家庭變故對中老年人健康軌跡之影響：成長模型之應用

The Influence of Family Hardship on Health Trajectory among Middle-aged and Elderly in Taiwan: An Application of Hierarchical Growth Modeling

10.6342/NTU201602376

謝淑玲

家庭變故 ； 成長模型 ； 自評不健康 ； 因健康問題而影響生活 ； family hardships ； growth model ； poor self-rated health ； health problems

國立臺灣大學健康政策與管理研究所學位論文

2016年

碩士

陳端容

繁體中文

研究背景：臺灣老年人口比例上升，並即將進入高齡社會。社會強調家庭價值，家庭除了是社會組成的重要元素，亦是中老年人情感與經濟的來源基礎，為老年人提供照護的功能、支持個人生活，並提供社會支持，過去研究發現自身及家庭成員經歷的事件都會影響中老年人健康。然而，過去對於中老年人健康狀況的縱貫性研究聚焦在追蹤時間結束當下之健康結果，較少探討健康隨著時間增加的改變狀況。本研究之目的在於瞭解中年人及老年人之自評健康及因健康而影響生活變化軌跡樣貌；重大家庭變故對中老年人自評健康及因健康問題而影響生活軌跡的影響，及其中之年齡及性別差異。 研究方法：本研究藉由分析「華人家庭動態資料庫」（Panel Study of Family Dynamics, PSFD）2005年至2014年之追蹤資料，以階層線性迴歸模型（Hierarchical Linear Model, HLM）之成長模型（Growth Model）分析臺灣中老年人經歷重大家庭變故與其健康狀況的關係。研究樣本之排除條件為2005年未滿40歲、2005年沒有任何家庭成員者、以及時間點資料少於三個，納入研究的樣本共1955位。 研究結果：本研究結果發現臺灣中老年人之自評不健康與時間呈線性成長關係；只有2005年時為65歲或以上受訪者有因健康問題而影響生活的機率會隨時間增加。經濟自主狀況、家庭關係品質、喪偶狀況及父母過世狀況是影響個體自評健康的重大家庭變故，這樣的結果有年齡及性別差異。個體因健康問題而影響生活的狀況會受經濟自主能力及家庭關係品質影響，同樣有年齡及性別差異。 結論：影響個體自評不健康與因健康問題而影響生活的因素不同，當中亦有性別及年齡差異，在執行介入時應考慮不同性別及年齡個體的需求。

Background: Studies have shown that difficult life events in family have adverse impact on family members. However, most studies focused on a particular health outcome at a certain point of time, usually the endpoint of a follow-up period. This study aims to understand 1) the trajectories of self-rated health and health problems change from 2005 to 2014 in a sample of middle-aged and elderly subjects in Taiwan, 2) the impact of family hardships on the trajectories of self-rated health and health problems change, and whether there is age and gender-specific pattern of health change trajectories. Method: The study analyzes the data of Panel Study of Family Dynamics (PSFD) from 2005 to 2014. Multilevel growth models were conducted. Subjects aged above 40, have at least one family member in 2005, and has at least three time points of data were included in the study. A total of 1955 subjects were included. Result: Results indicated that, for all subjects, self-rated health deteriorated as time went by from 2005 to 2014. However, only for subjects who were aged 65 or above in 2005, health problems became worse as time went by from 2005 to 2014. Low quality of family relationship, widowhood and parental loss are the factors that predicted the poor health trajectory. For men, widowhood and parental loss are crucial predictors, yet poor quality of family relationship can predict poor health trajectory for women. Conclusion: The results suggest that poor health trajectories is associated with family hardships, and there are age and gender differences. We should be aware of the differences when implementing interventions, in order to fulfill different needs of different individuals.

