Health benefits of compact cities for Chinese older adults: Nation-level study of Chinese cities

Abstract

Studies in North American and European cities since the 2000s have found that living in compact cities led to health gains for urban residents, although the benefits can be small and nuanced. Studies in China have shown mixed results, and higher urban density can be associated with adverse health outcomes due to heavier air pollution and overcrowding in Chinese cities. This paper examines the relationship between urban compactness and the self-rated health of older adults in 278 Chinese prefectural and up-level cities based on China’s 2010 census. We use a composite urban compact index incorporating population density, land use, and transportation patterns—salient characteristics according to the compact city and health literature. Our results show that living in compact cities in China is associated with significant statistical gain in self-evaluations of health for older adults, controlling for demographic, socioeconomic, and environmental variables, but the extents of the benefit vary among cities in Eastern, Central, and Western Regions of China, confirming the nonlinear relationship suggested by other studies on individual Chinese cities. The research calls for greater attention to the role of compact cities in supporting the healthy aging processes for older adults in urban China and the potential damage to their physical and mental well-being due to rapidly declining urban compactness in recent decades. The model also identifies other distinctive contributing factors for the self-rated health of older adults in three geographical zones and policy implications.