scholarly journals Health Disparities between the Rural and Urban Elderly in China: A Cross-Sectional Study

Author(s):  
Jian Zhang ◽  
Dan Li ◽  
Jianmin Gao

Background: China is becoming an aging society, and the proportion of the population aged 60 years and above is increasing. There is a dualistic urban–rural economic structure between urban and rural areas in China, but there are few comparative health studies on the self-assessed health (SAH) status of the elderly between urban and rural areas. The aim of this study is to explore the SAH status of the elderly in China, and to identify the health disparity between the urban and rural elderly. Methods: The data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS) in 2018 were adopted. A total of 9630 participants aged 60 and above were included in this study. SAH was used as the indicator, measuring the health status. Fairlie decomposition analysis was conducted to find the SAH disparity. Results: The proportion of good SAH of the rural elderly (24.01%) was significantly higher than the urban elderly (19.99%). The association of SAH was widely different between the rural and urban elderly. There was a stronger association between SAH and sleeping time in the urban elderly (Odds ratios (OR) = 3.347 of 4–8 hours; OR = 3.337 of above 8 hours) than the rural elderly (OR = 1.630 of 4–8 hours; OR = 2.293 of above 8 hours). Smoking and social activity were significant only in the urban elderly, while region and assets were significant only in the rural elderly. Drinking (11.45%), region (−33.92%), and assets (73.50%) were the main factors contributing to the urban–rural health disparities. Conclusions: This is the first comparative study examining SAH disparity, focusing on the elderly aged 60 and above in China. From the perspective of drinking, region, and assets, our study highlighted substantial urban–rural health disparities, and provided evidence for policy making on narrowing the health gap between urban and rural areas in China.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhenhua Zheng ◽  
Hong Chen

Abstract Background Although social network is a known determinant of the elderly’s well-being, it is not clear, in urban-rural and age-comparison, what its structural characteristics are and how it works for well-being. The research aims to discuss the features of the elderly’s social network and the social network efficacies on the well-being of older adults in China’s urban and rural areas as well as revealing the urban-rural disparities among the elderly of different age groups. Methods In this study, descriptive statistical analysis and structural equation Modeling (SEM) were used to make a group comparison between the urban and rural elderly of different age groups. All data are quoted from 2014 China Longitudinal Aging Social Survey (CLASS). The survey adopted the multi-stage probability sampling method, targeting Chinese senior citizens aged 60 and above, the ultimate samples totaled 11,511. Results The social network of the elderly in China feature a “reverse structure” in age sequences: with ageing, family network of the elderly expand while their friend network shrink; also, the expansion scale of the rural elderly’s family network is significantly larger than that of the city’s while the shrinkage scale of their friend network is smaller compared with its urban counterpart. The effect of family network on the rural elderly’s well-being shows a remarkable increase with age. However, there is no noticeable change in urban elderly groups of different ages. Conclusion The social network characteristics of the Chinese elderly are different between different age stages. Namely, the family network and the friend network have the “reverse structure “ in age sequences. Meanwhile, the family network and the friend network have different efficacies on the well-being of the elderly in China, and the differences between urban and rural areas are even more obvious. For rural elderly, family network has very important effects on their well-being. Moreover, With the increase of age, family network’s efficacies increase gradually. For urban elderly, comparatively, family network is just as important as friend network.


2021 ◽  
Author(s):  
Haixia Liu ◽  
Xiaojing Fan ◽  
Huanyuan Luo ◽  
Zhongliang Zhou ◽  
Chi Shen ◽  
...  

Abstract Background: The imbalance between urban and rural areas leads to heterogeneous loci of depression in urban and rural elderly and affects the depressive symptoms of elderly by changing the social environment. Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban-rural dual structure, depressive symptoms of the elderly in urban and rural areas are different.Methods: Based on the data of China Health and Retirement Longitudinal Study (CHARLS) in 2018y, 7690 elderly people aged ≥ 60 years were included in the final analysis. Center for Epidemiologic Studies Depression Scale (CES-D-10) were used to measure the depressive symptoms, and the generalized linear model (GLM) and binary logistic regression were employed to assess the association between urban and rural source and depression.Results: Depressive symptoms of the elderly in urban and rural areas were significantly different (P<0.001). GLM showed that the risk of depression in the rural elderly is 1.52 times (OR=1.52, 95% CI: 1.32 to 1.76) that of the urban elderly. The result of logistic regression showed that the influencing factors of depression in urban and rural areas were different. Gender, education level, life satisfaction, chronic disease and social activities were influencing factors of depression among the urban elderly. But for the rural elderly, influencing factors of depression were gender, education level, minorities, self-reported health status, life satisfaction, sleep duration (≤5h), chronic disease, social activities and income (except for pension). Conclusions: The results of our study indicated that targeted and precise intervention strategies to prevent depression should be proposed for the urban and rural elderly respectively.


