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Although the world population has been aging at an unprecedented rate, the speed of change is considerably different depending on national history and life circumstances. The association between age and culture can be best understood in the light of the life span perspective and the family. Different cultural backgrounds affect individuals’ aging experiences contemporaneously and cumulatively. Family is both the conveyer and interpreter of culture. The life span attachment model and the convoy model emphasize that close relationships accumulate over time and differentially affect the aging process and, consequently, the physical and psychological well-being of individuals who live in different cultural milieus.
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- Aging and Demographics
- Aging, Culture, and Families
- Cultural Diversity and Aging
- Age, Culture, and Social Relations
- Cultural Influences on the Health of Aging People
- Summary and Conclusions
The study of aging has a long and ancient history, with notable comments having come from historical luminaries such as Aristotle, Socrates, and Plato. Despite the increasingly youth-oriented society, the modern study of aging has garnered increased attention during recent years for many reasons, not the least of which is recognition of the significantly changing world demography. This research paper first presents a brief overview of these changes. It then considers the association between aging and culture, noting the role of family and cultural diversity as well as the implications of both family and culture for health and well-being among the elderly. The research paper closes with a consideration of how culture shapes aging and health in the United States as well as around the world.
2. Aging And Demographics
Changing world demographics are nowhere as dramatic as they are with respect to the age structure of the world population. According to the UN Populations Division and the U.S. Census, the world is graying at an unprecedented rate. For example, comparison of the percentages of people who will be age 60 years or over in the years 2005 and 2030 indicates that approximately 20% of the European population will be at least 60 years old in 2005 and that 30% of the population will share that status by 2030. The situation in the United States is not quite as dramatic, but the increase is still noteworthy. In 2005, 17% of the U.S. population will be age 60 years or over, and in the year 2030, one-quarter of the U.S. population will be in that age bracket. The figures are much smaller for Latin America, where 9 and 15% of the population are expected to be at least 60 years old in 2005 and 2030, respectively. The lowest figures are for Africa, where only 5% of the population is currently age 60 years or over and a mere 7% is expected to reach that age bracket by 2030. The AIDS epidemic is actually reducing the life expectancy in some African countries. These differences make it clear that the age distribution of the world is changing differently, depending on national history and current life circumstances. Interestingly, and perhaps contrary to the assumptions of most people, the United States ranks only 28th in ‘‘aging’’ among the oldest countries of the world, with most European countries and Japan reporting older populations. Although these changing age structures reflect increased longevity, this longevity is due mostly to changes at the other end of the life span. That is, fewer children are dying in childbirth, thereby increasing the numbers of people who will live to old age, and fewer children are being born, thereby reducing the proportion of a population of young people and naturally increasing the proportion of older people in each society. The decline in fertility has reached critical proportions in many countries, including Italy, Greece, Sweden, Japan, and Spain. Although fertility has been declining in the United States, it has not reached the crisis levels being experienced in other parts of the world.
3. Aging, Culture, and Families
The effort to understand the association between age and culture must include consideration of both the life span perspective and the family. The life span perspective incorporates a long-term view of the growth and maturity of individuals throughout their lifetimes on multiple dimensions. Development on these dimensions is influenced by previous developmental periods that can manifest through stability or change as well as through continuity or discontinuity. Consequently, individuals become more different from each other as they develop over time. This is noteworthy because life span development both affects and is affected by the cultural milieus within which individuals live. During recent times, those cultural milieus have been changing in unprecedented ways in the United States as well as around the world. Examples of cultural milieus include specific individual experiences (e.g., ethnic identity) as well as more universal experiences (e.g., the unprecedented advances in technology experienced during recent years).
Although the life span perspective focuses on the individual, any effort to understand the aging experience must also include the families within which most people age. The family usually surrounds an individual with a protective convoy that nourishes and supports the individual as he or she faces the challenges of life. The family also is often the embodiment of the cultural perspective that the individual values. Just as each individual emerges as an older person who has evolved throughout his or her lifetime, so too does the individual bring that lifetime of growth and development to the family. At the same time, the family also evolves. A family might begin as a young couple who are the parents of a small child and evolve to a family composed of an adult child with aging parents and later to a family that includes grandparents with adult children and grandchildren. The family can be thought of as the vessel within which the individual experiences culture. Although people experience culture at multiple levels—as an individual, as a family member, and as a member of society—it is the family that most often is both the conveyor and interpreter of the culture. The United States may not be the oldest country in today’s industrialized world, but the increased longevity of Americans means that most individuals will at some point be members of three-, four-, or even five-generation families. Hence, the role of the older person as a family member in both promoting and maintaining culture has been steadily increasing.
