Neighborhood Support and Aging-in-Place Preference Among Low-Income Elderly Chinese City-Dwellers

OBJECTIVES: Preferences for aging-in-place are unclear among low-income elderly Chinese city-dwellers, who are more likely to be geographically bound, to have little care support, but possess strong filial values and family cohesiveness. This study investigated the preferences for aging-in-place and its contributing neighborhood factors among low-income Chinese elderly in a metropolitan city. METHOD: We conducted interviews with 400 older people residing in public housing estates in Hong Kong. RESULTS: The majority of low-income elderly persons (80.4%) prefer to age in place even if their health and functioning has deteriorated beyond independent living. Logistic regression showed that (a) having very low income (<HK$2,000/month) and not receiving means-tested welfare predicted lower preference for this option [odd ratios (OR) = 0.27]; and (b) having medical facilities within reach (OR =9.02); and (c) an elderly center in the area (OR = 2.98) were associated with a preference for aging in place, after controlling for demographic, and functioning characteristics. DISCUSSION: Low-income elderly Chinese city-dwellers prefer to age in place, given appropriate neighborhood support. These findings can be interpreted in light of Lawton's ecological theory of aging and suggest a service model similar to the Naturally Occurring Retirement Community with Supportive Service Programs.