Individual-level factors attributable to urban-rural disparity in mortality among older adults in China

BMC Public Health

Matthew E. Dupre¹  Yuan Zhao²  Danan Gu³  Li Qiu³  Xin Xu⁴  Qianqian Xie⁵ 

[1] Department of Population Health Sciences & Department of Sociology, Duke University, Durham, NC, USA;Ginling College & School of Geographic Sciences, Nanjing Normal University, Nanjing, China;Independent Researcher, New York, NY, USA;International Center on Aging and Health & School of Geographic Sciences, Nanjing Normal University, Nanjing, China;School of Geographic Sciences, Nanjing Normal University, Nanjing, China;

关键词: Urban-rural disparity;    Mortality;    Older adults;    Oldest-old;    China;    CLHLS;   

DOI  :  10.1186/s12889-020-09574-9

来源: Springer

【 摘 要 】

BackgroundUrban-rural disparity in mortality at older ages is well documented in China. However, surprisingly few studies have systemically investigated factors that contribute to such disparity. This study examined the extent to which individual-level socioeconomic conditions, family/social support, health behaviors, and baseline health status contributed to the urban-rural difference in mortality among older adults in China.MethodsThis research used the five waves of the Chinese Longitudinal Healthy Longevity Survey from 2002 to 2014, a nationally representative sample of older adults aged 65 years or older in China (n = 28,235). A series of hazard regression models by gender and age group examined the association between urban-rural residence and mortality and how this association was modified by a wide range of individual-level factors.ResultsOlder adults in urban areas had 11% (relative hazard ratio (HR) = 0.89, p < 0.01) lower risks of mortality than their rural counterparts when only demographic factors were taken into account. Further adjustments for family/social support, health behaviors, and health-related factors individually or jointly had a limited influence on the mortality differential between urban and rural older adults (HRs = 0.89–0.92, p < 0.05 to p < 0.01). However, we found no urban-rural difference in mortality (HR = 0.97, p > 0.10) after adjusting for individual socioeconomic factors. Similar results were found in women and men, and among the young-old and the oldest-old populations.ConclusionsThe urban-rural disparity in mortality among older adults in China was largely attributable to differences in individual socioeconomic resources (i.e., education, income, and access to healthcare) regardless of gender and age group.

【 授权许可】

CC BY