1. 朱為民（2015）。職涯晚期失業對於台灣中老年人全死因死亡率與失能的影響（未出版之碩士論文）。中山醫學大學，臺中市。
   連結：
2. 朱敬一（2002）。華人家庭動態資料庫的建立：第一年計畫（RI1999）（C00102）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00102-1
   連結：
3. 朱敬一（2002）。華人家庭動態資料庫的建立：第二年計畫（RI2000）（C00103_3）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00103_3-1
   連結：
4. 朱敬一（2002）。華人家庭動態資料庫的建立：第二年計畫（RII2000）（C00103_4）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00103_4-1
   連結：
5. 朱敬一（2002）。華人家庭動態資料庫的建立：第三年計畫（RII2001）（C00104_2）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00104_2-1
   連結：
6. 朱敬一（2002）。華人家庭動態資料庫的建立：第三年計畫（RIII2001）（C00104_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00104_1-1
   連結：
7. 朱敬一（2003）。華人家庭動態資料庫的建立：第四年計畫（RIII&RIV2002）（C00105_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00105_1-1
   連結：
8. 朱敬一（2004）。華人家庭動態資料庫的建立：第五年計畫（RI2003）（C00106_2）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫。doi:10.6141/TW-SRDA-C00106_2-1
   連結：
9. 朱敬一（2004）。華人家庭動態資料庫的建立：第五年計畫（RIV2003&RV2003）（C00106_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00106_1-1
   連結：
10. 朱敬一（2005）。華人家庭動態資料庫的建立：第六年計畫（RII、RV、RVI2004）（C00139_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00139_1-1
    連結：
11. 吳淑瓊、莊坤洋（2001）。在地老化：台灣二十一世紀長期照護的政策方向。臺灣公共衛生雜誌，20(3)，192-201。
    連結：
12. 李建德、柯乃熒、徐畢卿（2006）。照顧精神病患之經驗-男性家屬之觀點。實證護理,，2(3)，180-188。
    連結：
13. 李美玲、楊亞潔、伊慶春（2000）。家務分工：就業現實還是平等理念？。台灣社會學刊，24，59-88。
    連結：
14. 林佳臻、杜明燦、陳俊傑、陳宣志、顏啟華、李孟智（2013）。台灣地區老人自覺健康狀況相關因子之探討。台灣老年醫學暨老年學雜誌，8(2)，75-89。
    連結：
15. 陳惠真、王香蘋、羅慶徽、謝瀛華（2005）。台灣老人健康狀況初探：1989年至 1999年。臺灣家庭醫學雜誌，15(1)，25-35。
    連結：
16. 簡錦漢（2007）。華人家庭動態資料庫的建立：第七年計畫（RR2005）（C00164_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00164_1-1
    連結：
17. 簡錦漢（2008）。華人家庭動態資料庫的建立：第八年計畫（RR2006）（C00170_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00170_1-1
    連結：
18. 簡錦漢（2011）。華人家庭動態資料庫的建立：第九年計畫（RR2007）（C00229_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00229_1-1
    連結：
19. 簡錦漢（2012）。華人家庭動態資料庫的建立：第十一年計畫（RR2009）（C00284_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00284_1-1
    連結：
20. 簡錦漢（2012）。華人家庭動態資料庫的建立：第十年計畫（RR2008）（C00256_2）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00256_2-1
    連結：
21. 簡錦漢（2013）。華人家庭動態資料庫的建立-第十二年計畫: RR2010（C00297_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00297_1-1
    連結：
22. 簡錦漢（2013）。華人家庭動態資料庫的建立-第十三年計畫: RR2011（C00298_1）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。doi:10.6141/TW-SRDA-C00298_1-1
    連結：
23. Arber, S., & Cooper, H. (1999). Gender differences in health in later life: the new paradox?. Social science & medicine, 48(1), 61-76.
    連結：
24. Arber, S., & Ginn, J. (1993). Gender and inequalities in health in later life. Social science & medicine, 36(1), 33-46.
    連結：
25. Bangerter, L. R., Zarit, S. H. & Fingerman, K. L. (2016). Moderators of Mother’s Problems on Middle-Aged Offspring Depressive Symptoms. The Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 71(1), 41-48.
    連結：
26. Berg, C. A., & Upchurch, R. (2007). A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychological bulletin, 133(6), 920.
    連結：
27. Bernard, S. L., Kincade, J. E., Konrad, T. R., Arcury, T. A., Rabiner, D. J., Woomert, A., ... & Ory, M. G. (1997). Predicting mortality from community surveys of older adults: the importance of self-rated functional ability. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 52(3), S155-S163.
    連結：
28. Bosque-Prous, M., Espelt, A., Sordo, L., Guitart, A. M., Brugal, M. T., & Bravo, M. J. (2015). Job Loss, Unemployment & the Incidence of Hazardous Drinking during the Late 2000s Recession in Europe among Adults Aged 50–64 Years. PLos One,　10(10), e0140017.
    連結：
