PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

Abstract Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

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Prediction of the Number of and Care Costs for Disabled Elderly from 2020 to 2050: A Comparison between Urban and Rural Areas in China

Sustainability ◽

10.3390/su12072598 ◽

2020 ◽

Vol 12 (7) ◽

pp. 2598 ◽

Cited By ~ 1

Author(s):

Liangwen Zhang ◽

Sijia Fu ◽

Ya Fang

Keyword(s):

Rural Areas ◽

Urban Areas ◽

The Elderly ◽

Severe Disabilities ◽

Term Care ◽

The Sustainable Development ◽

Global Challenge ◽

Disabled Elderly ◽

Urban And Rural Areas ◽

Care Costs

An aging population and an increase in the proportion of elderly people who are disabled have created an unprecedented global challenge, especially in China. This study aimed to predict the number of, and the care costs for, disabled elderly from 2020 to 2050 in China. A comparison was made between urban and rural areas, and we analyzed what must be done to maintain the sustainable development of China’s long-term care insurance (LTCI) system. An overall simulation model and a Monte Carlo simulation were used to estimate the number of disabled elderly and their related care costs, in both urban and rural areas. According to the forecast, the total disabled population will increase rapidly, rising from 43.75 million in 2020 to 91.4 million in 2050. Of that total, 69.7% are expected to be urban elderly. Starting in 2020, the growth rates of the elderly with mild, moderate, and severe disabilities will be 108%, 104%, and 120%, respectively, by 2050. Accordingly, the total care costs will increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan in 2050, of which 80.2% will be required in urban areas. In addition, the per capita costs of care in urban and rural areas in 2050 will be 6 times and 11 times higher than in 2020, respectively. The predicted results show that the number of disabled elderly and the related care costs will increase sharply from 2020 to 2050, especially the growth rate of the number of severely disabled elderly. This study provides strong evidence of the need for the establishment of a unified national LTCI system in China.

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Green and Blue Space Availability and Self-Rated Health among Seniors in China: Evidence from a National Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020545 ◽

2021 ◽

Vol 18 (2) ◽

pp. 545

Author(s):

Chensong Lin ◽

Longfeng Wu

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Empirical Studies ◽

National Level ◽

The Elderly ◽

Coverage Ratio ◽

Self Rated Health ◽

Health Promoting ◽

Major River ◽

Urban And Rural Areas

Many empirical studies have shown evidence of multiple health benefits provided by green and blue spaces. Despite the importance of these spaces, investigations are scarce in details for blue spaces rather than green. Moreover, most research has focused on developed regions. A limited number of studies on blue spaces can be found in China with a focus on the city level. Outcomes have been mixed due to varying research scales, methodologies, and definitions. This study relies on a national-level social survey to explore how the self-rated health (SRH) of senior individuals is associated with local green and blue space availability in urban and rural areas. Results indicate that the coverage ratio of overall green spaces and waterbodies around a resident’s home have marginal effects on SRH status in both urban and rural areas. In urban areas, living close to a park can is marginally beneficial for older people’s health. Regarding different types of blue spaces, the presence of a major river (within 0.3–0.5 km) or coastline (within 1 km and 1–5 km) in the vicinity of home negatively affects SRH among the elderly in urban areas. Close proximity to lakes and other types of waterbodies with a water surface larger than 6.25 ha did not significantly influence SRH. These findings not only evaluate general health impacts of green/blue space development on senior populations across the county but inform decision makers concerning the health-promoting qualities and features of different green/blue spaces to better accommodate an aging population in the era of urbanization.

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Factors Associated with Happiness among Malaysian Elderly

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18073831 ◽

2021 ◽

Vol 18 (7) ◽

pp. 3831

Author(s):

Shamsul Azhar Shah ◽

Nazarudin Safian ◽

Saharuddin Ahmad ◽

Wan Abdul Hannan Wan Ibadullah ◽

Zulkefley bin Mohammad ◽

...

