School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China.
School of Law and Public Administration, China Three Gorges University, Yichang, China.
Front Public Health. 2024 Jan 5;11:1298657. doi: 10.3389/fpubh.2023.1298657. eCollection 2023.
With the increasing in aging in China, there has been an increase in older adults suffering from chronic diseases. However, little is known about the differences in chronic disease conditions between rural and urban older adults. The objective of this study is to identify chronic disease conditions and investigate the factors that cause differences in chronic disease conditions between urban and rural older adults.
The data are from the fourth wave of the China Health and Retirement Longitudinal Study. The coarsened exact matching (CEM) method was used to reduce the biases for a comparative study. After the CEM method, this study included 5,927 participants aged 60 and above. Chronic disease condition was used as the indicator to measure the health of older adults. Specifically, Fairlie's decomposition analysis was carried out to discover the differences in chronic disease conditions between urban and rural older adults.
The study showed that the proportion of those suffering from chronic diseases was significantly higher among urban older adults (51.26%) than rural older adults (46.56%). In those suffering from chronic diseases, there were significant differences in gender, education level, minorities, religiosities, duration of sleep, drinking alcohol, social activity, insurance, and socioeconomic status between rural and urban older adults, while in those not suffering from chronic diseases, there were significant differences in age, education level, marital status, drinking alcohol, social activity, insurance, region, and socioeconomic status between rural and urban older adults. For rural older adults, those who were widowers [Odds ratios (OR): 1.267], who drink alcohol (OR: 1.421), and having government medical insurance (OR: 4.869) had higher odds of having chronic diseases. However, those who were in high school and above (OR: 0.802), reporting a duration of sleep of 4-8 h (OR: 0.745) or above 8 h (OR: 0.649), having social activity (OR: 0.778), and having the most affluent socioeconomic status (OR: 0.778) had lower odds of having chronic diseases. As for urban older adults, those who were aged 65-74 years (OR: 1.246) and had government medical insurance (OR: 2.362) had higher odds of having chronic diseases. Fairlie's decomposition analysis indicated that 23.57% of the differences in chronic diseases conditions could be traced to duration of sleep, drinking alcohol, social activity, and region.
This study illustrated that the proportion of chronic diseases was higher among urban older adults than rural older adults. Considering duration of sleep, drinking alcohol, region, social activity, and region, the study demonstrated health differences between urban and rural older adults and provided evidence for policy-making to narrow the health gap between urban and rural areas.
随着中国老龄化的加剧，越来越多的老年人患有慢性病。然而，对于城乡老年人慢性病状况的差异知之甚少。本研究旨在确定慢性病状况，并探讨导致城乡老年人慢性病状况差异的因素。
数据来自中国健康与退休纵向研究的第四波调查。使用粗糙精确匹配（CEM）方法来减少比较研究中的偏差。在 CEM 方法之后，本研究纳入了 5927 名 60 岁及以上的参与者。慢性病状况用于衡量老年人的健康状况。具体来说，进行了费尔利分解分析以发现城乡老年人慢性病状况的差异。
研究表明，城市老年人（51.26%）患有慢性病的比例明显高于农村老年人（46.56%）。在患有慢性病的人群中，城乡老年人在性别、教育程度、少数民族、宗教信仰、睡眠时间、饮酒、社会活动、保险和社会经济地位方面存在显著差异，而在未患有慢性病的人群中，城乡老年人在年龄、教育程度、婚姻状况、饮酒、社会活动、保险、地区和社会经济地位方面存在显著差异。对于农村老年人，丧偶者（优势比[OR]：1.267）、饮酒者（OR：1.421）和参加政府医疗保险者（OR：4.869）患有慢性病的几率更高。然而，那些接受过高中及以上教育（OR：0.802）、报告睡眠时间为 4-8 小时（OR：0.745）或 8 小时以上（OR：0.649）、有社会活动（OR：0.778）和处于最富裕社会经济地位的人（OR：0.778）患有慢性病的几率较低。对于城市老年人，65-74 岁的老年人（OR：1.246）和参加政府医疗保险的老年人（OR：2.362）患有慢性病的几率更高。费尔利分解分析表明，23.57%的慢性病状况差异可归因于睡眠时间、饮酒、社会活动和地区。
本研究表明，城市老年人慢性病的比例高于农村老年人。考虑到睡眠时间、饮酒、地区、社会活动和地区，本研究展示了城乡老年人之间的健康差异，并为缩小城乡地区健康差距的政策制定提供了证据。
