Institute of Population Research, Peking University, Beijing, China.
Geriatr Gerontol Int. 2024 Jan;24(1):109-115. doi: 10.1111/ggi.14768. Epub 2023 Dec 12.
Driven by rapid socioeconomic development over recent decades, there are widening income inequalities and subjective health disparities among older adults in China. This study explored the relationship between income inequalities and self-rated healthy life expectancy (HLE) considering potential sex-specific differences.
From a cohort of 1760 individuals aged ≥60 years from the China Health and Nutrition Survey (1997-2006), we calculated age-specific life expectancy (LE), HLE and the proportion of HLE to LE (HLE/LE) by sex using the IMaCh software, incorporated time-varying income levels of older adults.
Although longevity has significantly improved, the well-being of Chinese older adults could be further enhanced by assessing HLE, as the results showed that at age 60 years, ~20% of their LE was characterized by unhealthiness. Discriminated by economic status, lower-income individuals experienced worse self-rated health compared with the general population and affluent counterparts. For instance, at age 60 years, the LE, HLE and HLE/LE of low-income men were 19.8 (95% CI 18.4-21.1), 16.2 years (95% CI 15.0-17.5) and 81.8%, respectively, lower than their general (21.7, 95% CI: 20.4-23.0; 18.0, 95% CI 16.8-19.2; and 82.9%) and high-income counterparts (25.1, 95% CI 23.1-27.2; 21.4, 95% CI 19.5-23.3; and 85.3%). Sex disparities were noticeable among low-income individuals in HLE/LE, with low-income women showing the most significant disadvantage.
Income inequalities exacerbated subjective health disparities among older adults, particularly among lower-income individuals and women. Our findings carry significant implications for formulating public health and social welfare strategies, especially in nations grappling with an aging population and undergoing parallel socioeconomic development. Geriatr Gerontol Int 2024; 24: 109-115.
近几十年来,中国社会经济快速发展,导致老年人的收入差距不断扩大,主观健康状况也存在差异。本研究旨在探讨考虑到潜在的性别差异,收入不平等与自评健康预期寿命(HLE)之间的关系。
本研究基于中国健康与营养调查(1997-2006 年)中 1760 名年龄≥60 岁的个体队列,使用 IMaCh 软件计算了按性别划分的特定年龄的预期寿命(LE)、HLE 和 HLE 与 LE 的比例(HLE/LE),并纳入了老年人的时变收入水平。
尽管寿命显著延长,但通过评估 HLE,中国老年人的幸福感仍有进一步提高的空间,因为结果表明,在 60 岁时,约 20%的 LE 是不健康的。按经济状况划分,低收入个体的自评健康状况比一般人群和富裕个体差。例如,在 60 岁时,低收入男性的 LE、HLE 和 HLE/LE 分别为 19.8(95%CI 18.4-21.1)、16.2 岁(95%CI 15.0-17.5)和 81.8%,低于一般人群(21.7,95%CI:20.4-23.0;18.0,95%CI 16.8-19.2;和 82.9%)和高收入个体(25.1,95%CI 23.1-27.2;21.4,95%CI 19.5-23.3;和 85.3%)。在 HLE/LE 方面,低收入个体存在明显的性别差异,其中低收入女性的劣势最为显著。
收入不平等加剧了老年人的主观健康差异,尤其是在低收入个体和女性中更为明显。我们的研究结果对制定公共卫生和社会福利战略具有重要意义,特别是在面临人口老龄化和社会经济发展并行的国家。老年医学与老年健康学杂志 2024;24:109-115。