John Knodel

• PhD
• Professor at University of Michigan

Studies on the two major health-risk behaviors of smoking tobacco and drinking alcohol among older populations, particularly in Southeast Asia, are limited. This paper provides comparative analyses of the prevalences and correlates of smoking tobacco and drinking alcohol among older people in Myanmar, Vietnam, and Thailand, using data from the late...

Myanmar's population has been on the move at an unprecedented level since 2011. Given the country's lack of data infrastructure, little is known about how parental migration affects children in Myanmar's migration‐source areas. Based on the 2017 Dry Zone Migration Impact Survey, this study examines the extent to which parental migration is associat...

The main objective of this report is to provide an updated profile of the situation of older persons in Thailand based primarily on the 2017 Survey of Older Persons in Thailand. Following the introductory chapter which examines trends in population aging in Thailand and includes a brief review of government responses, subsequent chapters provide re...

This chapter examines the critical roles played by demographic trends and development levels in explaining cross-country variations in grandparental care in Southeast Asia. Based on analyses of recent national-level surveys of older persons in Myanmar, Thailand and Vietnam, we examine the extent and circumstances of grandparenting and their consequ...

Introduction The extent, nature and consequences of grandparenting are profoundly shaped by social contexts and how these contexts change over time (Arber and Timonen, 2012; Hermalin et al., 1998). For instance, grandparental care in the United States is often prompted by problematic situations (for instance, death or incarceration of the grandchil...

This book is a sequel to Contemporary grandparenting, published in 2012 (Arber and Timonen, 2012). Both macro and micro level issues are covered, with a particular focus on gender, welfare states, economic development, and grandparental agency; this ensures that the book covers many topic areas of greatest relevance and interest. It emphasises that...

Objective: To provide a situation analysis of recent long-term care (LTC) needs among older persons in Thailand. Method: The 2014 Survey of Older Persons in Thailand (SOPT) provides data to assess patterns of caregiving, whether care needs are met, and who are main caregivers for older Thais. We examine how types of familial and nonfamilial caregiv...

Alarmist views regarding the burden that older persons pose for family and society are prevalent; yet, such views are not necessarily warranted. To fill the research gap, this study examines prevalence and differentials in later-life productive engagement in developing Southeast Asia with a focus on the roles of educational attainment and gender. B...

Myanmar is one of the poorest and least healthy countries in Southeast Asia. As elsewhere in the region, population aging is occurring. Yet the government welfare and health systems have done little to address the long-term care (LTC) needs of the increasing number of older persons thus leaving families to cope on their own. Our study, based on the...

This spotlight provides an overview of the situation of older persons in Myanmar, an understudied country of over-50-million population. Myanmar is of particular interest to researchers and policy makers, given its overall level of poverty and modestly rapid population aging. Research on older persons, while increasing in recent years, remains spar...

Myanmar is one of the poorest and least healthy countries in Southeast Asia. Nevertheless, population aging is taking place. Myanmar's policy makers have only begun to pay attention to the implications of population aging for its economy and society, including the health system. There is virtually no official policy or program in place to provide l...

Thailand is experiencing more acute population aging than most developing Asian countries. Its population aged 60 and older is anticipated to grow from 10% in 2000 to 38% by 2050. Meanwhile, the oldest-old population that is most likely to require long-term care (LTC) is estimated to increase tenfold during the first half of the 21st century. Famil...

Rapid development and social change in Asia have led many to assume that proportions of elderly living alone are rising and that they tend to live in destitute situations. These assumptions often lack empirical validation. We address the trends and correlates of solitary living among older persons in Myanmar, Vietnam, and Thailand. We examine the e...

This study documents the existence of data related to ageing issues as provided by surveys of older persons, censuses, and Demographic and Health Surveys (DHS) for 25 low- and middle-income Asia-Pacific countries . Using a systematic review approach, we evaluate the content and quality of data sources and their comparability. We showcase best pract...

Objective: We examine the association between poverty, economic inequality, and health among elderly in Myanmar. Method: We analyze 2012 data from Myanmar’s first representative survey of older adults to investigate how health indicators vary across wealth quintiles as measured by household possessions and housing quality. Results: Poverty and poor...

The present study compares living arrangements and related intergenerational support in Myanmar and Thailand based on recent national surveys of older persons in both countries and prior surveys in Thailand. The countries share relatively similar cultural contexts but differ radically in economic development. Substantially higher percentages of old...

Recent surveys in Myanmar, Thailand and Vietnam reveal that substantial proportions of persons aged 60 and older co-reside with grandchildren and commonly provide grandparental care. Usually the grandchildren's parents are also present. Situations in which the grandchildren's parents are absent are considerably less frequent. Parents are commonly t...

