Abstract
BackgroundThe proportion of population ageing in China will grow significantly in the next few decades but the pace of population ageing and social change vary considerably across regions. Notably, Eastern coastal areas are economically more advanced compared to the Western region. These economic disparities could result in differing adverse health outcomes.MethodsWe investigate geographical variations in self-rated overall health and functional limitations in a national representative sample of Chinese aged 50 years and older (n = 13,175) using the WHO Study on global AGEing and adult health (WHO SAGE). We used multivariable logistic regression to investigate urban-rural inequalities across regions, adjusting for sociodemographic and health covariates. Two main outcomes were self-rated overall health and functional limitations based on the WHO Disability Assessment Schedule 2.0 for a range of daily activities.ResultsThe largest urban-rural differences in adverse health outcomes were in Shandong (AORs for urban versus rural of 6.32 [95% Confidence Interval 4.53–8.82] for poor or very poor self-rated overall health and 5.14 [CI 3.55–7.44] for functional limitations), followed by Jilin (AORs 2.71 [CI 2.04–3.61] and 4.72 [CI 3.43–6.49]), and Hubei (AORs 2.36 [CI 1.82–3.07] and 4.11 [CI 2.80–6.04]), respectively. Covariates significantly associated with both adverse health outcomes were older age, poor income, no health insurance, and increasing number of chronic diseases.ConclusionOur study reveals substantial disparities between urban and rural areas observed in both the well-developed areas (eg Shandong) and also the lower end of the economic spectrum (eg Hubei and Jilin). Targeted economic development policy and systematic health prevention and healthcare policies could be beneficial in improving health in later life whilst minimising geographical inequalities.
Highlights
The proportion of population ageing in China will grow significantly in the few decades but the pace of population ageing and social change vary considerably across regions
Covariates significantly associated with both adverse health outcomes were older age, poor income, no health insurance, and increasing number of chronic diseases
The crude differences in poor self-rated overall health and functional limitations between urban and rural areas were remarkably large in Shandong and Hubei areas
Summary
The proportion of population ageing in China will grow significantly in the few decades but the pace of population ageing and social change vary considerably across regions. Eastern coastal areas are economically more advanced compared to the Western region. Population ageing in China is projected to increase significantly over the few decades. According to the United Nations (UN) Population Division 2015 report, currently 15% of the Chinese population is aged 60 years and over and this is expected to increase to 25% by 2030. The implications of population change and longevity include the rise in non-communicable diseases and subsequent increases of health care needs. These trends present major challenges to the social and health systems to enable older persons to maintain their independence and overall quality of life [2, 3]. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated
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