Population Ageing and Women's Health: A Cross-Country Comparative Study of Experiences from Select Asian countries.

保健服务的改善和医疗技术的进步，加上平均预期寿命的延长，加上生育率的下降，正在导致全球向人口老龄化转变。虽然不统一，但通过人口转型模型的各个阶段看到的这些“新的人口现实”意味着，解决中老年人在身心健康以及社会和经济福祉方面的需求，日益成为学者和政策制定者的优先事项。然而，了解女性在这一领域独特的健康和福祉挑战仍然是一个关键的研究差距，大多数研究采用性别中立的方法。例如，有必要考虑包括更年期在内的生命历程事件对妇女晚年健康和福祉的影响，因为目前的研究大多将妇女几乎完全视为生殖生物。由于预期寿命延长，妇女面临着与年龄和生活方式因素有关的非传染性疾病负担不断增加的问题，同时还面临着卫生和社会保健服务日益增加的压力。同时，传统家庭和社区支助结构的转变也对老年妇女产生了不成比例的影响。亚洲国家处于人口转型的不同阶段：日本和韩国等国家面临“人口悬崖”，马来西亚和印度尼西亚正在向低死亡率和不断下降的出生率过渡，而印度和中国的人口增长和老龄化正在同时发生，尽管速度不同。这6个例子简要说明了人口老龄化和人口结构转型对妇女健康和福祉的各种影响。这篇论文利用生命历程方法来研究人口老龄化背景下妇女健康和福祉转型的未充分探索的方面，以及实现创造健康老龄化的雄心壮志的辩论。采用先进的定量研究方法和计量经济学技术，本文将使用来自亚洲国家的全球老龄化门户的纵向数据，为人口老龄化如何影响亚洲社会的女性提供一个强大而深入的视角。它将使用来自全球人口增长和老龄化趋势前沿的6个亚洲国家的数据，包括印度（印度纵向老龄化研究，LASI）；中国（中国健康与退休纵向研究，CHARLS）；马来西亚（马来西亚老龄化和退休调查）；印度尼西亚（印度尼西亚家庭生活调查）；韩国（韩国老龄化纵向研究，KLoSA）；和日本（日本老龄化和退休研究，JSTAR）。它将研究诸如衰老的生物标志物作为老年人身心健康和福祉的预测因素的作用等问题；更年期过渡的意义和长期影响生命历程事件的影响；以及获得卫生服务和卫生系统运作如何影响妇女晚年的健康和福祉。这对于了解妇女在整个生命过程中的生活经历如何影响她们在老年时的健康经历至关重要。因此，本创新论文旨在为人口老龄化的知情研究和政策制定提供循证分析，以改善妇女的健康和福祉结果。

Improvements in health care provision and medical advancements with increasing average life expectancies, alongside declining fertility rates, is resulting in global shifts to population ageing. Though not uniform, these 'new demographic realities' seen through the stages of the demographic transitions model mean that addressing the needs of middle- and older-age adults in terms of their physical and mental health, alongside social and economic wellbeing, is a growing priority for scholars and policymakers. However, understanding women's distinctive health and wellbeing challenges in this area remains a key research gap with most research taking a gender-neutral approach. For example, there is need to consider the impacts of life course events including the menopause on women's health and wellbeing in later life, with current research mostly treating women almost exclusively as reproductive beings. As a result of higher life expectancies, women face both the rising burden of non-communicable diseases (NCDs) linked to age- and lifestyle- factors, alongside the brunt of increasing pressures on health and social care services. Meanwhile, transformations in traditional family and community support structures are also disproportionately affecting older age women. Asian countries are at different points in the demographic transition: with countries such as Japan and South Korea facing the 'demographic cliff', Malaysia and Indonesia transitioning to low mortality and falling birth rates, and India and China where population growth and ageing are happening concurrently albeit at different rates. These 6 examples provide snapshots of the varied consequences of population ageing and demographic transitions on women's health and wellbeing. This thesis on utilises a life course approach to examine under-explored dimensions of transformations in women's health and wellbeing in the context of population ageing and debates over realising ambitions of creating healthy ageing. Using advanced quantitative research methods and econometric techniques, this thesis will use longitudinal data from the Gateway to Global Ageing from select Asian countries to provide a robust and in-depth view of how population ageing is impacting women across Asian societies. It will use data from 6 Asian countries at the forefront of global population growth and ageing trends including India (the Longitudinal Ageing Study in India, LASI); China (the China Health and Retirement Longitudinal Study, CHARLS); Malaysia (the Malaysian Ageing and Retirement Survey, MARS); Indonesia (the Indonesian Family Life Survey, IFLS); South Korea (the Korean Longitudinal Study of Ageing, KLoSA); and Japan (the Japanese Study of Ageing and Retirement, JSTAR). It will examine issues such as the role of biomarkers of ageing as predictors of older age physical and mental health and wellbeing; the significance and long- term implications of menopausal transitions; the impact of life course events; and how access to health and health system functioning affects women's health and wellbeing in later life. This is essential to understand how the lived experience of women impacts across the life course impacts on their health experiences in older age. Thus, this innovative thesis aims to provide an evidence-based analysis for informed research and policy development on population ageing towards improving women's health and wellbeing outcomes.