2021 ◽  
Author(s):  
Shekhar Chauhan ◽  
Shobhit Srivast ◽  
Pradeep Kumar ◽  
Ratna Patel

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.


2021 ◽  
Author(s):  
Shekhar Chauhan ◽  
Shubham Kumar ◽  
Ratna Patel ◽  
David Jean Simon ◽  
Aradhana Singh

Abstract Background: While controlling the outbreak of communicable diseases (CDs) remained a priority, non-communicable diseases (NCDs) are placing an unavoidable burden on the health and social security system. India, a developing nation in South Asia, has seen an unprecedented economic growth in the past few years; however, it struggled to fight the burden of communicable and non-communicable diseases. Therefore, this study aimed at examining the burden of CDs and NCDs among elderly in India.Methods: Data from Longitudinal Ageing Study in India (LASI Wave-I, 2017-18) were drawn to conduct this study. Response variables were the occurrence of CDs and NCDs. The bi-variate and binary logistic regression were used to predict the association between communicable and non-communicable diseases by various socio-demographic and health parameters. Furthermore, to understand the inequalities of communicable and non-communicable diseases in urban and rural areas, the Fairlie decomposition technique was used to predict the contribution toward rural-urban inequalities in CDs and NCDs.Results: Prevalence of communicable diseases was higher among uneducated elderly than those with higher education (31.9% vs. 17.3%); however, the prevalence of non-communicable diseases was higher among those with higher education (67.4% vs. 47.1%) than uneducated elderly. The odds of NCDs were higher among female elderly (OR=1.13; C.I. = 1-1.27) than their male counterparts. Similarly, the odds of CDs were lower among urban elderly (OR=0.70; C.I. = 0.62-0.81) than rural elderly, and odds of NCDs were higher among urban elderly (OR=1.85; C.I. = 1.62-2.10) than their rural counterparts. Results found that education (50%) contributes nearly half of the rural-urban inequality in the prevalence of CDs among the elderly. Education status and current working status were the two significant predictors of widening rural-urban inequality in the prevalence of NCDs among the elderly.Conclusion: The burden of both CD and NCD among the elderly population requires immediate intervention. The needs of men and women and urban and rural elderly must be addressed through appropriate effort. In a developing country like India, preventive measures, rather than curative measures of communicable diseases, will be cost-effective and helpful.


Author(s):  
Anna Augustynowicz ◽  
Michał Waszkiewicz ◽  
Sławomir Szopa ◽  
Mariola Borowska ◽  
Aleksandra Czerw

Abstract Background In Poland, between 1989 and 2018 the number of the elderly increased by over 3.9 million. Demographic changes justify a senior policy focussed on the longest possible social, professional and family activity of the elderly. Directions of undertaken actions should include health policy programmes aimed at creating conditions healthy and active life of the elderly. The programmes should be particularly important in rural areas as the health of rural and urban residents differs. The study presents programmes for creating conditions for a healthy and active life of the elderly run by rural and urban-rural communes in 2012–17. Methods The study was conducted on the basis of existing data analysis. Data from the summary information prepared by voivodes and provided to the Minister of Health about implemented health policy programmes were used. Data on programmes concerning a healthy and active life for the elderly conducted by rural and urban-rural communes between 2012 and 2017 were extracted from the aggregate information. Results Between 2012 and 2017, 354 programmes were implemented, the most in 2016, and the least in 2015. There were 171 000 people participating in the programmes. The total cost was USD 2 491 664. Conclusion It can be presumed that in 2016 communes implemented more diagnostic and therapeutic programmes than in 2017. A small number of programmes and a small involvement of financial resources in communes with the largest number of the elderly may indicate marginalization of the importance of an active and healthy life for the elderly.


2003 ◽  
Vol 8 (3) ◽  
pp. 160-167 ◽  
Author(s):  
Constança Paúl ◽  
António M. Fonseca ◽  
Ignácio Martín ◽  
João Amado

In the scope of the ecology-of-aging paradigm, we studied two different groups of independent elderly living in rural versus urban Portuguese settings. The main objectives were: (1) to develop knowledge on aging in different contexts; (2) to analyze the differences in autonomous behavior, social relationships, psychological satisfaction (e.g., morale), and self-perception of general health and quality of life between rural and urban residents; (3) to contribute to the design of policies for the elderly. We did 1.5h home interviews of 234 elderly (117 rural and 117 urban) to collect socio-demographic data, and access the capacity to perform instrumental activities of daily living (IADL Scale) and life satisfaction (Philadelphia Morale Scale). Although all the subjects were to some extent deprived, results show that the two communities are different in some socio-demographic characteristics such as education level and financial situation (favoring urban elderly), and in their level of autonomy (higher in rural elderly); they also differ in their social network (larger for rural elderly), feeling of anxiety (lower in rural elderly), and attitudes toward their own aging (more positive in rural elderly). Both communities have a similar feeling of loneliness and a somewhat negative perception of health and quality of life. All the elderly consider aging-in-place as very important and require more community-based services.