4. Cultural Diversity And Aging
The United States has, at least ostensibly, always embraced a commitment to the blending of many cultures. This phenomenon is perhaps best exemplified in the term ‘‘melting pot.’’ This term was used to refer to the blending of many cultures, but these cultures were mostly Western European. Although immigrants also came from China (e.g., to work on the railroads) and from Africa (e.g., to work as slaves), those immigrants were generally not among the ‘‘blended.’’ An important new development in the cultural influences on aging in the United States is the recent immigration from different parts of the world, namely, Central and Latin America, the Middle East, and Southeast Asia. The nature of this immigration is important not only because it represents different cultural influences but also because the immigration patterns are affecting how the United States ages. As noted earlier, the country is aging rapidly, but particularly important is the fact that among certain ethnic and racial minority groups (i.e., the ‘‘new’’ immigrant groups), aging is taking place at an even more rapid pace because more older people are immigrating to be with their children. Hence, as the U.S. population ages, it is also becoming more diverse both racially and ethnically. This will pose a challenge as different immigrant groups seek to maintain their identities while at the same time embracing the American culture.
Several kinds of aging experiences that will be directly influenced by cultural background and perspective can be identified. For example, some older people came to the United States as young immigrants and are now aging. Having arrived during childhood or early adulthood, they are familiar with the American culture and understand it, often while maintaining some ‘‘old world’’ values. At the same time, their children and grandchildren were most likely born in the United States and have embraced only American values. Some problems may arise if, as these individuals age, they identify more strongly with their cultures of origin, especially in terms of their expectations about the role of families and the experience of aging.
Potentially even more problematic is the phenomenon of immigrating in old age. Some people came to the United States to join their children, who had immigrated earlier and settled in the country. The motivation could be emotional ties (i.e., a desire to be close to their children as they age), or it could be based on pragmatic need (i.e., the expectation that children will care for their aging parents). The potential for conflict in such families is even greater because the elderly immigrants are less likely to have embraced American values; therefore, the situation may exist where parents and their adult children have fundamentally different expectations about the aging experience.
It is clear that people, whether they recognize it or not, experience age through a cultural lens. Thus, the changing racial and ethnic population of the United States represents a unique group of individuals. These different cultural backgrounds affected their individual lifetime experiences as children, adolescents, and adults. It will, of course, also affect their aging experiences both cumulatively and contemporaneously. Each cultural group has a unique history. For example, consider the case of Cuban immigrants in Miami, Florida, who fled Fidel Castro’s dictatorship and arrived in the United States feeling forcibly expelled from their homeland. When they arrived in the country, they found very sympathetic Americans who believed that Castro was an evil and unjust dictator who was treating Cuban people unfairly. On the other hand, Middle Easterners also have come to the United States to escape an unpopular dictator, but during recent times, Americans have become more hostile, rather than less hostile, toward people from the Middle East. In addition, despite the fact that Middle Easterners also came to escape an unjust dictator, war, and oppression, they are currently viewed with suspicion, unkindness, and resentment. But another current example indicates that these more recent reactions are not ubiquitous. Interestingly, although the United States is experiencing increased hostilities with North Korea, this hostility does not seem to extend to Koreans in this country. They also fled a homeland torn by war, but somehow Americans are more accepting of their presence and their culture. The attitudes of the American public certainly influence the aging experience of both early and later immigrants.
Although these comments have addressed the general concept of culture, there are culture-specific expectations and beliefs concerning health and aging. The next section briefly considers the health implications of culture on aging persons and their family.
5. Age, Culture, And Social Relations
Individuals age within families, communities, and society. They interact with these organized structures most frequently through social relations. Social scientists have studied social relations extensively, and it is increasingly understood that social relations affect both the psychological health and physical health of people of all ages. This is evident in models emerging from the childhood literature, such as the life span attachment model, as well as in those emerging from the adult literature, such as the convoy model of social relations. Both of these models emphasize that social relations accumulate over time and influence both contemporaneous and longitudinal choices. These literatures have identified several elements of social relations that influence both morbidity and mortality. In the convoy model, as well as in other adult social relations models, these elements include structural characteristics such as the number, age, gender, role relationship, and years known of network members; support exchanged with network members such as love, tangible aid, and advice; and evaluation of these relationships, that is, whether one feels that they are positive or negative and whether one is satisfied and/or happy with them. Although some elements of social relations transcend age and culture, other aspects of social relations are fundamentally influenced by culture and age. For example, most people of all ages have close social relations with their parents, spouses, and children. Europeans tend to include more extended family members among their close social relations, whereas this is less true among Americans, who are more likely to include friends.
