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Abstract

Filial support has been recognized as a main source of social support for China’s aging population. While traditional Chinese families generally adhere to patrilineal, patriarchal, and patrilocal principles, there have been signs of an emerging trend of a complex, bilateral family system that has influenced the ways in which married women support elderly family members, both natal kin and in-laws, in contemporary China. However, little research exists focusing on the perspectives of married women in China on intergenerational support. Drawing on nationally representative data from the Chinese General Social Survey, this study investigates the patterns and determinants of women’s financial and instrumental support of their parents and parents-in-law in China. The main results show that, while education and income separately affect women’s support patterns, their husband’s income level is the crucial factor determining women’s financial support for parents and parents-in-law. In terms of instrumental support, norms of reciprocity are evident between women and parents/parents-in-law. Despite a positive association between financial support that women give to parents-in-law and that which they receive from parents-in-law, women’s financial support tends to be less frequent when their own parents have financially supported them. The implications of these findings for our understanding of intergenerational support mechanisms and for future research are discussed.

Keywords

Intergenerational support filial piety married women socioeconomic resources reciprocity family context

Introduction

An unprecedented rate of growth in the aging population in China has spurred new demands on families and the need for a clarification of citizens’ attitudes towards filial obligations. In the wake of the improved living standards and health care brought by rapid economic development over the past 40 years, China’s life expectancy at birth increased from 67 years in 1980 to 76 years in 2016 (World Bank, 2017). The number of citizens aged 60 or above reached 241 million by the end of 2016, representing 17.3% of the total population, and this number is estimated to peak at 487 million by the middle of this century (Xiang, 2018). On the other hand, as a result of the decades-old one-child policy, the total fertility rate in China decreased from 2.6 in 1980 to 1.6 in 2016, which was well below the replacement level (World Bank, 2017). Long life expectancy and low fertility contribute to a high elderly dependency ratio in China, which is expected to reach more than 0.5 by 2038, indicating that, on average, fewer than two young adults will support one elder adult (Hu and Yang, 2012). Although China has been developing its public pension system since the 1960s, the state has not yet established a comprehensive social security system (Vilela, 2013). The public pension system covers a small proportion of the whole population, with only a small percentage of retirees living in urban areas actually receiving their pensions in 2002 and less than 10% of the rural population joining the rural pension insurance schemes in 2007 (Shen and Williamson, 2010; Vilela, 2013).

Under such circumstances, the traditional discourse of the filial obligation to provide elderly care and support has become particularly significant. Elderly citizens, especially those living in rural areas, have conventionally relied on their adult children for financial and instrumental support, regardless of recent demographic and socioeconomic challenges to these ideals of filial piety in China (Jackson and Liu, 2017; Tu, 2016; Whyte, 2020). Previous research has found that nearly half of urban elders and more than 60% of the rural elderly population in China rely on their adult children to satisfy their financial needs (Lee and Xiao, 1998; Ng et al., 2002). Intergenerational support is significantly associated with the subjective well-being of the elderly in China (L Zhang, 2016). Indeed, filial support has been recognized as a main source of social support for China’s aging population (Deutsch, 2006; Lin and Yi, 2011; Whyte, 2005). The filial roles and obligations of sons, daughters, and daughters-in-law are clearly defined within the traditional Chinese family structure. Adult sons, as well as their spouses (daughters-in-law), assume filial duties for their elderly parents; by contrast, after marriage adult daughters are supposed to leave their natal families and move to provide care for their parents-in-law (Lee et al., 1994; Lin and Yi, 2011; Lin et al., 2003; Yang, 1996). However, in the wake of the sociopolitical and economic transformation in China over the past decades, there have been signs of an emerging trend toward a complex, bilateral family system, which has influenced the ways married women support their elderly parents and parents-in-law (Cong and Silverstein, 2012a, 2012b; Deutsch, 2006; Ji and Wu, 2018; Ji et al., 2020; Lei, 2013; Xie and Zhu, 2009; Yi et al., 2016; Zhan and Montgomery, 2003; Y Zhang, 2016; Zheng and Di, 2018).

Little empirical research has focused on married women regarding filial norms and relationships with parents and parents-in-law by using large, representative samples of China’s population (Zheng and Di, 2018). This study is one of the rare attempts to examine the perspective of married women on intergenerational support for their parents and parents-in-law. Notably, in light of recent trends in China’s aging population, this study generates further insights to address the ongoing discussion concerning the role of married women as the main source of support for an ever-larger retired population in post-reform China (Ji and Wu, 2018). Despite China’s implementation of a universal two-child policy in late 2015, the tremendous impact of the decades-long one-child policy, together with the traditional preference for sons, on the aging demographics will not be reversed in the near future (Jackson and Liu, 2017; Tu, 2016). Academic and policy attention need to be extended to a systematic understanding of filial piety norms and intergenerational relationships among married women (Yi et al., 2016; Zheng and Di, 2018).

Drawing on nationally representative data from the 2006 Chinese General Social Survey (CGSS), this study aims to gain a better understanding of the patterns of intergenerational support provided by married daughters in China. Specifically, this study investigates women’s perceived financial and instrumental (e.g. helping with household chores) support for their parents and parents-in-law and identifies mechanisms underlying the support patterns by testing three main theoretical models: socioeconomic resources, reciprocity between generations, and the family context (i.e. geographic proximity and family composition).

The role of women in caring for parents and parents-in-law

It is well established that intergenerational support behavior is not gender neutral or homogeneously patterned among parents and parents-in-law (Henz, 2009, 2010; Raley and Bianchi, 2006; Swartz, 2009; Szinovacz and Davey, 2008). As men are traditionally expected to be the breadwinners and women are expected to be the caregivers, men are more likely to manage the financial tasks, while women tend to take care of emotional support (Chesley and Poppie, 2009). Numerous studies have shown that men spend significantly less time taking care of elderly parents than women do (Gerstel and Gallagher, 2001; Henz, 2009; Lee et al., 2003; Sarkisian and Gerstel, 2004). Notably, in brother-only families, wives and husbands tend to behave in gender-appropriate ways, with wives caring for their husbands’ parents as daughters-in-law by helping with household chores or personal care and providing emotional support and husbands performing “masculine” tasks such as transportation and home maintenance (Matthews and Heidorn, 1998).

