Geography matters to disability: regional disparity of bathing difficulty among older adults in China

Abstract

Bathing is a major type of disability among older adults. While studies on bathing difficulties have recently started to go beyond the limitations of the human body to examine bathroom amenities; researchers have rarely considered the environment beyond the bathroom. This study explored the regional disparities in bathing disability among older adults in China. Using data from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2018, random-effects logistic regressions were performed to examine how bathing difficulties differed across regions among older adults in China. We found that older adults residing in the northern regions were significantly more likely to experience bathing disability compared to those from the South after controlling for confounding variables. Women and the oldest-old were also the most likely to experience bathing disabilities. Within the Northern regions itself, individuals from the Northeast stood out for having the highest likelihood of experiencing bathing disability. Interestingly, this regional disparity only existed for bathing disability and not the other Activities of Daily Living (ADL) items. It is concluded that the large regional disparity could be due to both climate differences and uneven economic development across the different regions in China. As bathing is a highly environment-dependent activity, this study highlights the potential for policy interventions to reduce the prevalence of bathing disability among older adults through improving the bathing environment. Additionally, we aim to put forth the notion that disability research should move towards analyses of specific disability items rather than an undifferentiated ADL index.