29. Chan, D., Kwok, A., Leung, J., Yuen, K., Choy, D., Leung, P. C. (2012). Association between life events & change in depressive symptoms in Hong Kong Chinese elderly. Journal of Affective Disorders, 136, 963-970.
    連結：
30. Charles, K. K. (2004). Is retirement depressing?: labor force inactivity and psychological well-being in later life. Research in Labor Economics, 23, 269-299.
    連結：
31. Cheng, Y. H., Chi, I., Boey, K. W., Ko, L. S. F., & Chou, K. L. (2002). Self-rated economic condition and the health of elderly persons in Hong Kong. Social science & medicine, 55(8), 1415-1424.
    連結：
32. Clayton, P. J. (1974). Mortality and morbidity in the first year of widowhood. Archives of general psychiatry, 30(6), 747.
    連結：
33. Clémence, A., Karmaniola, A., Green, E. G. T., & Spini, D. (2007). Disturbing life events & wellbeing after 80 years of age: a longitudinal comparison of survivors & the deceased over five years. Ageing & Society, 27 (02), 195-213.
    連結：
34. Coe, N. B., & Van Houtven, C. H. (2009). Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health economics, 18(9), 991-1010.
    連結：
35. Coe, N. B., & Zamarro, G. (2011). Retirement effects on health in Europe. Journal of Health Economics, 30(1), 77-86.
    連結：
36. Dannefer, D. (1988). Differential Gerontology and the Stratified Life Course: Conceptual and Methodological Issues. In Maddox, G. L. & Lawton, M. P. (Eds.), Annual Review of Gerontology & Geriatrics, Volume 8: Varieties of Aging (pp. 3-68) New York: Springer Publishing Company.
    連結：
37. Dave, D., Rashad, I., & Spasojevic, J. (2006). The effects of retirement on physical and mental health outcomes (No. w12123). National Bureau of Economic Research.
    連結：
38. Depner, C. E., & Ingersoll-Dayton, B. (1985). Conjugal social support: Patterns in later life. Journal of Gerontology, 40(6), 761-766.
    連結：
39. DeSalvo, K. B., Bloser, N., Reynolds, K., He, J., Muntner, P. (2006). Mortality Prediction with a Single General Self-Rated Health Question: A Meta-Analysis. Journal of General Internal Medicine, 21(3), 267-275.
    連結：
40. Dunlop, D. D., Hughes, S. L., & Manheim, L. M. (1997). Disability in activities of daily living: patterns of change and a hierarchy of disability. American journal of public health, 87(3), 378-383.
    連結：
41. Ferraro, K. F. (1984). Widowhood and social participation in later life: Isolation or compensation? Research on Aging, 6, 451–468.
    連結：
42. Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of health and social behavior, 21, 219-239.
    連結：
43. Forman, D. E., Berman, A. D., McCabe, C. H., Baim, D. S., & Wei, J. Y. (1992). PTCA in the Elderly: The “Young‐Old” versus the “Old‐Old”. Journal of the American Geriatrics Society, 40(1), 19-22.
    連結：
44. Gibbons, C., Creese, J., Tran, M., Brazil, K., Chambers, L., Weaver, B., & Bédard, M. (2014). The psychological and health consequences of caring for a spouse with dementia: A critical comparison of husbands and wives.Journal of women & aging, 26(1), 3-21.
    連結：
45. Ginsberg, G. M., Hammerman-Rozenberg, R., Cohen, A., & Stessman, J. (1999). Independence in instrumental activities of daily living and its effect on mortality. Aging (Milan, Italy), 11(3), 161-168.
    連結：
46. Goldman, N., Korenman, S., & Weinstein, R. (1995). Marital status and health among the elderly. Social science & medicine, 40(12), 1717-1730.
    連結：
47. Gove, W. R. (1984). Gender differences in mental and physical illness: The effects of fixed roles and nurturant roles. Social science & medicine, 19(2), 77-84.
    連結：