As the “kin-keeper” role of women has been widely acknowledged (Allen et al., 2000), women are expected to maintain closer contact with parents and parents-in-law than are men. However, asymmetry in couples’ relations with husbands’ parents and wives’ parents has conventionally existed in American families (Noël-Miller and Tfaily, 2009). When facing the competing demands of two sets of parents, couples are more responsive to wives’ parents despite the predominant bilateral kinship in most Western societies (Kuznesof, 2005). Women’s centrality in kin networks is restricted to their own original kin and does not extend to the relationship with their husbands’ families (Rossi and Rossi, 1990). Given the higher position of parents in the kin hierarchy, parents generate a higher level of obligation than parents-in-law and thus claim the privilege of the time and resources of adult children, which results in parents receiving more support from adult children. Drawing on a nationally representative sample of American middle-aged married persons, Lee et al. (2003) determined that women give priority to their relations with their own parents, providing more contact and assistance to their parents than to their parents-in-law. Waite and Harrison (1992) found that middle-aged women have contact with their own parents more frequently than with their parents-in-law. However, Noël-Miller and Tfaily’s (2009) study in Mexico showed the opposite results: a couple is more likely to provide financial assistance to the husband’s mother than to the wife’s mother when there is similar financial need; in cases in which the wife has previously been in paid employment, the financial transfer given solely to the husband’s mother actually increases. In addition, Shuey and Hardy (2003) argued that couples show a unilineal assistance pattern, in terms of both time and money, to their parents and parents-in-law and that the matrilineal line is privileged in American families. Henz (2009) found that British daughters-in-law generally assume direct responsibility for caring for their parents-in-law and assist their parents-in-law for significantly greater amounts of time than sons-in-law do with their parents-in-law.

The contemporary Chinese context: Continuity and change in intergenerational relations

The Chinese family system is traditionally patrilineal, patriarchal, and patrilocal in principle. Traditional Chinese families emphasize a hierarchical order based on age and gender, with the senior male members as the patriarch and family provider; only sons are entitled to receive most family investments and possess the right of inheritance (Whyte, 2005). As part of the filial norms in Confucian beliefs, adult children, especially sons, are obligated to provide various kinds of support and care for elderly parents. By contrast, daughters are traditionally regarded as transitory members of their natal families and are expected to live with and be devoted to their marital families (Whyte and Xu, 2003). Married daughters, traditionally described as “spilled water”, cease to fulfill their support obligations for their birth parents and instead shift their support to their parents-in-law, assuming a caregiver/kin-keeper role primarily out of obligation to their spouses (Y Zhang, 2009).

Despite the continuing relevance of traditional norms and values in modern Chinese families, many norms and values have begun to weaken as a consequence of China’s socialist reform and one-child policy in the post-war era and the rise of consumerism under China’s transition to a market economy in the 1990s (Whyte, 2005). Chinese parents’ strong preference for sons over daughters in providing care for them has relatively diminished in both urban and rural areas (Hu and Chen, 2019; Li et al., 2004; Song et al., 2012). In contemporary Chinese families, as patrilineal norms have been undermined and individual conjugal families increasingly live separately, the dynamics of intergenerational support among married women are changing (Cong and Silverstein, 2012a, 2012b; Deutsch, 2006; Lei, 2013; Xie and Zhu, 2009; Yi et al., 2016; Zhan and Montgomery, 2003; Y Zhang, 2016; Zheng and Di, 2018). An illustration of the importance of this changing pattern of support is that the kin-keeper role of women may cause them to maintain even closer contact with both their parents and parents-in-law than do their husbands (Chappell and Kusch, 2007; Rossi and Rossi, 1990). Daughters-in-law play an important caregiving role for the psychological well-being of elderly parents in rural China (Cong and Silverstein, 2008). Filial obligations of adult daughters and daughters-in-law are also closely associated with the significance of maintaining family reputation (mianzi) (Y Zhang, 2016).

Indeed, there have been signs that the Chinese family has taken new shapes and forms in recent decades, one of which is the trend toward a complex, bilateral family system (Ji et al., 2020). Xie and Zhu (2009) found that, in contemporary Chinese families in urban areas, thanks to women’s rising economic status, married daughters, especially those living with their parents, provide more financial support to their birth parents than their male counterparts do. However, parents still favor sons over daughters when providing support to children in need (Xie and Zhu, 2009; Zhu and Xie, 2017). Lin et al. (2003) found that sons in Taiwan assume the major responsibility of caring for their elderly parents, while daughters are not expected to do so unless they have no brothers. Married sons assist their parents more than unmarried sons do, and unmarried daughters provide more assistance to their parents than married daughters do (Lin et al., 2003). Compared to those in Taiwan region, daughters in Chinese mainland are more prone to provide physical support to their parents (Lin and Yi, 2011). Furthermore, Lei’s (2013) study using national data shows that there is little gender difference in financial support, but daughters provide more instrumental and emotional support to their parents than sons do in urban China. Similar gender differences in intergenerational support were found in China’s rural areas (e.g. Li et al., 2004; Song et al., 2012). Despite the persistence of filial piety norms in general, adult children and their elderly parents can negotiate how to enact these norms and responsibilities in upward generational support (Eklund, 2018; Zhu and Xie, 2017). Taken together, there has been continuity within change in the gendered nature of intergenerational support in contemporary Chinese society, which involves different, sometimes contradictory, filial roles, expectations, and obligations prescribed to sons, daughters, and daughters-in-law.

To extend our understanding of the support mechanisms between married women and parents/parents-in-law, we draw upon three main theoretical models according to the existing literature on intergenerational support: socioeconomic resources, reciprocity, and the family context (family composition and geographic proximity). These models are not competing with each other and are closely related. The formulation of the hypotheses to be tested in the present study is grounded in these three theoretical models.

Hypotheses

Although adult children in Chinese families are traditionally expected to support their elderly parents, the type and extent of the support a child devotes to his or her parents varies not just according to gender but also by his or her capacity and socioeconomic status (Sun, 2002). Adult children’s socioeconomic resources, often measured by education and/or income, influence their capacity and motivation to provide intergenerational support. In general, educational attainment is found to be positively associated with adult children’s recognition of filial norms and obligations to provide financial support to their elderly parents (De Koker, 2009; Lei, 2013). Adult children who have received financial resources from their parents, such as educational opportunities and monetary support in their early life stages, are often socialized to provide support as repayment to their aging parents (Lin et al., 2003). Lillard and Willis’s (1997) study in Malaysia showed that highly educated children were more likely than those with lower education levels to provide monetary and material support to their parents. On the other hand, providing instrumental support to parents is often difficult for working couples due to time constraints. If educational attainment has a normative influence on women’s tendency towards intergenerational financial support, then we would expect the following:

Hypothesis 1: Higher-educated women tend to more frequently provide financial support to their parents/parents-in-law.