Keyword(s):

Emotional Support ◽

Rural Areas ◽

Social Engagement ◽

Urban Areas ◽

Elderly Population ◽

Handgrip Strength ◽

The Elderly ◽

Evaluation Study ◽

Factors Associated ◽

Urban And Rural Areas

Happiness is an essential component to experience healthy ageing. Hence, understanding the factors that contribute to happiness is important. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia. In this study, 1204 respondents were recruited from urban and rural areas in Selangor. A face-to-face interview was conducted using the Bahasa Malaysia version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60-years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study. Among the 1204 respondents, 953 (79.2%) were happy. Sociodemographic characteristics showed that being a men, age of 60 to 74 years, and living in urban areas were significantly associated with happiness. A logistic regression model showed that locality (aOR 1.61), income category (Bottom 40% aOR 0.49; Middle-class group 40% aOR 1.40), social engagement (active aOR 1.77; less active aOR 1.25), receiving emotional support (aOR 2.11) and handgrip strength (aOR 1.02) were significantly associated with happiness. Thus, ensuring the elderly population in receiving emotional support and active social engagement among them can enhance their happiness level.

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Decomposing Urban-rural Differences in Multimorbidity Among Older Adults in India: A Study Based on Lasi Data

10.21203/rs.3.rs-701569/v1 ◽

2021 ◽

Author(s):

Shekhar Chauhan ◽

Shobhit Srivast ◽

Pradeep Kumar ◽

Ratna Patel

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Decomposition Analysis ◽

The Public ◽

Analysis Techniques ◽

Ageing Study ◽

Urban Rural ◽

The Difference ◽

Urban And Rural Areas

Abstract Background: Multimorbidity is defined as the co-occurrence of two or more than two diseases in the same person. With rising longevity, multimorbidity has become a prominent concern among the older population. Evidence from both developed and developing countries shows that older people are at much higher risk of multimorbidity, however, urban-rural differential remained scarce. Therefore, this study examines urban-rural differential in multimorbidity among older adults by decomposing the risk factors of multimorbidity and identifying the covariates that contributed to the change in multimorbidity.Methods: The study utilized information from 31,464 older adults (rural-20,725 and urban-10,739) aged 60 years and above from the recent release of the Longitudinal Ageing Study in India (LASI) wave 1 data. Descriptive, bivariate, and multivariate decomposition analysis techniques were used.Results: Overall, significant urban-rural differences were found in the prevalence of multimorbidity among older adults (difference: 16.3; p<0.001). Moreover, obese/overweight and high-risk waist circumference were found to narrow the difference in the prevalence of multimorbidity among older adults between urban and rural areas by 8% and 9.1%, respectively.Conclusion: There is a need to substantially increase the public sector investment in healthcare to address the multimorbidity among older adults, more so in urban areas, without compromising the needs of older adults in rural areas.

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Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

Acta Scientiarum Health Sciences ◽

10.4025/actascihealthsci.v43i1.51421 ◽

2021 ◽

Vol 43 ◽

pp. e51421

Author(s):

Roberta Dayanny Soares ◽

Aíla Maropô Araújo

Keyword(s):

Activities Of Daily Living ◽

Rural Areas ◽

Urban Areas ◽

Daily Living ◽

Functional Limitation ◽

Rio Grande ◽

The Elderly ◽

Northeast Region ◽

Instrumental Activities ◽

Urban And Rural Areas

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

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Comparison of The Risk Factors For Falls Among Older Adults Between Urban and Rural Areas of Shantou City, China

10.21203/rs.3.rs-72830/v1 ◽

2020 ◽

Author(s):

Xiaodong Chen ◽

Zeting Lin ◽

Ran Gao ◽

Yijian Yang ◽

Liping Li

Keyword(s):