Social relations involve the exchange of social support in all cultures. How often these supports are exchanged, as well as who exchanges them, what supports are exchanged, and when the supports are exchanged, often varies by age and cultural expectations. Although it is common across cultures to expect that parents will provide for their children when their children are young, the degree to which parents continue to do so when those children become adults, or the way in which the expectation might reverse such that parents expect support from their adult children, varies by culture and country. In a recent Italian court case, parents were sued by their employed, 35-year-old son because he was reluctant to accede to his parents’ wishes that he move out and live on his own. The Italian court ruled in favor of the son, requiring the parents to continue providing room and board for as long as the son so desired. A similar case would be unheard of in the United States because it is nonnormative for an able adult son to live with his parents and because no court would sustain such a petition. Similarly, in the United States, it is common for parents to attempt to provide for their adult children, for example, through gifts, favors, and loans. But in Japan, the culture assumes the opposite; that is, no matter what age, children are understood to be in a state of indebtedness to their parents and, thus, are expected to be constantly in the position of providing to their parents rather than receiving from them.
There are many factors that influence how social relations are evaluated. There are objective characteristics that influence this evaluation, but a solid accumulation of empirical evidence indicates that significant subjective characteristics influence this evaluation as well. Subjective evaluation could be considerably different depending on the age and culture within which the social relations are embedded. The Italian son just described would rate his parental support received as poor, whereas an American son would not. An adult American son might be dissatisfied and unhappy if his parents did not provide a college fund or a down payment on a house, whereas the lack of either of these in another culture would generate no parallel dissatisfaction or unhappiness. For older family members, it is clear that their expectations vary depending on both age and culture. Interestingly, in the United States, some evidence indicates that younger people expect to provide more support than their elders expect to receive, whereas in other countries, parents report rather high expectations of what their children should provide. Regardless of the cultural convention regarding who is in an individual’s social network or an objective assessment of what is exchanged, evaluation of social relations varies considerably. This variation, although influenced by many factors, has been well documented in the influence of culture on health and well-being.
6. Cultural Influences On The Health Of Aging People
Different cultural experiences, traditions, and values have direct implications for the expectations of both elders and their families. These expectations range from minor considerations (e.g., concerning customs around favorite foods or holiday traditions) to more significant ones (e.g., concerning family roles and responsibilities).
There is clear evidence that culture influences health. Some examples are illustrative. It has been documented that elderly Japanese living in Japan are much more likely to die of a stroke than are elderly Japanese living in the United States, where the leading cause of death has been cardiovascular disease. This difference has been traced to dietary differences in ethnically Japanese people living in Japan versus those living in the United States. Similarly, hypertension is a major health problem among people of African descent living in the United States but is relatively rare among Africans living in Africa. Researchers have suggested that this difference is caused by the stressful life circumstances of racial discrimination experienced in the United States. Another interesting example is menopause. Research in medicine, epidemiology, and anthropology has consistently documented that women in many countries (e.g., Japan) experience fewer and/or lighter menopause symptoms (e.g., hot flash, insomnia, depression) than do American women. Although a consensus explanation has not yet been reached, these differences have been attributed to diet (e.g., soybeans) and cultural attitude toward (e.g., acceptance of) the physical and physiological changes associated with aging. A final and compelling argument for the influence of culture on health is that, regardless of the health differences evident among people of different countries, by the third generation all immigrants exhibit patterns more similar to other Americans than to people from their countries of origin.
Cultural expectations of family roles and responsibilities are critical when they have a direct impact on an older person’s health and expectations concerning health care. Some simple examples are illuminating. In some countries (e.g., Japan), it is much more common for older people to live with their adult children. The differences in customs have both positive and negative implications. In Japan, older people often live in their own home, and an adult child—often the eldest son— continues to live at home with his wife and children. Although this is a traditional custom that has been changing in modern Japan, it does mean that traditionally a live-in relative attended to the health care needs of a family’s oldest members. This live-in relative was most often not the eldest son but rather his wife, that is, the daughter-in-law. Much has been made of the advantages of coresidence for the elderly in terms of meeting their health care and other needs as they get older. However, social scientists have increasingly documented that not all such arrangements are ideal. There is often tension between the daughter-in-law and her parents-in-law as well as between the son and his parents. This coresidential custom is much less common in the United States, and when it does occur, it is often the case that a parent moves in with an adult child, although the opposite may be the case when the adult child is impoverished or experiencing a life crisis such as divorce or job loss. Under the coresidential condition where the elder moves in with a child, the power dynamics are reversed in terms of the traditional American family dynamics as well as the situation just described in Japan. Tension can arise in this case as well, although health care needs and expectations are also more likely to be met. Certainly, these examples provide persuasive testimony concerning the influence of culture on the health experience of aging people.
7. Summary And Conclusions
With the radically changing world demographics leading to a significant increase in the number of older people, it is critical to attend to those factors that positively or negatively affect the experience of aging. Although culture is an important influence, one should be aware that there are also other factors that influence aging and family relations such as socioeconomic status, race, and industrialization. Therefore, culture should be neither overlooked nor overestimated. It remains for researchers and clinicians to identify when culture is a primary factor and when it is not and to determine at what point one should seek to optimize the experience of aging both within and across cultures.
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