Previous research has suggested that adult children’s higher income is related to greater financial support for retired parents (Cai et al., 2006; Lei, 2013; Lin and Yi, 2011). Given the constraints of competing demands and limited resources, couples tend to develop strategies to balance the type and amount of support they provide to parents. For example, adult children with lower incomes tend to substitute financial support for instrumental support of parents (Taniguchi and Kaufman, 2017). Conversely, couples with high incomes may rely heavily on financial support and outsourcing services, instead of caring for parents themselves (Couch et al., 1999), but such a positive correlation between income and outsourcing of elderly care has not been strongly established (Silverstein et al., 2006). Women’s economic independence increases their bargaining power in marital relations, and increasingly individualized marital relationships also enable wives to have more autonomy to manage their own lives and marital resources (Zheng and Di, 2018). If women’s individual economic status has an effect on their financial allocations independently of marital resources, then we would expect the following:

Hypothesis 2a: Women’s income is positively related to their frequency of providing financial support to their parents/parents-in-law.

By contrast, intergenerational financial support may depend largely on the husband’s economic status, given the patriarchal marriage norms that paternal authority and paternal earning power influence allocative strategies deployed by couples to manage financial resources (Shu et al., 2012). In addition, Zuo and Bian (2005) argue that couples in post-Mao China have a collective orientation to the allocation of family resources. Regardless of how much they earn on their own, women’s motivations to provide financial support to their parents and parents-in-law may depend on their husbands’ income. In this case, we would expect to find the following:

Hypothesis 2b: Women’s husbands’ income has a positive effect on women’s frequency of providing financial support to their parents/parents-in-law.

In addition, intergenerational flows of support are reciprocal over the life course and involve short-term exchange (Morgan and Hirosima, 1983; Silverstein and Giarrusso, 2010). The above-mentioned hypothetical effect of socioeconomic resources on intergenerational family support essentially rests on the normative assumption of long-term reciprocity in parent–child relations over the life course. Adult children feel indebted to their parents for raising them and guilty and ashamed if they do not attend to their aging parents’ needs later in life. Conversely, there are also norms of reciprocity to determine the so-called short-term intergenerational exchanges of instrumental support (Ikkink et al., 1999). To maintain intergenerational family bonds and obligations, adult children and their parents/parents-in-law tend to engage in frequent contact and offer assistance to each other with household chores and logistics in everyday life. If short-term, reciprocal norms in intergenerational exchanges of support affect both wives’ and husbands’ lineages, then we would expect the following:

Hypothesis 3: Women who have received instrumental support from their parents/parents-in-law will tend to provide financial/instrumental support to their parents/parents-in-law more frequently than women who have not received such support.

In terms of financial support, however, intergenerational exchanges may differ between parents and parents-in-law. Previous studies have shown that elderly parents in rural China help their adult children with household chores and childcare, and in turn, they receive financial support from their adult children (Cong and Silverstein, 2012b). This pattern is sometimes described as an exchange of money for time (Frankenberg et al., 2002; Morgan and Hirosima, 1983). However, the intergenerational parent–child relationship that once favored senior parents has increasingly tended towards the opposite, with parents continuing to provide support to adult children (Wang, 2010). For instance, Fingerman et al. (2009) found that grown children with greater needs tend to receive more material and financial support from their parents. In turn, these children may give less financial support back to their parents, who do not have financial needs. However, these children may not have the same expectations of their parents-in-law, perhaps due to possible conflicting norms attached to in-law relationships (Willson et al., 2003). In this case, we would expect the following:

Hypothesis 4: Women who have received financial support from their parents tend to provide financial support to their parents less frequently than women who have not received such support.

Hypothesis 5: Women who have received financial support from their parents-in-law tend to provide financial support to their parents-in-law more frequently than women who have not received such support.

Geographic proximity and family composition, including the geographic distance to parents/parents-in-law, the presence of dependent children, and the number of siblings/siblings-in-law constitute a “context” that affects the needs and availability of intergenerational support (Guo et al., 2011). Geographic distance between adult children and their parents and parents-in-law determine how convenient it is for adult children to provide instrumental support to their parents or vice versa. Adult children who live closer to their parents are more likely to provide them with instrumental support than those who live farther away (Chu and Yu, 2007; Knijn and Liefbroer, 2006). Taniguchi and Kaufman (2017) found that geographic proximity among Japanese families has no effect on financial support of parents and parents-in-law but has a positive effect on instrumental support. In this case, we would expect the following:

Hypothesis 6: Women who live closer to their parents/parents-in-law tend to more frequently provide instrumental support to their parents/parents-in-law.

Middle-aged couples with dependent children and elderly parents are generally described as the “sandwich generation”, as they are confronted with the demands of both caring for parents and raising children (Liu et al., 2020; Tan, 2018). Studies have shown that couples tend to prioritize children’s needs when facing competing demands from parents and children (Fingerman et al., 2010; Wong et al., 1999). Grundy and Henretta’s (2006) study examining the support behavior of married daughters aged 55 to 65 in British and American families also found that married daughters with three children or more were less likely to support their parents. If dependent children’s needs are the priority among married women, then we would expect the following:

Hypothesis 7: Women who have children tend to provide financial/instrumental support to their parents/parents-in-law less frequently than women who do not.

Siblings may be able to share the obligation of providing support to elderly parents. In Taiwan, women with no siblings are more likely to provide parents with instrumental support than those with three or more sisters (Lin et al., 2003). Lei’s (2013) study found that having brothers significantly decreases support of parents among married women. If siblings and/or siblings-in-law can share the filial obligations, then we would expect the following:

Hypothesis 8: Women who have more siblings/siblings-in-law tend to less frequently provide financial/instrumental support to their parents/parents-in-law.

Data and methods

The data for this analysis are taken from the 2006 CGSS, which includes the socioeconomic and demographic characteristics of the respondents and their family members. Compared with other national datasets such as the China Family Panel Studies, China Health and Retirement Longitudinal Study, and Chinese Longitudinal Healthy Longevity Survey, the 2006 CGSS is one of the few available datasets on China that provides the comprehensive data containing the variables of intergenerational support, particularly for married women, that are required to test the hypotheses in this study.