48. Grant, M. D., Piotrowski, Z. H., & Chappell, R. (1995). Self-reported health and survival in the longitudinal study of aging, 1984–1986. Journal of Clinical Epidemiology, 48(3), 375-387.
    連結：
49. Greenhaus, J. H., & Beutell, N. J. (1985). Sources of conflict between work and family roles. Academy of management review, 10(1), 76-88.
    連結：
50. Groffen, D. A., Bosma, H., van den Akker, M., Kempen, G. I., & van Eijk, J. T. M. (2008). Material deprivation and health-related dysfunction in older Dutch people: findings from the SMILE study. The European Journal of Public Health, 18(3), 258-263.
    連結：
51. Grundy, E. & Holt, G. (2000). Adult life experiences & health in early old age in Great Britain. Social Science & Medicine, 51, 1061-1074.
    連結：
52. Haan, M., Kaplan, G. A., & Camacho, T. (1987). Poverty and health prospective evidence from the alameda county study. American journal of epidemiology, 125(6), 989-998.
    連結：
53. Hays, J. C., Schoenfeld, D., Blazer, D. G., & Gold, D. T. (1996). Global self-ratings of health and mortality: Hazard in the North Carolina Piedmont. Journal of Clinical Epidemiology, 49(9), 969-979.
    連結：
54. Heistaro, S., Jousilahti, P., Lahelma, E., Vartiainen, E., & Puska, P. (2001). Self rated health and mortality: a long term prospective study in eastern Finland. Journal of Epidemiology and Community Health, 55(4), 227-232.
    連結：
55. Hewitt, B., & Turrell, G. (2011). Short-term functional health and well-being after marital separation: Does initiator status make a difference?. American journal of epidemiology, 173(11), 1308-1318.
    連結：
56. Hewitt, B., Turrell, G., & Giskes, K. (2010). Marital loss, mental health and the role of perceived social support: findings from six waves of an Australian population based panel study. Journal of epidemiology and community health, jech-2009.
    連結：
57. Hirve, S., Juvekar, S., Sambhudas, S., Lele, P., Blomstedt, Y., Wall, S., ... & Ng, N. (2012). Does self-rated health predict death in adults aged 50 years & above in India? Evidence from a rural population under health & demographic surveillance. International journal of epidemiology, 41(6), 1719-1727.
    連結：
58. Hogerbrugge, M. J., & Silverstein, M. D. (2014). Transitions in Relationships With Older Parents: From Middle to Later Years. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(3), 481-495.
    連結：
59. Holmes, T. H., & Rahe, R. H. (1967). The social adjustment rating scale. Journal of Psychosomatic Research, 11, 213-218.
    連結：
60. Idler, E. L., & Benyamini, Y. (1997). Self-rated health & mortality: a review of twenty-seven community studies. Journal of health & social behavior, 38, 21-37.
    連結：
61. Isengard, B., & Szydlik, M. (2012). Living apart (or) together? Coresidence of elderly parents & their adult children in Europe. Research on Aging. Advance online publication. http://dx.doi.org/10.1177/0164027511428455.
    連結：
62. Johnston, D. W. & Lee, W. S. (2009). Retiring to the good life? The short-term effects of retirement on health. Economics Letters, 103(1), 8-11.
    連結：
63. Kahn, J. R., & Pearlin, L. I. (2006). Financial strain over the life course and health among older adults. Journal of Health and Social Behavior, 47(1), 17-31.
    連結：
64. Kang, H., Johnson, D., & Rolling, P. (2013). Association between marital status, health & family network in later life. Journal of Family & Consumer Sciences, Summer, 105(3), 27-32.
    連結：
65. Kaplan, G. A., Goldberg, D. E., Everson, S. A., Cohen, R. D., Salonen, R., Tuomilehto, J., & Salonen, J. (1996). Perceived health status and morbidity and mortality: evidence from the Kuopio ischaemic heart disease risk factor study. International Journal of Epidemiology, 25(2), 259-265.
