The Effects of Adult Offspring Migration on Nutrient Intake of Rural Elderly People in China

Sufficient and Reasonable nutrient intake is essential for guaranteeing elderly people’s health, especially in rural China where elderly people are the main labor inputs in agricultural sector. Using the 2011 wave data of China Health and Nutrition Survey, this study has empirical analyzed the impact of adult children’s migration on nutrient intake of their elderly parents in rural areas. The results show that dietary energy and protein intake of rural elderly parents are inadequate where it is less than the Chinese RNI value significantly. Adult offspring migration positively relates with rural elderly parents’ protein intake as well as the dietary energy intake. In the families that partly adult offspring have out-migrated or in the one-child families, elderly parents benefit more from children migration. And for male, younger and low education elders, their nutrient intake is more likely to be improved by offspring migration.

Factors associated with active aging in Chinese elderly in rural areas of Xiangtan County, China†

Objectives To explore the level of active aging and correlates among rural elderly in Xiangtan County, China. Methods A cross-sectional survey was conducted from July to November 2019. A total of 945 rural elderly from 3 towns in Xiangtan County, China, were investigated by using the positive aging evaluation questionnaire (PAEQ), the activity of daily living scale (ADL), and the depression in old-age scale (DIA-S). Results The average score in the PAEQ among the rural elderly of Xiangtan County was 72.81 (range = 21–105). A moderate negative correlation was found between the score in the PAEQ and those in the ADL (r = −0.361) and DIA-S (r = −0.495). Symptoms of depression (β: −0.321, P = 0.001), number of chronic diseases (β: −0.281, P = 0.001), subjective economic status (β: 0.239, P = 0.001), ADL (β: −0.196, P = 0.001), education (β: 0.126, P = 0.001), number of children (β: 0.097, P = 0.001), and marital status (β: −0.060, P = 0.001) were significantly associated with levels of active aging in rural elderly, whereas gender and age were not independently related to active aging. Conclusions The level of active aging is at a moderately high level in the Chinese elderly in rural areas in Xiangtan County. The focus group of active aging in rural areas should be elderly people suffering from chronic diseases, physical decline, poor education and economic conditions, childlessness, and those without partners.

Spatial Analysis and Comparison of the Economic Burden of Common Diseases: An Investigation of 5.7 Million Rural Elderly Inpatients in Southeast China, 2010–2016

Background: As China embraced an aging society, the burden of age-related diseases had increased dramatically. Knowledge about spatial distribution characteristics of disease burden and the influencing factors of medical expenditure is of great significance to the formulation of health policies. However, related research in rural China is still insufficient.Methods: A total of 5,744,717 records of hospitalized rural elderly in southeast China were collected from 2010 to 2016. We described the temporal trends of hospitalization medical expenditure and the prevalence of catastrophic health expenses (CHE) in the rural elderly by common diseases. Then, geographical information tools were used for visualization of geographic distribution patterns of CHE, the ordinary least squares methods (OLS) and geographically weighted regression (GWR) were employed to examine the influencing factors of medical expenditure.Results: The number of CHE hospitalizations and the total number of hospitalizations for the rural elderly people increased by 2.1 times and 2.2 times, respectively, from 2010 to 2016. Counties with a high prevalence of CHE were clustered in the eastern coastal area (Moran's I = 0.620, P < 0.001, General G < 0.001, P < 0.001). Unspecified transport accidents, cardiovascular disease, and essential hypertension were the top causes of CHE in the rural elderly. Adequate hospital beds (P < 0.05) and reasonable utilization and distribution of town-level (P < 0.001) and county-level hospitals (P < 0.001) may help reduce medical expenditures.Conclusions: In the context of an aging society, the disease burden for the elderly in rural areas should arouse more attention. These findings highlight the importance of age-related disease prevention and the rational allocation of medical resources in rural areas.