Based on the sampling frame of counties, towns, and communities from the 2000 Chinese census, the respondents were selected using a four-stage cluster sampling method. In the first stage, 125 counties were randomly selected from 28 provinces, autonomous regions, and centrally administered municipalities (i.e. Beijing, Shanghai, Tianjin, and Chongqing) in China. Then, four towns or sub-districts from each county were randomly selected, which resulted in 500 second-stage units. At the third stage, two neighborhood communities were drawn from each town, and 1000 communities were obtained. At the final stage, 10 households were randomly chosen from each community, amounting to 10,000 households. An individual aged 18–69 was randomly selected from each household to answer the questionnaire. A sub-sample of 3208 respondents, including 1754 females and 1454 males, completed an additional family module of the survey. Among 730 married female respondents with at least one surviving parent and one surviving parent-in-law, 11 records with missing values for dependent variables and 26 records with missing values for independent variables were dropped from the analysis.¹ Subsequently, the final sample for regression analyses was 693. As geographic proximity had the most missing values, multiple imputations were used to address the missing data (Allison, 2001; Cong and Silverstein, 2008).

Dependent variables

The two dependent variables were financial support and instrumental support provided by married daughters to both their parents and parents-in-law. The respondents were asked, “How often did you provide the following types of help to your parents/parents-in-law in the past year?”² The two types of help listed were “Providing money” and “Helping with household chores (including cleaning, preparing dinners, shopping, running errands, and taking care of children or other family members)”. The responses were measured on a 5-point scale (1 = Very often; 2 = Often; 3 = Sometimes; 4 = Rarely; 5 = Never). As a small number of responses fell into the categories of “Very often” and “Often”, those two categories were combined into one category labelled “Often”. The scale was also reverse-coded, with higher values indicating more frequent support of parents and parents-in-law.

Independent variables

The analysis had three sets of predictor variables, including socioeconomic resources, support provided by parents and parents-in-law, and family composition and geographic proximity. Socioeconomic resources were measured by women’s educational attainment, women’s annual income, and husbands’ income. Educational attainment was measured by years of schooling, which ranged from 0 to 19 years. Annual income was measured by the logged value of the annual incomes that the respondents earned during the previous year (+1).

Financial support and instrumental support received from parents and parents-in-law were measured on a 5-point scale. Financial support was based on the frequency of married women receiving money from their parents and parents-in-law. Instrumental support was measured by the frequency of receiving support in household chores: “How often did your parents/parents-in-law provide help with housework (such as house cleaning and preparing dinner) and personal care (such as taking care of a baby or an elderly individual) in the past year?” The two types of support were transformed into dummy variables for the present study: whether the respondents were given financial/instrumental support by their parents/parents-in-law in the past year.

Geographic proximity and family composition were measured by geographic distance from the parents/parents-in-law, whether the respondent had children, and number of siblings/siblings-in-law. The distance to a parent/parent-in-law was measured by six ordered categories, including “in the same community”, “within a 15-minute walk”, “within a 30-minute drive”, “a 30-minute-to-1-hour drive”, “a 1-hour-to-3-hour drive”, and “more than a 3-hour drive”, which were coded from 1 to 6, respectively. If both the parents and parents-in-law were alive, the longer distance was selected. If either the parents or parents-in-law were not alive, then the other’s score was used. In this study, the distance was recoded to a dummy variable (more than 30 minutes = 1). Whether the respondent had children was dummy-coded, with 0 indicating having children. The number of siblings/siblings-in-law was coded as a continuous variable (0, 1 or 2, 3 or more).

The analysis also included several control variables. Age was controlled in the models, given that intergenerational transfers vary substantially over the family life cycle. For example, the support that parents provide to adult children may decline with age and then the children might tend to spend more time, effort, and money to care for their aging parents. As a proxy for relative marital power,³ the husband-to-wife annual income ratio was coded as a continuous variable. Dummy variables were used for Hukou (i.e. place of registered residence; Rural = 1) and the health status of the parents/parents-in-law (Unhealthy = 1). Previous studies have shown a positive relationship between the health status of parents and the likelihood of children providing support (e.g. Shuey and Hardy, 2003; Silverstein et al., 2006).

A preliminary analysis was performed to compare the difference in upward intergenerational support between that provided to parents and parents-in-law and between that provided by married women and married men. Then, ordinal logistic regression models were used to analyze the impact of the three sets of independent variables on the two types of support for parents and parents-in-law.

Results

Table 1 shows the descriptive analysis of the two types of support provided by married women to their parents and parents-in-law. There were no distinct differences in the type and frequency of support for parents and parents-in-law. More than half of married women reported that they often or sometimes provided financial support (57.9%) and instrumental support (54.4%) to their parents. Similarly, most reported that they often or sometimes supported their parents-in-law financially (55.8%) and instrumentally through household help (55.3%).

Table 1.

Descriptive statistics of the dependent variables.

Variables	%
Financial support provided to parents
Not at all	15.3
Seldom	26.8
Sometimes	39.4
Often	18.5
Instrumental support provided to parents
Not at all	14.4
Seldom	31.2
Sometimes	35.8
Often	18.6
Financial support provided to parents-in-law
Not at all	16.7
Seldom	27.4
Sometimes	40.8
Often	15.0
Instrumental support provided to parents-in-law
Not at all	16.0
Seldom	28.7
Sometimes	32.2
Often	23.1

Table 2 displays the descriptive statistics of the independent and control variables. In the analytic sample of 693 married women (age range: 20–63 years), the mean education level for the women was approximately 8.8 years of schooling. On average, the women had 2.8 siblings and 2.6 siblings-in-law. The women had an average annual income of 10,481.3 yuan in 2005, while their spouses had an average annual income of 14,123.6 yuan; the husband-to-wife income ratio was 1.1. An overwhelming majority of the women (91.2%) reported having children, and more than half (57.6%) were urban hukou holders.

Table 2.

Descriptive statistics of the independent and control variables.

