This study provides a profile of the level of resilience among older Taiwanese adults and identified factors associated with resilience, while also comparing gender differences in those factors. Although resilience research has recently garnered more attention, it has been difficult to conduct any international comparisons due to the limited number of articles, and variations in measurements and study population. This study revealed that older men were more resilient than women in Taiwan, similar to another study conducted in Pakistan (16). Such a finding is not surprising, since resilience can be influenced by social norms or values. In this study, participants were raised in a traditional society in which Taiwanese men were likely to have a higher social status than women (17), and they inherit the family name and wealth. Frequently, women are often seen as less valuable (18). Hence, women, with fewer resources and lower self-esteem, would likely to have lower resilience compared to men. However, with changes in social norms in recent years, women have been given greater opportunities and resources compared to women in earlier years. The difference in resilience between older man and women will likely decrease in the near future.
Consistent with previous findings (9), higher self-rated health was associated with higher resilience in the overall sample, as well as in the stratified sample. This points to the fact that resilience is associated with one’s self-perception of health. Although self-rated health is highly associated with resilience in both men and women, it may play a more-influential role among women, since older women tend to report worse self-rated health than men. Since men tend to over-report their health (19), this can possibly explain why the ‘fair’ health group did not statistically differ from the ‘poor’ health group among older men.
For both older men and women, education was positively associated with resilience. For older women, any increase in education was associated with higher resilience, while only the highest level of education was associated with higher resilience among older men. In Taiwan, older women traditionally had fewer socioeconomic resources, such as power, authority, and earnings compared to men (20). A large proportion of the older women had no formal education, and only a few had a secondary level or higher education. Thus, any increase in the level of education for older women would go a long way to improving their socioeconomic status. However, the association between education and resilience will likely to decrease in future studies, as education has become more accessible regardless of gender.
For both men and women, other factors such as family relationships, religion, and time spent on leisure were all positively associated with resilience. In the literature, this trend was observed for hobbies (21, 22), family relationships (23), and religion (7, 24). However, one study suggested that the relationship between religion and resilience is more pronounced in women (25). Family relationships and religion can possibly be sources of happiness, gratitude, social support, and a sense of purpose; all of which are also characteristic of resilience (26).
When stratified by gender, it appeared that older men and women showed very different profiles of resilience. Marriage was associated with lower resilience among older women but was not associated with resilience among older men. More research is needed to assess the underlying association between marriage and resilience. The nature of spousal relationships within the culture, and the expectations placed upon marriage could play roles in how gender moderates the relationship between marriage and resilience. Some research indicated that women, who provide most of the caregiving within the family in Taiwan, were under greater social pressure, and their health needs could be easily neglected (27). Thus, it is possible that older Taiwanese women, in trying to fulfil the traditional roles of wife/caregiver, are more likely than men to face social isolation due to housework, as well as increased familial responsibilities and stress (28), and hence are more likely to have lower resilience.
Similarly, financial stress was associated with resilience among older women, but not among men in this study. This is supported by a previous study in women which showed that a higher income was associated with higher resilience (6). The association between household income and resilience in women can be attributed to traditional roles of women in Taiwan, where women often do much of the household shopping and bookkeeping (29). Thus, it is possible that women may be more sensitive to financial stresses of the household.
Satisfaction with one's living environment was also associated with resilience among olderwomen, but not among men. Little information is available regarding satisfaction with one's living environment and resilience. However, previous research indicated that women tend to internalize issues such as environmental security more than men (30) and probably would be more likely to be influenced by the environment than men would. Age also had a negative association with resilience among older women, consistent with the previous literature (6), but not among older men. Several pieces of literature pointed out increasing challenges of life events for older women, more so than for older men. Phenomena such as ‘feminization of poverty’ (31–33) and ‘feminization of caregiving’ (33) indicate that older women face significant challenges as they age (34). Poverty and caregiving stresses were reported to be associated with resilience (6, 35).
This study used cross-sectional data, and hence the results should be interpreted accordingly; we are unable to imply a causal relationship between the various factors and resilience. Restricted by the length of the questionnaire, we were unable to include the full-length version of the resilience questions; however, the personal strength/perception of the Resilience Scale for Adults was seen to be reliable and valid (36, 37). Only those who were able to communicate verbally and provide written consent were included in this study, and hence, we may overestimate the resilience level since older adults with severely poor health were excluded.
To sum up, older women were more likely to have low resilience than men. Self-rated health, education, religion, leisure time, and family relationships were significant factors in resilience for both older men and women, while the marital status, age, financial stress, and satisfaction with one's living environment were significant factors only for older women. Older women are at a higher risk of negative influences of low resilience, especially those with lower education and lower financial security. From the perspective of policymaking, interventions featuring optimism, problem solving, coping, positive emotions, and establishing and maintaining strong positive relationships may prove successful in bolstering resilience in vulnerable groups. More research is needed to understand how contextual factors, such as male-preference social norms in Asia and marriage relationships and obligations, influence resilience as women age.