    連結：
66. Kawada, T. (2003). Self-rated health & life prognosis. Archives of Medical Research, 34, 343–347.
    連結：
67. Kraaij, V., Arensman, E., & Spinhoven P. (2002). Negative Life Events & Depression in Elderly Persons: A Meta-Analysis. Journal of Gerontology: Series b, 57 (1), 87-94.
    連結：
68. Lazarus, R. S. (1966). Psychological stress and the coping process. New York: McGraw-Hill.
    連結：
69. Li, L. W., & Seltzer, M. M. (2003). Parent care, intergenerational relationship quality, and mental health of adult daughters. Research on Aging, 25(5), 484-504.
    連結：
70. Lichtenstein, P., Gatz, M., & Berg, S. (1998). A twin study of mortality after spousal bereavement. Psychological medicine, 28(03), 635-643.
    連結：
71. Long, S. O., & Harris, P. B. (2000). Gender and elder care: Social change and the role of the caregiver in Japan. Social Science Japan Journal, 3(1), 21－36.
    連結：
72. Luhmann, M., Hofmann, W., Eid, M., Lucas, R. E. (2012). Subjective Well-Being & Adaptation to Life Events: A Meta-Analysis. Journal of Personality & Social Psychology, 102 (3), 592-615.
    連結：
73. Lundin, A., Falkstedt, D., Lundberg, I., & Hemmingsson, T. (2014). Unemployment & coronary heart disease among middle-aged men in Sweden: 39 243 men followed for 8 years. Occupational and Environmental Medicine, 71, 183–188.
    連結：
74. Lundin, A., Lundberg, I., Hallsten, L., Ottosson, J., Hemmingsson, T. (2010) Unemployment & mortality—a longitudinal prospective study on selection & causation in 49321 Swedish middle-aged men. Journal of Epidemiology and Community Health, 64, 22-28.
    連結：
75. Manor, O., & Eisenbach, Z. (2003). Mortality after spousal loss: are there socio-demographic differences?. Social science & medicine, 56(2), 405-413.
    連結：
76. Manzoli, L., Villari, P., Pirone, G. M., & Boccia, A. (2007). Marital status and mortality in the elderly: a systematic review and meta-analysis. Social science & medicine, 64(1), 77-94.
    連結：
77. Martikainen, P., & Valkonen, T. (1996). Mortality after death of spouse in relation to duration of bereavement in Finland. Journal of epidemiology & community health, 50(3), 264-268.
    連結：
78. Martikainen, P., & Valkonen, T. (1996). Mortality after death of spouse in relation to duration of bereavement in Finland. Journal of epidemiology and community health, 50(3), 264-268.
    連結：
79. McDonough, P., Sacker, A., & Wiggins, R. D. (2005). Time on my side? Life course trajectories of poverty and health. Social science & medicine, 61(8), 1795-1808.
    連結：
80. Meadows, S. O. (2009). Family structure and fathers' well-being: trajectories of mental health and self-rated health. Journal of Health and Social Behavior,50(2), 115-131.
    連結：
81. Meneton, P., Kesse‑Guyot, E., Méjean, C., Fezeu, L., Galan, P., Hercberg, S., & Ménard, J. (2015). Unemployment is associated with high cardiovascular event rate & increased all‑cause mortality in middle‑aged socially privileged individuals. International Archives of Occupational and Environmental Health, 88, 707–716.
    連結：
82. Minkler, M., Fuller-Thomson, E., & Guralnik, J. M. (2006). Gradient of disability across the socioeconomic spectrum in the United States. New England Journal of Medicine, 355(7), 695-703.
    連結：
83. Mirowsky, J., & Ross, C. E. (2001). Age and the effect of economic hardship on depression. Journal of health and social behavior, 42, 132-150.
    連結：
84. Morris, J. K., Cook, D. G., & Shaper, A. G. (1994). Loss of employment and mortality. BMJ, 308(6937), 1135-1139.
    連結：
85. Mossey, J. M., & Shapiro, E. (1982). Self-rated health: a predictor of mortality among the elderly. American journal of public health, 72(8), 800-808.