Variables	Mean	SD	%
Education	8.8	3.9
Age	36.8	8.7 (range: 20–63)
Number of siblings	2.8	1.7
Number of siblings-in-law	2.6	1.7
Married women’s annual income (yuan)	10,481.3	15,360.9
Spouse’s annual income (yuan)	14,123.6	17,793.2
Income ratio	1.1	1.9
Presence of children
Yes			91.2
No			8.8
Hukou
Urban			57.6
Rural			42.4
Financial support from parents
Yes			28.9
No			71.1
Instrumental support from parents
Yes			33.0
No			67.0
Distance to parents
Less than 30 minutes			52.7
More than 30 minutes			47.3
Health status of parents
Healthy			74.6
Unhealthy			25.4
Financial support from parents-in-law
Yes			23.8
No			76.2
Instrumental support from parents-in-law
Yes			37.8
No			62.2
Distance to parents-in-law
Less than 30 minutes			58.2
More than 30 minutes			41.8
Health status of parents-in-law
Healthy			76.9
Unhealthy			23.1

Note: SD: standard deviation; N = 693.

More married women in this sample had received financial support from their parents (28.9%) than from their parents-in-law (23.8%). On the other hand, a higher proportion of the women had received instrumental support from their parents-in-law (37.8%) than their parents (33.0%). Slightly more than half (52.7%) and nearly three-fifths (58.2%) of the women lived at a distance equivalent to less than a 30-minute drive away from their parents and their parents-in-law, respectively. In addition, most parents (74.6%) and parents-in-law (76.9%) were reported to be healthy.

Before the regression analysis procedures, a chi-square test was conducted using the larger sample from the dataset (N = 1309) that consisted of both male and female respondents to capture a general pattern of gender differences in intergenerational support. Table 3 presents the difference in the mean levels of frequency of support of parents and parents-in-law between married women (N = 719) and married men (N = 590). Married men provided more financial and instrumental support to their parents than did married women. However, the significant difference for parents-in-law was in the other direction: women provided more instrumental support to their parents-in-law than did men. In addition, there was no gender difference in married women’s and married men’s financial support of their parents-in-law. These results are broadly indicative of the gendered division of caregiving, as discussed earlier, among married sons and daughters for parents and parents-in-law (Ji et al., 2020; Zhan and Montgomery, 2003).

Table 3.

Gender differences in the provision of support to parents and parents-in-law.

Variables	Married women	Married men
Financial support provided to parents (1–5)	2.60**	2.90**
Instrumental support provided to parents (1–5)	2.59*	2.71*
Financial support provided to parents-in-law (1–5)	2.54	2.54
Instrumental support provided to parents-in-law (1–5)	2.63**	2.18**

Notes: N = 1309; *p < 0.5, **p < 0.001(level of significance from the chi-square test).

Regression results

Support for parents

Table 4 shows the results of ordinal regression models of women’s support of their parents. Years of schooling was positively related to the frequency of financial and instrumental support of parents. Controlling for relative earnings, husband’s income, but not women’s income, had a significant positive effect on women’s financial support of their parents.⁴ Therefore, Hypotheses 1 and 2b were supported.

Table 4.

Ordered logistic regression models predicting married women’s provision of support to parents.

	Model 1: Financial support		Model 2: Instrumental support
	b	SE	b	SE
Education	0.06*	0.02	0.06*	0.02
Annual income (logged)	−0.02	0.06	0.07	0.06
Spouse’s annual income (logged)	1.45***	0.23	−0.19	0.22
Financial support from parents(reference: No)
Yes	−0.38*	0.17	0.33	0.17
Instrumental support from parents(reference: No)
Yes	0.74***	0.17	1.08***	0.17
Presence of children(reference: No)
Yes	0.33	0.27	0.21	0.27
Number of siblings	0.06	0.05	0.01	0.05
Distance to parents(reference: More than 30 minutes)
Less than 30 minutes	−0.02	0.15	0.59***	0.15
Age	0.01	0.01	0.03***	0.01
Income ratio	0.15***	0.05	−0.07	0.05
Hukou(reference: Rural)
Urban	−0.27	0.18	0.14	0.18
Health status(reference: Unhealthy)
Healthy	0.17	0.16	−0.12	0.16
Nagelkerke pseudo R²	0.13		0.17

Notes: N = 693; *p < 0.05, **p < 0.01, ***p < 0.001.

Married women who received instrumental support from their parents tended to provide financial and instrumental support to their parents more frequently than those who had not. Receiving financial support from parents decreased the frequency of financial support provided to parents. The results supported Hypotheses 3 and 4.

Consistent with Hypothesis 6, geographic distance was positively related to women’s frequency of providing instrumental support to their parents. In other words, married women who lived close to their parents were more likely to provide instrumental support. However, Hypotheses 7 and 8 (family composition) were not supported. Whether respondents had children did not affect financial and instrumental support provided by married women to their parents. The number of siblings had no impact on married women providing any type of support to their parents.⁵

Support for parents-in-law

Two models predicting financial support (Model 3) and instrumental support (Model 4) provided by married women to their parents-in-law are presented in Table 5. Those with a higher level of education more frequently provided financial support to their parents-in-law, but education had no effect on their instrumental support of their parents-in-law. Similarly, husbands’ income, not women’s income, was a significant predictor of financial support of parents-in-law. These results were, again, consistent with Hypotheses 1 and 2b.

Table 5.

Ordered logistic regression models predicting married women’s provision of support to parents-in-law.

	Model 3: Financial support		Model 4: Instrumental support
	b	SE	b	SE
Education	0.06*	0.02	0.00	0.02
Annual income (logged)	0.01	0.06	−0.02	0.06
Spouse’s annual income (logged)	1.23***	0.23	0.25	0.22
Financial support from parents-in-law(reference: No)
Yes	0.44*	0.19	0.22	0.19
Instrumental support from parents-in-law(reference: No)
Yes	0.50**	0.17	1.77***	0.18
Presence of children(reference: No)
Yes	0.26	0.27	0.51	0.27
Number of siblings-in-law	0.09	0.05	−0.04	0.05
Distance to parents-in-law(reference: More than 30 minutes)
Less than 30 minutes	0.09	0.16	0.52**	0.18
Age	0.02*	0.01	0.01	0.01
Income ratio	0.07	0.04	0.01	0.04
Hukou(reference: Rural)
Urban	−0.45*	0.18	−0.16	0.18
Health status(reference: Unhealthy)
Healthy	−0.13	0.17	−0.25	0.17
Nagelkerke pseudo R²	0.10		0.24

Notes: N = 693; *p < 0.05, **p < 0.01, ***p < 0.001.