2010 ◽  
Vol 44 (02) ◽  
pp. 105-120 ◽  
Author(s):  
SAIDATULAKMAL MOHD ◽  
AZLINDA AZMAN ◽  
JAMALLUDIN SULAIMAN ◽  
ISMAIL BABA

This study determines and compares the influence of various demographic factors in achieving well-being of the elderly population in the rural and urban areas in Indonesia. Age, marital status, social class, perceived health and economic condition are some of the main contributing factors in measuring well-being. In addition, social aspects such as living and familial arrangement were also investigated to establish elderly population well being. Data were collected using a survey-interview method. A total of 157 elderly in the urban areas and 145 elderly in the rural areas were surveyed. A causal model of well-being was employed to analyse the data obtained. The model of well-being was then tested using path analysis to test the causal relationships among the variables. Although the study indicated that there was no significant difference of well-being between the rural and urban elderly, the social support variables generally help improve the well-being of the elderly population.


Author(s):  
Haixia Liu ◽  
Xiaojing Fan ◽  
Huanyuan Luo ◽  
Zhongliang Zhou ◽  
Chi Shen ◽  
...  

Depression amongst the elderly population is a worldwide public health problem, especially in China. Affected by the urban–rural dual structure, depressive symptoms of the elderly in urban and rural areas are significantly different. In order to compare depressive symptoms and its influencing factors among the elderly in urban and rural areas, we used the data from the fourth wave of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7690 participants at age 60 or older were included in this study. The results showed that there was a significant difference in the prevalence estimate of depression between urban and rural elderly (χ2 = 10.9.76, p < 0.001). The prevalence of depression among rural elderly was significantly higher than that of urban elderly (OR-unadjusted = 1.88, 95% CI: 1.67 to 2.12). After adjusting for gender, age, marital status, education level, minorities, religious belief, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities and having income or not, the prevalence of depression in rural elderly is 1.52 times (OR = 1.52, 95% CI: 1.32 to 1.76) than that of urban elderly. Gender, education level, self-reported health, duration of sleep, chronic diseases were associated with depression in both urban and rural areas. In addition, social activities were connected with depression in urban areas, while minorities, marital status and having income or not were influencing factors of depression among the rural elderly. The interaction analysis showed that the interaction between marital status, social activities and urban and rural sources was statistically significant (divorced: coefficient was 1.567, p < 0.05; social activities: coefficient was 0.340, p < 0.05), while gender, education level, minorities, self-reported health, duration of sleep, life satisfaction, chronic disease, social activities having income or not and urban and rural sources have no interaction (p > 0.05). Thus, it is necessary to propose targeted and precise intervention strategies to prevent depression after accurately identifying the factors’ effects.


2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Tunjung Sri Yulianti ◽  
Anggit Ike Prascika

AbstractElderly will fail maintaining a balance of physiological conditions, thereby increasingvulnerability to depression. Factors that influence is the socio-economic changes, socialvalues, awareness among individuals and others. More urban environment isindividualistic and socioeconomic pressures are higher, while rural areas have theeducational background lower. The results showed not a few elderly people who returnedto the village because they felt pressured by the situation in the city, the elderly should bealone in the house and no neighbors who could be invited to communicate, so it isdifficult to be happy. But there are also elderly who live in the village reveal feelingdepressed and showed signs of depression. Purpose of the study to determine the levelof depression in the elderly in urban, rural and differences in the level of depressionamong the elderly who live in rural and urban areas.Subjects were elderly who live in the village of Palur Sukoharjo and Kampung SewuSurakarta. Methods of analytical study comparative research design. Measuringinstrument used is the Geriatric Depression Scale. Test data normality using theKolmogorov-Smirnov Test. Statistical test with independent t test.The results of the study obtained significancy value of t-test (two-tailed) 0.001.Conclusion of research is significant difference in rates of depression among the elderlyin urban and rural areas, the elderly in urban areas have higher levels of depression thanelderly people in rural areasKeywords: Elderly Depression Level, Rural, Urban


2021 ◽  
Vol 3 (2) ◽  
pp. 12-19
Author(s):  
Lifang Shi

This article aims to overcome the challenges faced by traditional elderly care services in China and discuss the development opportunities of smart elderly care services in urban and rural areas. Additionally, seek feasible countermeasures based on the basic ideas of smart elderly care to promote the transformation of urban and rural elderly care services to smart and intelligent. Therefore, we can bridge the gap between urban and rural areas, break the urban-rural dual structure, and encourage cities and villages to share the benefits of reform and development.


Sign in / Sign up

Export Citation Format

Share Document