Trends in elderly health by cohort: Evidence from China

Abstract

China has the world's largest number of older persons and is undergoing rapid demographic and economic transitions. Using longitudinal data from seven waves of the China Health and Nutrition Survey (CHNS) spanning 1991–2009, this study examines trends by birth cohort for persons born during 1912–54 on several dimensions of elderly health—chronic diseases, physical function limitations, and excess weight. A fixed effects specification was used to distinguish trends in health, physical function, and weight common to all adult age groups and differential trends in these measures according to the person's birth year. The empirical results show that while there was a decline in physical function limitations over time, persons born in later years were more likely to experience a stroke and physical function limitations at older ages than were persons born earlier. A similar pattern occurred for stroke, but not for the other heath indicators. These findings are robust after accounting for sample attrition. The secular changes in health and function could have occurred for several reasons. Among the underlying mechanisms the data allow us to analyze, improved access to medical care and expanded health insurance coverage only had minor effects on observed changes in health and physical function.