The reciprocity between married women and their parents-in-law produced strong significant effects, which also supported Hypotheses 3 and 5. Women tended to provide more instrumental support to their parents-in-law if they had received instrumental support from their parents-in-law. Women increased their financial support of their parents-in-law in return for receiving financial or instrumental support from their parents-in-law.

Proximity was also found to be a strong predictor of support for parents-in-law, which supported Hypothesis 6. The closer women lived to their parents-in-law, the more frequently they provided instrumental support to them. However, Hypotheses 7 and 8 (family composition) were not supported.

Discussion and conclusion

The present study provides insights into mechanisms underlying intergenerational family support, with a particular focus on married women and their filial relationship with their parents/parents-in-law. Specifically, the results show that (a) higher-educated women more frequently provided financial and instrumental support to their parents and more frequently provided financial support to parents-in-law; (b) spousal income was positively linked to women’s financial support for parents and parents-in-law; (c) instrumental support of parents and parents-in-law was more frequent among women who had received instrumental support from their parents and parents-in-law than those who had not; (d) while there was a positive association between receiving financial support from and providing financial support to parents-in-law, women who had received financial support from their parents tended to provide financial support to their parents less frequently than those who had not; (e) women’s instrumental support for their parents and parents-in-law was positively related to geographic proximity; and (f) women’s family composition (presence of children and number of siblings/siblings-in-law) had no effect while controlling for age and other related variables.

One notable finding of this study is the suggestion that education and income separately affect women’s support patterns. The more years of education women have attained, the more frequently they tend to support their parents financially and instrumentally and support their parents-in-law financially. Higher-educated women may have a stronger sense of filial obligation to do something “in return” for their parents’ investment in their childhood and educational qualifications (Lei, 2013). Irrespective of how much women earn, however, their husband’s income level is the crucial factor determining financial support for parents and parents-in-law. In regard to financial resource allocation across generations, the traditional patriarchal concept of men’s dominant economic contribution may persist in many Chinese families in the present era. Another important finding is that intergenerational reciprocity also operates differently between financial and instrumental support. Norms of reciprocity in instrumental support are evident between women and parents/parents-in-law. However, women’s financial support tends to be less frequent when their own parents have financially supported them. This finding may be understood by the idea that those grown children who tend to receive their parents’ financial support are those who are more in need (Fingerman et al., 2009). For these cases, parental obligations (caring for adult children) may overshadow filial norms in financial exchanges between children and their own parents, but not with their parents-in-law. It is also important to note that the differences of reciprocity in financial support may also be related to the different norms between parent–child relations and in-law relations. When parents-in-law provide financial support to their daughters-in-law, they may in fact want to support their son’s family as a unit. While daughters who receive support from their own parents may not be expected to return the favor as suggested above, sons are traditionally supposed to do so. In this case, daughters-in-law may give financial support to their parents-in-law on behalf of their husbands (or at least have taken this into consideration when providing support).

In addition, the hypotheses regarding dependent children and siblings are not supported. As noted earlier, the possible effects of family composition may be confounded by differences in age. A shift in the flows of intergenerational support would likely occur when women and their parents/parents-in-law get older (this study’s results indicate that older women more frequently provide instrumental support to their parents and financial support to parents-in-law, respectively). It is also possible that regardless of the number of siblings, the overall efforts of parental care among siblings might increase when parents/parents-in-law age and become dependent (Tolkacheva et al., 2010). Geographic proximity is found to be a main determinant of instrumental support to parents/parents-in-law, which is perhaps attributable to the convenience of proximity that increases the likelihood of upward instrumental support. It is also possible that those families opt for living close to each other because parents/parents-in-law are more dependent on children for instrumental support. Sibling effects were non-significant in the models, which may be attributable to the “offset” effects of the family life-cycle stages. Interestingly, although it is not the focus of this study, urban women are found to be less likely to provide financial support to their parents-in-law than their rural counterparts. It is possible that, compared with rural women, urban women are more “individualized” and economically independent in their conjugal family, and thereby perhaps less prone to consider financial support to the parents of their spouses as their filial duty.

There are several limitations to this study that should be acknowledged. First, we modeled the support behavior of married women without full information on the patterns of support across spouses and siblings. As noted above, the norms of intergenerational support exchanges may apply to sons, daughters, daughters-in-law, siblings, and siblings-in-law differently. It should be also noted that how women provide support to or receive support from their parents-in-law might hinge, at least in part, on the conjugal family as a unit (for example, supporting parents-in-law on behalf of their husbands). Thus, researchers using the measures of intergenerational support used in this study should remain aware of potential validity limitations. More specific information involving the resources, needs, and support behaviors of spouses, siblings, and siblings-in-law would be of use to better understand married women’s perceived support of their parents and parents-in-law. Another important caution in interpreting the results of this study is that the measurement of the two dependent variables concerns the frequency, but not the magnitude, of the support. This might explain, as the findings of this study show, a lack of difference between support provided to parents and parents-in-law. Third, this study is unable to identify the socioeconomic resources of parents and parents-in-law due to the missing data from the sample. Previous research has shown that parents with higher income and education levels tend to receive less support from their children (Logan and Bian, 2003). To address this issue, future research should employ a dataset that includes the socioeconomic characteristics of parents and parents-in-law. Finally, this study is solely based on cross-sectional data, which cannot account for causal mechanisms underlying married women’s intergenerational support. As such, longitudinal data would be useful for examining the changes over time in married women’s patterns of providing support to their parents and parents-in-law.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship and/or publication of this article.

Notes

References

Allen

Blieszner

Roberto

(2000) Families in the middle and later years: A review and critique of research in the 1990s. Journal of Marriage and Family 62(4): 911–926.

Allison

(2001) Missing Data. Thousand Oaks, CA: SAGE.

Cai

Giles

Meng

(2006) How well do children insure parents against low retirement income? An analysis using survey data from urban China. Journal of Public Economics 90(12): 2229–2255.

Chappell

Kusch

(2007) The gendered nature of filial piety—a study among Chinese Canadians. Journal of Cross-Cultural Gerontology 22(1): 29–45.

Chesley

Poppie

(2009) Assisting parents and in-laws: Gender, type of assistance, and couples’ employment. Journal of Marriage and Family 71(2): 247–262.

Chu

(2007) Kinship networks and intergenerational transfers. In: Gauthier AH, Chu CYC and Tuljapurkar S (eds) Allocating Public and Private Resources across Generations. Dordrecht: Springer, pp.39–61.

