (Johnsen, 2001), intergenerational support plays a positive role in enhancing the living ability and psychological resilience of the elderly. In this way, they also have opportunities to treat physical diseases in time to reduce the physical discomfort. Therefore, the intergenerational exchange of support can help improve the perceived health of the elderly. Based on the above, perceived health played a partial mediating role in the model. And intergenerational support indirectly influenced the elderly’s SWB through the mediating impact of perceived health. For Chinese elders, intergenerational support is beneficial to their perceived health, and then they will live peacefully in their later years.

Concretely, providing intergenerational support significantly positively influenced perceived health, which was consistent with most conclusions, but disagreed with the findings in Chile (Herrera et al., 2022). They did not find an association between them. The reason may be that the research focus is inconsistent. They stressed the support provided by the elderly to look after grandchildren. But this paper paid attention to overall support more than just caring for grandchildren. Thus, the results were significant that can be acceptable. And combined with the above results, perceived health can partially mediate the relationship between intergenerational support and the elderly’s SWB. Because seniors provided support for children that contributed to their perceived and mental health, this health status can matter to their happiness in life. This chain reaction cannot be separated for elderly individuals.

Unexpectedly, receiving intergenerational support had no significant effect on perceived health, which also failed to support the mediating effect of perceived health in this path. This might be because recipients often had insufficient self-ability compared with providers, such as poor health, inconvenience, and no source of self-income. Receiving assistance made the elderly feel useless and lower self-efficacy, which threatened their perceived-health level (Han et al., 2021). Receiving intergenerational support may be less important for their perceived health than providing intergenerational support. Even in China, where filial piety is really important, older people still need to maintain a certain degree of independence and realize their self-worth. This is why perceived health failed to mediate the relationship between receiving intergenerational support and the elderly’s SWB.

Contributions and Limitations

These research findings have made certain contributions. At the theoretical level, the results compensated for knowledge gaps. On the one hand, the results in China found that (providing) intergenerational support and perceived health had a positive impact on the elderly’s SWB, but intergenerational support received had no significant impact on perceived health, which facilitated the response to existing disputes and guided further the research directions. Maybe more factors or methods needed to be considered to confirm the relationship between variables. On the other hand, the intergenerational exchange model with perceived health was developed, and the mediating role of perceived health provided some references for the follow-up research. The explanatory effects of the above theories were confirmed in this study. It laid the foundation for domestic scholars and even foreign scholars to develop these theories to adapt to their own scenarios.

Several practical implications were as follows. First, the results suggested that bi-directional intergenerational support was advantageous to the elderly’s SWB in China. They needed space to realize their self-worth through mutual intergenerational support. To protect the legitimate rights and interests of the elderly, the government should advocate and promote the culture of filial piety at the moral and legal levels. It will encourage children to communicate with elderly parents and provide care, condolences, and support for older parents to improve their SWB. Meanwhile, the elderly should be treated as valuable people. The government should establish a platform for the elderly to offer advice and suggestions, absorbing their views to improve social governance. The younger generations can accept their assistance and suggestions appropriately, and provide convenience for them to achieve SWB.

Second, due to the correlation between perceived health and the elderly’s SWB, the country should improve public services and basic entertainment facilities, and build elderly-friendly communities. For example, it can increase medical benefits and provide physical examination services for the elderly to ensure their physical health. And expand the social networks of the elderly by providing leisure places for the elderly, senior clubs, etc. to improve their psychological well-being and health. This stimulates their overall perceived health, thereby improving SWB.

In addition, because of the relationship between intergenerational support and the perceived health of elders, aging policies should pay more attention to the role of the parent-child relationship. Especially in the current environment of the COVID-19 epidemic, intergenerational support should be used to improve the perceived health of the elderly and SWB. When the society cannot meet the basic needs of the elderly, it can advocate intergenerational communication, promoting the exchange of emotional or material support, to improve the self-assessment health of seniors and happiness in life. And young children should provide old parents with adequate life care to prevent the elderly from feeling incapacitated, which is beneficial to perceived health, increasing their SWB.

It is undeniable that this study had certain limitations. Firstly, the research used cross-sectional data, which can analyze the relationship between variables but cannot explore the causal link. Thus, it is crucial to actively obtain the support of the long-term data results. Secondly, second-hand data was utilized with issues of timeliness and data reconciliation. Although we tried to select the latest and appropriate date in CGSS, the problem of stale data cannot be avoided, which may not reflect the current situation well. This requires future research to actively collect first-hand data and supplement updated research conclusions. Thirdly, the measures of perceived health and SWB in this study were all measured in a single dimension. Even though some scholars said that the difference between multi-dimensional and single-dimensional measurement methods was not obvious (Ngamaba et al., 2018). More multi-dimensional measurement methods still need to be developed to improve accuracy. Fourthly, this data was collected in China, so the results were likely to be explained in the Chinese context rather than in other countries. A broader range of research and comparison is necessary. Finally, it has to be admitted that the effect of income on the elderly’s SWB. But due to the availability of data, we were able to incorporate income into the model, which requires the research to add more detailed data to supplement this model in the future.

Supplemental Material

sj-docx-1-sgo-10.1177_21582440231159014 – Supplemental material for Intergenerational Support and Subjective Wellbeing of the Elderly in Mainland China: The Role of Perceived Health

Supplemental material, sj-docx-1-sgo-10.1177_21582440231159014 for Intergenerational Support and Subjective Wellbeing of the Elderly in Mainland China: The Role of Perceived Health by Na Li and Mang He in SAGE Open

Footnotes

Data used were from the 2017 Chinese General Social Survey (CGSS) in this research,originally collected by Renmin University of China. The authors appreciated the assistance in providing data of 2017 CGSS.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,authorship,and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research,authorship,and/or publication of this article: This work was supported by the National Social Science Fund of China [Grant number 19BSH006,22BSH132].

Ethical Approval

This article does not contain any studies with human participants performed by the author(s).

ORCID iD

Na Li

Supplemental Material

Supplemental material for this article is available online.

Data Availability

The raw data that support the findings of this study are openly available on the official website of the Chinese General Social Survey at http://cgss.ruc.edu.cn/,reference number 2017CGSS. And data in this study can be obtained by connecting with the corresponding author.

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