Risk Factors ◽

Older Adults ◽

Fall Prevention ◽

Rural Areas ◽

Urban Areas ◽

Multivariable Analysis ◽

Living Environment ◽

Balance Function ◽

Urban And Rural Areas ◽

Risk Factors For Falls

Abstract Background: To investigate the prevalence of falls and risk factors among older adults in urban and rural areas and to facilitate the design of fall prevention interventions.Methods: We used cluster random sampling to investigate the sociodemographic information, living habits, medical history, and falls among 649 older adult participants. Univariable and multivariable logistic regression was used to examine fall risk factors in urban and rural areas.Results: The fall rate and rate of injury from falls among older adults in urban areas were 27.3% and 18.6%, respectively, which were higher than those in rural areas (17.0% and 12.2%; P<0.05). Multivariable analysis showed that the risk factors for falls among urban older adults included a high school or below education level (OR=3.737, 95% CI: 1.503~9.291); diabetes medicine use (OR=4.518, 95% CI: 1.228~16.626); incontinence (OR=8.792, 95% CI: 1.894~40.824); lack of fall prevention education (OR = 11.907, 95% CI: 1.321～107.354); and reduced balance function (OR = 3.901, 95% CI: 1.894~7.815). The risk factors among rural older adults included a previous nonfarming occupation (OR=2.496, 95% CI: 1.416~4.398); incontinence (OR =11.396, 95% CI: 1.901~68.327); poor living environment (OR=3.457, 95% CI: 1.488~8.033); and reduced balance function (OR =4.260, 95% CI: 2.361~7.688).Discussion: The rate of falls among older adults in urban areas is higher than that in rural areas of Shantou City. Fall prevention in urban areas should target older adults with low education and modify the diabetes medication use. Interventions should focus on improving the home environment of older adults in rural areas.

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Mapping poverty using mobile phone and satellite data

Journal of The Royal Society Interface ◽

10.1098/rsif.2016.0690 ◽

2017 ◽

Vol 14 (127) ◽

pp. 20160690 ◽

Cited By ~ 67

Author(s):

Jessica E. Steele ◽

Pål Roe Sundsøy ◽

Carla Pezzulo ◽

Victor A. Alegana ◽

Tomas J. Bird ◽

...

Keyword(s):

Rural Areas ◽

Urban Areas ◽

Census Data ◽

Data Sources ◽

Human Potential ◽

Public And Private ◽

Middle Income ◽

Mobile Data ◽

Poverty Measures ◽

Urban And Rural Areas

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to complement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evaluate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources provide the best predictive power (highest r 2 = 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of data collection.

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Association Between Happiness and Objective/Subjective Economic Status Among Older Adults in Myanmar

10.21203/rs.3.rs-122513/v1 ◽

2020 ◽

Author(s):

Yuri Sasaki ◽

Yugo Shobugawa ◽

Ikuma Nozaki ◽

Daisuke Takagi ◽

Yuiko Nagamine ◽

...

Keyword(s):

Older Adults ◽

Rural Areas ◽

Urban Areas ◽

Economic Status ◽

Wealth Index ◽

Economic Indicator ◽

Sampling Procedure ◽

Household Asset ◽

Face To Face ◽

Urban And Rural Areas

Abstract BackgroundFew studies have examined whether objective or subjective economic status (ES) has a greater effect on the happiness of older adults in developing countries with ageing populations. This study examined whether objective/subjective economic status (ES) is associated with happiness in older adults in Myanmar.MethodA multistage, random sampling procedure and face-to-face interviews were conducted in urban and rural areas in Myanmar. The happiness of 1,200 participants aged 60+ was evaluated using a single happiness score of 0 (very unhappy) to 10 (very happy). The wealth index, used as an objective economic indicator, was calculated from household asset items. Subjective economic status was assessed by asking “Which of the following best describes your current financial situation in light of general economic conditions?” The possible responses ranged from (1) very difficult to (5) very comfortable. ResultsThe mean happiness score was lower among participants with low objective and subjective ES than among those with medium or high objective ES (6.24 versus 6.80 points, p < 0.001) and average or higher subjective ES (5.62 versus 6.83 points, p < 0.001), respectively. Both low objective and subjective ES were negatively associated with happiness after adjusting for confounding variables (B: -0.41, 95% confidence interval [CI]: -0.69, -0.13 and B: -0.71, 95% CI: -1.00, -0.42, respectively) and stratification by region (low objective ES, urban: B: -0.52, 95% CI: -1.03, -0.02; low subjective ES, urban: B: -0.50, 95% CI: -0.96, -0.03; low objective ES, rural: B: -0.37, 95% CI: -0.73, -0.02; and low subjective ES, rural: B: -0.80, 95% CI: -1.18, -0.41). ConclusionsIn Myanmar, both objective and subjective ES might influence happiness among older adults. Although they had a similar impact on happiness in urban areas, subjective ES had a stronger impact in rural areas. Interventions for promoting happiness in older adults should consider differences in how objective/subjective ES impacts happiness in different regions, and focus should be placed not only on improving objective ES but also subjective ES in society.

