School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
School of Public Management, Northwest University, Xi'an 710127, China.
Int J Environ Res Public Health. 2021 Jul 29;18(15):8056. doi: 10.3390/ijerph18158056.
China is becoming an aging society, and the proportion of the population aged 60 years and above is increasing. There is a dualistic urban-rural economic structure between urban and rural areas in China, but there are few comparative health studies on the self-assessed health (SAH) status of the elderly between urban and rural areas. The aim of this study is to explore the SAH status of the elderly in China, and to identify the health disparity between the urban and rural elderly.
The data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were adopted. A total of 9630 participants aged 60 and above were included in this study. SAH was used as the indicator, measuring the health status. Fairlie decomposition analysis was conducted to find the SAH disparity.
The proportion of good SAH of the rural elderly (24.01%) was significantly higher than the urban elderly (19.99%). The association of SAH was widely different between the rural and urban elderly. There was a stronger association between SAH and sleeping time in the urban elderly (Odds ratios (OR) = 3.347 of 4-8 h; OR = 3.337 of above 8 h) than the rural elderly (OR = 1.630 of 4-8 h; OR = 2.293 of above 8 h). Smoking and social activity were significant only in the urban elderly, while region and assets were significant only in the rural elderly. Drinking (11.45%), region (-33.92%), and assets (73.50%) were the main factors contributing to the urban-rural health disparities.
This is the first comparative study examining SAH disparity, focusing on the elderly aged 60 and above in China. From the perspective of drinking, region, and assets, our study highlighted substantial urban-rural health disparities, and provided evidence for policy making on narrowing the health gap between urban and rural areas in China.
中国正逐渐步入老龄化社会，60 岁及以上人口比例不断增加。中国城乡之间存在二元经济结构，但针对城乡老年人自评健康状况的比较健康研究较少。本研究旨在探讨中国老年人的自评健康状况，并确定城乡老年人健康差异。
本研究采用 2018 年中国健康与养老追踪调查（CHARLS）的第四轮数据。共纳入 9630 名 60 岁及以上的参与者。采用自评健康作为指标，衡量健康状况。采用公平分解分析来发现自评健康差异。
农村老年人（24.01%）良好自评健康的比例明显高于城市老年人（19.99%）。城乡老年人自评健康的关联差异较大。城市老年人自评健康与睡眠时间的关联更强（4-8 小时的优势比（OR）=3.347；8 小时以上的 OR=3.337），而农村老年人则较弱（4-8 小时的 OR=1.630；8 小时以上的 OR=2.293）。吸烟和社会活动仅在城市老年人中显著，而地区和资产仅在农村老年人中显著。饮酒（11.45%）、地区（-33.92%）和资产（73.50%）是造成城乡健康差异的主要因素。
这是第一项针对中国 60 岁及以上老年人自评健康差异的比较研究。从饮酒、地区和资产的角度来看，本研究强调了城乡之间存在实质性的健康差异，并为中国缩小城乡健康差距的政策制定提供了证据。