Cong

Silverstein

(2008) Intergenerational support and depression among elders in rural China: Do daughters-in-law matter? Journal of Marriage and Family 70(3): 599–612.

Cong

Silverstein

(2012a) A vignette study on gendered filial expectations of elders in rural China. Journal of Marriage and Family 74(3): 510–525.

Cong

Silverstein

(2012b) Caring for grandchildren and intergenerational support in rural China: A gendered extended family perspective. Ageing & Society 32: 425–450.

10.

Couch

Daly

Wolf

(1999) Time? Money? Both? The allocation of resources to older parents. Demography 36: 219–232.

11.

De Koker

(2009) Socio-demographic determinants of informal caregiving: Co-resident versus extra-resident care. European Journal of Ageing 6(1): 3–15.

12.

Deutsch

(2006) Filial piety, patrilineality, and China’s one-child policy. Journal of Family Issues 27(3): 366–389.

13.

Eklund

(2018) Filial daughter? Filial son? How China’s young urban elite negotiate intergenerational obligations. NORA-Nordic Journal of Feminist and Gender Research 26(4): 295–312.

14.

Fingerman

Miller

Birditt

, et al. (2009) Giving to the good and the needy: Parental support of grown children. Journal of Marriage and Family 71(5): 1220–1233.

15.

Fingerman

Pitzer

Chan

, et al. (2010) Who gets what and why? Help middle-aged adults provide to parents and grown children. Journals of Gerontology Series B: Psychological Sciences and Social Sciences 66(B1): 87–98.

16.

Frankenberg

Lillard

Willis

(2002) Patterns of intergenerational transfers in Southeast Asia. Journal of Marriage and Family 64(3): 627–641.

17.

Gerstel

Gallagher

(2001) Men’s caregiving: Gender and the contingent character of care. Gender & Society 15(2): 197–217.

18.

Grundy

Henretta

(2006) Between elderly parents and adult children: A new look at the intergenerational care provided by the “sandwich generation”. Ageing & Society 26(5): 707–722.

19.

Guo

Chi

Silverstein

(2011) Family as a context: The influence of family composition and family geographic dispersion on intergenerational relationships among Chinese elderly. International Journal of Social Welfare 20(S1): S18–S29.

20.

Henz

(2009) Couples’ provision of informal care for parents and parents-in-law: Far from sharing equally? Ageing & Society 29(3): 369–395.

21.

Henz

(2010) Parent care as unpaid family labor: How do spouses share? Journal of Marriage and Family 72(1): 148–164.

22.

Chen

(2019) Which child is parents’ preferred caregiver/listener in China? Research on Aging 41(4): 390–414.

23.

Yang

(2012) The real old-age dependency ratio and the inadequacy of public pension finance in China. Journal of Population Ageing 5: 193–209.

24.

Ikkink

Van Tilburg

Knipscheer

(1999) Perceived instrumental support exchanges in relationships between elderly parents and their adult children: Normative and structural explanations. Journal of Marriage and Family 61(4): 831–844.

25.

Jackson

Liu

(2017) The social context of ageing and intergenerational relationships in Chinese families. The Journal of Chinese Sociology 4(2). DOI: 10.1186/s40711-016-0050-1.

26.

(2018) New gender dynamics in post-reform China: Family, education, and labor market. Chinese Sociological Review 50(3): 231–239.

27.

Wang

Liu

, et al. (2020) Young women’s fertility intentions and the emerging bilateral family system under China’s two-child family planning policy. China Review 20(2): 113–142.

28.

Knijn

Liefbroer

(2006) More kin than kind: Instrumental support in families. In: Dykstra PA, Kalmijn M, Knijn TCM, et al. (eds) Family Solidarity in the Netherlands (Population Studies). Amsterdam: Dutch University Press, pp.89–105.

29.

Kuznesof

(2005) The house, the street, global society: Latin American families and childhood in the twenty-first century. Journal of Social History 38(4): 859–872.

30.

Lee

Spitze

Logan

(2003) Social support to parents-in-law: The interplay of gender and kin hierarchies. Journal of Marriage and Family 65(2): 396–403.

31.

Lee

Xiao

(1998) Children’s support for elderly parents in urban and rural China: Results from a national survey. Journal of Cross-Cultural Gerontology 13: 39–62.

32.

Lee

Parish

Willis

(1994) Sons, daughters, and intergenerational support in Taiwan. American Journal of Sociology 99(4): 1010–1041.

33.

Lei

(2013) Sons, daughters, and intergenerational support in China. Chinese Sociological Review 45(3): 26–52.

34.

Feldman

Jin

(2004) Children, marriage form, and family support for the elderly in contemporary rural China: The case of Songzi. Research on Aging 26(3): 352–384.

35.

Lillard

Willis

(1997) Motives for intergenerational transfers: Evidence from Malaysia. Demography 34: 115–134.

36.

Lin

Goldman

Weinstein

, et al. (2003) Gender differences in adult children’s support of their parents in Taiwan. Journal of Marriage and Family 65(1): 184–200.

37.

Lin

(2011) Filial norms and intergenerational support to aging parents in China and Taiwan. International Journal of Social Welfare 20(S1): S109–S120.

38.

Liu

Feng

Jiang

, et al. (2020) Family structure and competing demands from aging parents and adult children among middle-aged people in China. Journal of Family Issues 41(2): 235–261.

39.

Logan

Bian

(2003) Parents’ needs, family structure, and regular intergenerational financial exchange in Chinese cities. Sociological Forum 18(1): 85–101.

40.

Matthews

Heidorn

(1998) Meeting filial responsibilities in brothers-only sibling groups. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences 53(5): S278–S286.

41.

Morgan

Hirosima

(1983) The persistence of extended family residence in Japan: Anachronism or alternative strategy? American Sociological Review 48(2): 269–281.

42.

ACY

Phillips

Lee

WKM

(2002) Persistence and challenges to filial piety and informal support of older persons in a modern Chinese society: A case study in Tuen Mun, Hong Kong. Journal of Aging Studies 16(2): 135–153.

43.

Noël-Miller

Tfaily

(2009) Financial transfers to husbands’ and wives’ elderly mothers in Mexico: Do couples exhibit preferential treatment by lineage? Research on Aging 31(6): 611–637.

44.