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Utilisation willingness for institutional care by the elderly: a comparative study of empty nesters and non-empty nesters in Shandong, China

BMJ Open ◽

10.1136/bmjopen-2018-022324 ◽

2018 ◽

Vol 8 (8) ◽

pp. e022324 ◽

Cited By ~ 4

Author(s):

Yangyang Qian ◽

Wen Qin ◽

Chengchao Zhou ◽

Dandan Ge ◽

Li Zhang ◽

...

Keyword(s):

Rural Areas ◽

Living Arrangements ◽

Urban Areas ◽

Institutional Care ◽

Binary Logistic Regression ◽

The Elderly ◽

Empty Nest ◽

Care Needs ◽

Term Care ◽

The Government

IntroductionInstitutional care has been strongly promoted in China to meet seniors’ long-term care needs. Empty-nest elderly, in comparison with their counterparts, have less social support and fewer caring networks. This study aimed to compare the utilisation willingness for institutional care and its predictors between empty-nest and non-empty-nest seniors.MethodsA total of 3923 seniors were included in the analysis. Binary logistic regression models were used to understand the association between the living arrangements of the elderly households and willingness for institutional care and to identify the predictors of the utilisation willingness for institutional care among empty nesters and non-empty nesters.ResultsOur study found that approximately 8.5% of the seniors had a willingness for institutional care in Shandong, China. Empty-nest singles (OR 5.301; 95% CI 2.838 to 9.904) and empty-nest couples (OR 1.547; 95% CI 1.135 to 2.107) were found to be more willing to receive institutional care. Our results also showed that residence was a key determinant for institutionalisation willingness in empty-nest and non-empty-nest elderly. Among empty-nest singles, psychological stress was a positive determinant for institutional care. Factors, including education attainment, relationship with adult children, household income and per capita living space, were determinants for empty-nest couple willingness for institutionalisation. Age, number of children and self-reported health status were found to be associated factors for willingness among non-empty nesters.ConclusionsThe government should pay more attention to institutional care in rural areas where there is still a gap in elder care compared with that in urban areas. Targeted policies should be made for different types of seniors to offer appropriate institutional care.

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Estimating Long-Term Care Costs among Thai Elderly: A Phichit Province Case Study

Journal of Aging Research ◽

10.1155/2018/4180565 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

Pattaraporn Khongboon ◽

Sathirakorn Pongpanich

Keyword(s):

Informal Care ◽

Rural Areas ◽

Urban Areas ◽

Socioeconomic Development ◽

Long Term Care ◽

The Elderly ◽

Term Care ◽

Rural And Urban Areas ◽

Rural And Urban

Background. Rural-urban inequality in long-term care (LTC) services has been increasing alongside rapid socioeconomic development. This study estimates the average spending on LTC services and identifies the factors that influence the use and cost of LTC for the elderly living in urban and rural areas of Thailand. Methods. The sample comprised 837 elderly aged 60 years drawn from rural and urban areas in Phichit Province. Costs were assessed over a 1-month period. Direct costs of caregiving and indirect costs (opportunity cost method) were analyzed. Binary logistic regression was performed to determine which factors affected LTC costs. Results. The total annual LTC spending for rural and urban residents was on average USD 7,285 and USD 7,280.6, respectively. Formal care and informal care comprise the largest share of payments. There was a significant association between rural residents and costs for informal care, day/night care, and home renovation. Conclusions. Even though total LTC expenditures do not seem to vary significantly across rural and urban areas, the fundamental differences between areas need to be recognized. Reorganizing country delivery systems and finding a balance between formal and informal care are alternative solutions.

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