Development is commonly assumed to undermine intergenerational solidarity in developing countries. Evidence from a series of surveys in Thailand calls this assumption into question. Intergenerational support networks have remained intact despite extensive social and economic development. Despite the recent universalisation of the Old Age Allowance...

This report provides a comprehensive overview of the situation of older persons in Myanmar based on the first national survey of persons age 60 and older. Chapters examine population aging, social characteristics of older persons, economic activity and income, material well-being, living arrangements, family support and intergenerational exchanges,...

This report provides an up-to-date and comprehensive overview concerning the situation of persons age 60 and over in Thailand. Chapters describe population aging in Thailand and government responses, social and demographic characteristics, living arrangements, sources of support and material well-being, family support and intergenerational relation...

Future cohorts of older Thais will have fewer and more dispersed children. This will result in a continuing decline in coresidence with children that has been the lynchpin of the traditional familial system of old age support. The aim of the present study is to examine how parents who are approaching old age and their adult children view these chan...

This study examines links between migration status and location of adult children and measures associated with the well-being of older parents. Data come from older adults born between 1940 and 1950 living in a region in northwest Cambodia near the Thai border with good access to Phnom Penh. Analyses are conducted from the perspectives of the older...

Purpose The purpose of this study is to examine inter‐generational arrangements in Thailand for personal care provided to older members and provided by them as grandparents to young children. Design/methodology/approach Results are based on analysis of the 2007 Survey of Older Persons in Thailand. Consideration focuses on persons aged 60 and older...

Trends and determinants of marriage payments have rarely been examined at the population level despite their plausible implications for the welfare of family and the distribution of wealth across families and generations. In this study, we analyze population-based data from the Vietnam Study of Family Change to document prevalence and directions of...

Previous research makes clear that before antiretroviral therapy (ART), when HIV led to disabling illness and certain death, many older persons as parents of infected adults experienced adverse emotional, material and social consequences. The present study examines how widespread access to ART is transforming the situation in Thailand. Interviews w...

Ensuring treatment adherence is critical for the success of antiretroviral therapy (ART) programs in developing countries. Enlisting NGOs or persons living with HIV/AIDS (PLHA) group members as treatment supporters is one common strategy. Less attention is given to family members and especially older-age parents. Yet ART patients often live with ot...

This study addresses the extent of change and regional differences in gender roles in the Vietnamese family based on innovative surveys in northern and southern Vietnam. The similarities and differences in political, economic, and social histories between northern and southern Vietnam provide a compelling setting to investigate the impact of social...

The consequences of adult children's migration from rural areas for older parents who remain behind are keenly debated. While the mass media and international advocacy organisations favour an ‘alarmist’ view of desertion, the academic literature makes more sanguine assessments using the ‘household strategy’ and ‘modified extended family’ perspectiv...

Objective: To examine the extent to which an association exists between health of older parents and return migration of children in rural Thailand. Method: Data come from the 2006 Migration Impact Survey specifically designed to obtain information on the impact of migration on older adults in rural areas. Associations are examined from both the per...

This study addresses the extent of change and region al differences in gender roles in the Vietnamese family based on innovative surveys in northern and southern Vietnam. The similarities and differences in political, economic, and social histories between northern and southern Vietnam provide a compelling setting to investigate the impact of socia...

Accounts of community reaction to persons with HIV/AIDS and their families typically focus only on negative reactions stemming from stigmatization with little acknowledgement of variation over time and across settings. To usefully guide local interventions, a broader view is needed that also encompasses attitudes and actions stemming from sympathy...

High levels of treatment adherence are crucial for the success of expanding ART treatment programs everywhere. Augmenting adherence through treatment supporters is one promising strategy. Most discussions focus on peers, especially members of PHA groups, for this purpose. Far less attention is given to family members and especially older age parent...

Population aging is proceeding at a rapid pace in Thailand posing important challenges for the government and society as a whole. On the positive side, the material well-being of older persons in Thailand has been improving. Older Thais live in better quality houses with far more appliances and amenities compared to a decades or two ago. The recent...

Intergenerational relations between older age parents and their children remain pervasive in Thailand. Over 70% of older persons live with or next to a child. Material assistance from children remains substantial. Desertion of elderly parents is quite rare. Family members, particularly children, are the main persons providing assistance to frail ol...

The advent of widespread ART provision in low- and middle-income countries requires not just medical attention, but also social and psychological support to encourage and monitor strict adherence to drug regimens. Developing innovative approaches to providing this broad support is a major challenge, especially within the financial constraints of re...

This paper examines interactions between older adults living in rural areas of Thailand and Cambodia and their adult children. Thai data come from the Survey of the Welfare of the Elderly (N= 3,202 older adults and 17,517 adult children). Cambodia data are from the Survey of the Elderly in Cambodia (N= 777 older adults and 3,751 adult children). Re...