    連結：
86. Murtagh, K. N., & Hubert, H. B. (2004). Gender differences in physical disability among an elderly cohort. American journal of public health, 94(8), 1406-1411.
    連結：
87. Ng, N., Hakimi, M., Santosa, A., Byass, P., Wilopo, S. A., & Wall, S. (2012). Is Self-Rated Health an Independent Index for Mortality among Older People in Indonesia? PLoS ONE, 7(4), e35308.
    連結：
88. Nourhashémi, F., Andrieu, S., Gillette-Guyonnet, S., Vellas, B., Albarède, J. L., & Grandjean, H. (2001). Instrumental activities of daily living as a potential marker of frailty a study of 7364 community-dwelling elderly women (the EPIDOS study). The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56(7), M448-M453.
    連結：
89. Pinquart, M., & Sörensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and aging, 18(2), 250.
    連結：
90. Pinquart, M., & Sörensen, S. (2006). Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 61(1), 33-45.
    連結：
91. Pu, C., Tang, G. J., Huang, N., & Chou, Y. J. (2011). Predictive power of self-rated health for subsequent mortality risk during old age: analysis of data from a nationally representative survey of elderly adults in Taiwan. Journal of Epidemiology, 21(4), 278-284.
    連結：
92. 內政部統計處，2016。內政統計月報。
93. 行政院，2015。《長期照顧保險法草案總說明》。
94. 行政院主計總處，2015。《國民幸福指數統計年報2015》。臺北：行政院主計總處。
95. 行政院主計總處（2012）。《99年人口及住宅普查（總報告統計結果提要分析）》。臺北：行政院主計總處。
96. 行政院護理及健康照護司（2013）。《長期照護服務網計畫（第一期）－102 年至 105 年》。臺北：護理及健康照護司。
97. 林子新、黃信洋、黃國清、鄭祖邦、謝昇佑（譯）（2005）。社會學（原作者：Bilton, T., Bonnett, K., Lawson, T., Stanworth, M., Webster, A.）。臺北市：學富文化。
98. 國家發展委員會（2014）。《中華民國人口推計（103至150年）》。臺北：國家發展委員會。
99. 華人家庭動態資料庫的建立：第十五年計畫: RR2014（未釋出）【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫https://srda.sinica.edu.tw。
100. 溫福星（2006）。階層線性模式：原理、方法與應用。臺北市：雙葉書廊。
101. 衛生福利部（2014）。《102年老年狀況調查報告》。臺北：衛生福利部。
102. 簡錦漢(2016)。華人家庭動態資料庫的建立:第十四年計畫(RR2012)(C00316_1)【原始數據】。取自中央研究院人文社會科學研究中心調查研究專題中心學術調查研究資料庫。doi:10.6141/TW-SRDA-C00316_1-1
103. Beard, J. R., Biggs, S., Bloom, D. E., Fried, L. P., Hogan, P., Kalache, A., & Olshansky, S. J. (2011). Global Population Ageing: Peril or Promise. Geneva: World Economic Forum.
104. Bound, J., & Waidmann, T. (2007). Estimating the health effects of retirement. Michigan Retirement Research Center Research Paper No. UM WP, 168.
105. Bowles, J., & Kington, R. S. (1998). The impact of family function on health of African American elderly. Journal of Comparative Family Studies, 29(2), 337-347.
106. Howden, L. M. & Meyer J. A. (2011). Age and Sex Composition: 2010. United States Census Bureau.
107. Japan Statistics Bureau (2015). The Statistical Handbook of Japan 2015. Tokyo, Japan: Japan Statistics Bureau. http://www.stat.go.jp/english/data/handbook/index.htm. Retrived on 2016/03/09
108. Lakka, H. M., Laaksonen, D. E., Lakka, T. A., Niskanen, L. K., Kumpusalo, E., Tuomilehto, J., & Salonen, J. T. (2002). The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. The Journal of the American Medical Association, 288(21), 2709-2716.
109. Lazarus, R. S. (1991). Emotion and adaptation (pp. 87-88). London: Oxford University Press.
110. Lin, S. T. (2006). Asian American middle-aged adults' attitudes and mental health after the death of a parent. THESIS
111. Mitchell, B. A. (2012). Families Facing Health Challenges and the Creation of Healthy Lifestyles. In Family matters: An introduction to family sociology in Canada (pp. 243-262). Toronto: Canadian Scholars’ Press.
112. Moloney, L., Weston, R., Qu, L., & Hayes, A. (2012). Families, life events & family service delivery (Research Report No. 20). Melbourne: Australian Institute of Family Studies.