Unmet family expectations linked to increased mortality among older Chinese Americans

Rutgers study finds gaps in filial expectations affect longevity of older Chinese Americans

Filial piety is the traditional Chinese value of caring for one’s aging parents and it plays an important role in family and intergenerational relationships. When older Chinese adults don’t receive the care they expect, however, it can lead to an increased risk of mortality, according to a study from Rutgers Institute for Health, Health Care Policy and Aging Research.

The study, published in the August 2020 edition of Aging and Mental Health, assessed the discrepancy between older Chinese Americans’ expectations versus receipt of six domains of filial piety: care, respect, greet, make happy, obey, and financial support.

“Strong intergenerational relationships play a protective role in the health and well-being of the aging population,” said lead author Mengting Li, a researcher at the Institute for Health and assistant professor at Rutgers School of Nursing. “Filial expectation and receipt are the belief and practice of filial piety, and discrepancies between the two have significant consequences to older Chinese adults’ psychological well-being and mortality. More must be done to preserve filial piety and reduce discrepancy among the younger Chinese American generations.”

Researchers interviewed 3,021 older Chinese American immigrants whose mean age was 73 and who had at least one child. They compared mortality risks among the six domains across three groups: no filial discrepancy, filial expectation above receipt, and filial expectation below receipt.

They found that higher expectations over receipt of respect, which includes listening to and consulting with aging parents, and greet, which involves expressing gratitude to aging parents, was associated with higher risks of mortality. When receipt of care exceeded expectations, participants had a lower risk of mortality. The remaining domains did not significantly affect longevity.

“Although further qualitative research is necessary to understand the filial discrepancy experience and how it affects longevity, the study has important practical implications for social and health care services and policies focused on older Chinese American adults,” Li said.

The study recommends that organizations adopt a culturally relevant approach to providing social services to older Chinese American immigrants. Action should be taken to reduce mortality risk by addressing filial discrepancy and awareness about expectations versus receipt in the areas of respect and greet. Educational programs and services should be created to foster children’s filial beliefs and behavior in intergenerational interactions. And particular attention should be paid to greeting, listening, and seeking advice from parents to improve the protective role of family for older adults.