The present study provides a comparative analysis of the impact of the AIDS epidemic in Cambodia and Thailand on the parents of adults who die of AIDS and how this impact interacts with poverty. It examines the relationship between economic status and routes through which losing an adult child can affect the parents, including caregiving during ill...

In Thailand and elsewhere, some older persons remain sexually active well into late middle and old age. Very little research, program, or advocacy effort has targeted this group with respect to HIV and their susceptibility to it. We explore these issues using qualitative data from two sets of semi-structured, in-depth interviews of unmarried older...

Little systematic quantitative research is available on the parents of adults who become ill and die of AIDS despite their large number and the wide range of adverse consequences. This study, based on survey data from Cambodia, explores economic and social effects on parents in a country characterized by extreme poverty and a substantial AIDS epide...

The present study explores the social and economic consequences of the migration of adult children to urban areas for rural parents in Thailand. Attention is given to the circumstances under which such migration takes place, including the role parents play in the process and the extent to which the implications of migration for the parents are take...

This study examines marital sexual activity in relation to age and its significance for marital relationships in Vietnam with particular attention to older persons. Results are compared with Thailand and the US. Two regional surveys provide the first quantitative assessment of marital sex in Vietnam. As elsewhere, marital sexual activity declines w...

In developing countries, older persons are often called upon to be primary caregivers for their children who contract HIV. Consequently, their understanding of the disease and willingness to provide care is critical for AIDS sufferers. This issue is examined among men and women aged 60 or over in Cambodia, a country with pervasive poverty. Results...

ABSTRACT Internal migration in Southeast Asia raises questions about strains upon traditional sys- tems of support ,for older adults. While remittances to parents’ households ,play a role in rural household economies, uncertainty remains regarding whether and under what circumstances children interact with their elderly parents. This paper focuses...

Premarital sexual activity is thought to be rising in Vietnam. However, there is little evidence documenting such an increase, and it is unknown whether levels of premarital sex differ between northern and southern Vietnam and whether premarital sex occurs primarily with a future spouse. Surveys conducted in northern Vietnam (Red River Delta) and s...

Cambodia experienced violence during the rule of the Khmer Rouge in the 1970s. Many who died were the children or spouses of today's elderly. This may have resulted in an erosion of family support in a country where formal channels of assistance are virtually absent. This article examines the extent to which current Cambodian elderly experienced de...

This study examines the role that older-aged parents play in the care and support of adult sons and daughters with HIV or AIDS and of AIDS orphans in Thailand within the context of a limited institutional safety net. The analysis draws on both quantitative and qualitative data from survey and open-ended interviews with the parents and from individu...

We examine the extent of change in gender relations within the Vietnamese family in the Red River Delta over the last four decades. During this time socialist policies emphasized gender equality although recent commentators speculate about negative effects of the transition to the market economy. Data come from a survey of three cohorts married dur...

This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material suppo...

An examination of the economic consequences for older-age parents of losing an adult child to AIDS in Thailand based on quantitative data derived from a key informant study and a direct interview survey with parents yielded the following main findings: (1) parents frequently paid for their children's care and treatment, but government health insura...

Although women and the elderly are assumed to be disadvantaged in much of the world, systematic empirical studies of gender differences in well-being among the elderly are rare. This article examines gender differences in elderly support and socio-economic well-being in Vietnam using census and survey data. Sources of support examined include work,...

Most persons with AIDS (PWAs) eventually require demanding caregiving. This can prompt changes in living arrangements during the course of the illness. Few studies have attempted to examine the potential links between AIDS and migration from this perspective. The present study uses both direct and indirect approaches to examine the extent of return...

The impact of the worldwide AIDS epidemic on persons aged 50 years or older has received relatively little consideration except in the United States, where interest has focused almost exclusively on older persons living with AIDS or at risk for infection. The place of older persons in the epidemic deserves international attention because their live...

The impact of the worldwide AIDS epidemic on persons aged 50 years or older has received relatively little consideration except in the United States, where interest has focused almost exclusively on older persons living with AIDS or at risk for infection. The place of older persons in the epidemic deserves international attention because their live...

In recent years, both population aging and gender issues have gained prominence in international forums concerned with population. It is frequently asserted or implied that older women are universally more vulnerable to social, economic, and health disadvantages than older men. The most significant manifestation of this exclusive concern with women...

Over the coming decades in Thailand, aging parents whose adult children sicken with AIDS will bear burdens of caregiving and loss. Using demographic microsimulation, we show that the new, lower projections of the HIV/AIDS epidemic still imply that 8% of Thais over the age of 50 in 1995 will lose one or more children to AIDS before their own deaths....

Levels of AIDS related knowledge are widely assumed to be high in Thailand, a country with probably the most effective response to the HIV/AIDS pandemic to date in the developing world. But efforts to verify these levels are sparse in recent years, and very little attention has ever been paid to AIDS knowledge and attitudes within the Thai older po...