Raley

Bianchi

(2006) Sons, daughters, and family processes: Does gender of children matter? Annual Review of Sociology 32: 401–421.

45.

Rossi

(1990) Of Human Bonding: Parent–Child Relations Across the Life Course. New York: Aldine de Gruyter.

46.

Sarkisian

Gerstel

(2004) Explaining the gender gap in help to parents: The importance of employment. Journal of Marriage and Family 66(2): 431–451.

47.

Shen

Williamson

(2010) China’s new rural pension scheme: Can it be improved? International Journal of Sociology and Social Policy 30(5/6): 239–250.

48.

Shu

Zhu

Zhang

(2012) Patriarchy, resources, and specialization: Marital decision-making power in urban China. Journal of Family Issues 34: 885–917.

49.

Shuey

Hardy

(2003) Assistance to aging parents and parents-in-law: Does lineage affect family allocation decisions? Journal of Marriage and Family 65(2): 418–431.

50.

Silverstein

Giarrusso

(2010) Aging and family life: A decade review. Journal of Marriage and Family 72(5): 1039–1058.

51.

Silverstein

Gans

Yang

(2006) Intergenerational support to aging parents: The role of norms and needs. Journal of Family Issues 27(8): 1068–1084.

52.

Song

Feldman

(2012) Out-migration of young adults and gender division of intergenerational support in rural China. Research on Aging 34(4): 399–424.

53.

Sun

(2002) Old age support in contemporary urban China from both parents’ and children’s perspectives. Research on Aging 24(3): 337–359.

54.

Swartz

(2009) Intergenerational family relations in adulthood: Patterns, variations, and implications in the contemporary United States. Annual Review of Sociology 35(1): 191–212.

55.

Szinovacz

Davey

(2008) The division of parent care between spouses. Ageing & Society 28(4): 571–597.

56.

Tan

(2018) Dual burdens of care: “Sandwiched couples” in East Asia. Journal of Aging and Health 30(10): 1574–1594.

57.

Taniguchi

Kaufman

(2017) Filial norms, co-residence, and intergenerational exchange in Japan. Social Science Quarterly 98(5): 1518–1535.

58.

Tolkacheva

Broese

Tilburg

(2010) Sibling influence on care given by children to older parents. Research on Aging 32(6): 739–759.

59.

(2016) Chinese one-child families in the age of migration: Middle-class transnational mobility, ageing parents, and the changing role of filial piety. The Journal of Chinese Sociology 3(15). DOI: 10.1186/s40711-016-0036-z.

60.

Vilela

(2013) Pension Watch: Briefings on Social Protection in Older Ages. London: HelpAge International.

61.

Wang

(2010) Intergenerational transmission of family property and family management in urban China. The China Quarterly 204: 960–979.

62.

Waite

Harrison

(1992) Keeping in touch: How women in mid-life allocate social contacts among kith and kin. Social Forces 70(3): 637–654.

63.

Whyte

(2005) Continuity and change in urban Chinese family life. The China Journal 53: 9–33.

64.

Whyte

(2020) Confronting puzzles in understanding Chinese family change: A personal reflection. Chinese Journal of Sociology 6(3): 339–363.

65.

Whyte

(2003) Support for aging parents from daughters versus sons. In: MK Whyte (ed.) China’s Revolutions and Intergenerational Relations. Ann Arbor, MI: University of Michigan, Center for Chinese Studies, pp.167–196.

66.

Willson

Shuey

Elder

Jr. (2003) Ambivalence in the relationship of adult children to aging parents and in-laws. Journal of Marriage and Family 65(4): 1055–1072.

67.

Wong

Capoferro

Soldo

(1999) Financial assistance from middle-aged couples to parents and children: Racial–ethnic differences. Journals of Gerontology Series B: Psychological Sciences and Social Sciences 54(3): S145–S153.

68.

World Bank (2017) Fertility rate, total (births per woman). World Bank Open Data. Available at: https://data.worldbank.org/indicator/SP.DYN.TFRT.IN (accessed 17 May 2019).

69.

Xiang

(2018) China home to 241 million people aged 60 or above. Xinhua, 26 February. Available at: http://www.xinhuanet.com/english/2018-02/26/c_137001436.htm (accessed 17 May 2019).

70.

Xie

Zhu

(2009) Do sons or daughters give more money to parents in urban China? Journal of Marriage and Family 71(1): 174–186.

71.

Yang

(1996) The distributive norm of monetary support to older parents: A look at a township in China. Journal of Marriage and Family 58(2): 404–415.

72.

George

Sereny

, et al. (2016) Older parents enjoy better filial piety and care from daughters than sons in China. American Journal of Medical Research 3(1): 244–272.

73.

Zhan

Montgomery

(2003) Gender and elder care in China: The influence of filial piety and structural constraints. Gender & Society 17(2): 209–229.

74.

Zhang

(2016) Intergenerational relations and Chinese elderly’s subjective well-being: An analysis of differentials by gender and residence. Chinese Journal of Sociology 2(3): 429–446.

75.

Zhang

(2009) “A married out daughter is like spilt water”? Women’s increasing contacts and enhanced ties with their natal families in post-reform rural North China. Modern China 35: 256–283.

76.

Zhang

(2016) Practising and displaying xiao—young mothers’ negotiations of obligations to elders. The Journal of Chinese Sociology 3(27). DOI:10.1186/s40711-016-0047-9.

77.

Zheng

(2018) Marital power, spousal relationship, and intergenerational support. The Journal of Chinese Sociology 5(14). DOI: 10.1186/s40711-018-0084-7.

78.

Zhu

Xie

(2017) Buying out of familial obligation: The tradeoff between financially supporting versus living with elderly parents in Urban China. Chinese Journal of Sociology 3(1): 56–73.

79.

Zuo

Bian

(2005) Beyond resources and patriarchy: Marital construction of family decision-making power in post-Mao urban China. Journal of Comparative Family Studies 36(4): 601–622.

Women’s perceived support of parents and parents-in-law in China: Socioeconomic resources,reciprocity,and family context

Abstract

Keywords

Introduction

The role of women in caring for parents and parents-in-law

The contemporary Chinese context: Continuity and change in intergenerational relations

Hypotheses

Data and methods

Dependent variables

Independent variables

Results

Regression results

Support for parents

Support for parents-in-law

Discussion and conclusion

Footnotes

Declaration of conflicting interests

Funding

Notes

References