We apply aggregate demographic analysis and computer microsimulation to project the number of older Thais who will lose children to AIDS during their own lifetimes and to assess their involvement with ill children through caregiving and coresidence. Parental bereavements from AIDS are predicted to peak at around 80,000 per year between 2003 and 200...

This special issue of the Journal of Cross-Cultural Gerontology contains a series of articles on the living arrangements of the elderly in four Asian countries (the Philippines, Singapore, Taiwan, and Thailand) as revealed in qualitative data provided by focus group discussions. These four countries are characterized by a mix of similarities and di...

Over the coming decades in Thailand, aging parents whose adult children sicken with AIDS will bear burdens of caregiving and loss. Using demographic microsimulation, we show that the new, lower projections of the HIV/AIDS epidemic still imply that 8% of Thais over the age of 50 in 1995 will lose one or more children to AIDS before their own deaths....

Local key informants provided data on individual adult cases of AIDS for assessing the impact of the epidemic in Thailand on aged parents and other family members. In most cases, parents provided care for their infected adult children, often assisted with expenses, and frequently played a main role in paying for treatment. For one third of the case...

Discussions of the AIDS epidemic rarely consider the impact on older people except as infected persons. Virtually no systematic quantitative assessments exist of the involvement of parents or other older generation relatives in the living and caretaking arrangements of persons with AIDS in either the West or the developing world. We assess the exte...

This study examines sexual activity among thepopulation aged 50 and over in Thailand inrelation to age, gender and health status. Itis the first study of older persons based on alarge nationally representative survey in anynon-Western or developing country. The resultsindicate substantial proportions of oldermarried Thais remain sexually active, bu...

The authors describe features of the older population and the history of the HIV/AIDS epidemic in Thailand and discuss potential links between them. Both direct and indirect impacts of AIDS on the Thai older population are discussed, but the focus is on how older persons could be indirectly affected by AIDS infections occurring among their adult ch...

This study examines variations in intergenerational support by family size, family composition, and location of children in Vietnam. Results from two regional surveys confirm the central role of children in assisting elderly parents but relationships with family size depend on the type of support considered. Co-residence with married children varie...

PIP Fertility decline and the consequent population aging that follows are likely to be the most important demographic developments in Asia during the past and future halves of the century. Despite the inextricable link of these two phenomena, government planners and policy makers view them quite differently. The aim of this article is to review so...

The present study explores aspects of living arrangements of the elderly in Thailand and how they relate to intergenerational support exchanges as revealed by a quasi-qualitative case study approach. The study describes some of the challenges this topic poses for measurement if surveys are used. These include difficulties in appropriately defining...

This study examines the contrast between Muslim reproductive attitudes and behaviour in Thailand and those of Buddhists, especially in the southern region. Results are based primarily on a large regional survey directed towards this topic and focus group discussions among Muslims in Southern Thailand. We interpret Muslim reproductive patterns from...

We explore some of the key social dynamics underlying patterns of male extramarital heterosexual behavior in Thailand. We analyze transcripts of focus group discussions and focused individual interviews conducted during 1993 and 1994 with married men and women living in both urban and rural areas of central Thailand. We discern several pathways of...

We examine patterns of intergenerational support, with a key focus on the gender of the providers, in four countries in East and Southeast Asia: Philippines, Singapore, Taiwan and Thailand. These countries make an interesting set for comparison because they are characterized by varying levels of social and economic development and different family...

This study explores popular attitudes towards female sex workers in Thailand by examining the general public's perceptions of a prostitute's ability to marry based on focus group data. The tentative conclusion emerging from our findings that the general public believes sex workers can marry is that a relative lack of severe or lasting social stigma...

Data from the nationally representative 1994 Inter-Censal Demographic Survey are used to examine the association between family size and children's schooling in Vietnam. The data provide information on several education measures for all children over age 10, including children no longer residing in the household. Although a clear inverse bivariate...

PIP This study examined family support for the elderly in Thailand. Data were obtained from the Survey of the Welfare of Elderly in Thailand (SWET), a 1995 nationally representative sample of 4486 persons aged over 60 years. Findings were compared to 1986 and 1994 surveys of the elderly. All survey populations lived in private households. Findings...

PIP This study examined social support for the elderly in Ho Chi Minh (HCM) City and Hanoi, Viet Nam, in 1996. The sample included the main towns and provinces surrounding the cities. Two major findings were that the family was the main source of social security for the elderly. Almost 75% of the elderly in Hanoi, and 80% in HCM City, lived with at...

This study explores popular attitudes towards female sex workers in Thailand by examining the general public's perceptions of a prostitute's ability to marry based on focus group data. The tentative conclusion emerging from our findings that the general public believes sex workers can marry is that a relative lack of severe or lasting social stigma...