The Effect of the New Rural Social Pension Insurance Program on the Choice of Medical Institutions for Rural Elderly

To explore the effect of the New Rural Social Pension Insurance (NRSPI) program on the choice of medical institutions for rural elderly is not only an effective entry point to test the influence of the NRSPI program, but also plays an significant role in maintaining people's health, improving our nation’s retirement pension system and the construction of the new countryside. To this end, based on the five periods of Chinese Family Panel Studies (CFPS) data from 2010 to 2018, this paper used Logit model and DID model to empirically investigate the impact of the NRSPI program on the choice of medical institutions for rural elderly. The empirical results show that: first, the NRSPI program can significantly promote the rural elderly to choose higher level of medical institutions for medical treatment. Specifically, receiving the NRSPI pension will increase the probability of rural elderly choosing hospitals at the county level and above by 8.6%, the hospitals at the township level by 2.5%, and will decrease the likelihood of choosing hospitals at the village level by 5.5%.Second, the effects of the NRSPI program are heterogeneous. Compared with the rural elderly in high income families, the program has a greater impact on the choice of medical institutions for those in low income families. Compared with the rural elderly in the eastern region, the program has a greater impact on the selection of county level hospitals and above by those in the central and western regions, but has less impact on the selection of village level hospitals.

Does Participation in Local Non-agricultural Employment Improve the Mental Health of Elderly Adults in Rural Areas? Evidence From China

A rising rate of suicide among the elderly in rural China has been recognized to be triggered by mental health-associated factors. This study uses 3,397 sampled rural elderly adults from China Labor-force Dynamic Survey in 2016 to explore the response mechanism through which non-agricultural employment participation by the elderly adults in rural China can influence their mental health. Utilizing the Multivariate Regression, Instrumental Variable and Propensity Score Matching methods, we find that, the rural elderly adults who participate in local non-agricultural employment significantly improve their mental health. Self-employment tends to have a greater positive contribution to the mental health of the elderly population than waged employment. Further, work income, need for belongingness and respect, and human capital development significantly mediates the influence of participation in local non-agricultural employment on the mental health of the elderly adults. Finally, we put forward relevant policy suggestions to improving the mental health of the elderly in the countryside.

Can Land Transfer Alleviate the Poverty of the Elderly? Evidence from Rural China

This study explores the impact of farmland transfer on the multidimensional relative poverty of the elderly in rural areas to provide a reference for the study of rural land transfer in China and improve the welfare system for the elderly. Based on the China Family Panel Studies (CFPS) rural sample data in 2018, this paper uses the AF multidimensional index measurement method to assess multidimensional relative poverty in rural areas. Logit regression estimation examines the single index poverty of rural older adults transferred from rural land and the impact of multidimensional relative poverty, using the propensity score matching method (PSM) to analyze the results’ robustness. The transfer of agricultural land has different impacts on the poverty of different rural elderly poverty indicators and negatively affects the comprehensive effect of rural elderly poverty. The transfer of agricultural land significantly alleviates rural elderly poverty. Reasonable and effective transfer of agricultural land, together with improved rural social security and a caring service system for the elderly, will promote the continuous operation of large-scale agricultural operations and alleviate rural elderly poverty.

Gender discrepancy in the predictive effect of metabolic syndrome and its components on newly onset cardiovascular disease in elderly from rural China

Background This study aimed to estimate whether metabolic syndrome (MetS) and its components could be used to predict cardiovascular disease (CVD) in a longitudinal analysis in a rural elderly Chinese population. Method At baseline during 2012–2013, a total of 2486 elderly from rural Chinese were enrolled and were followed up during 2015–2017. Stroke and coronary heart disease (CHD) were included in CVD and were diagnosed by clinicians. The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) and the International Diabetes Federation (IDF) criteria were used to define MetS separately. Result Hazard ratios adjusting for CHD, stroke and CVD in those with MetS using the NCEP ATP III criteria in females were 1.27 (95 % CI 0.73, 2.21), 1.54 (95 % CI 0.99, 2.40) and 1.45 (95 % CI 1.00, 2.10), respectively; 1.33 (95 % CI 0.77, 2.32), 1.44 (95 % CI 0.92, 2.25) and 1.36 (95 % CI 0.94, 1.97), respectively, with the AHA/NHLBI criteria; and 1.10 (95 % CI 0.89,1.36), 1.62 (95 % CI 1.03, 2.55) and 1.36 (95 % CI 0.93, 1.97), respectively, with the IDF criteria. Additionally, abdominal obesity using the AHA/NHLBI criteria was significantly associated with the incidence of stroke (HR: 1.60; 95 % CI 1.01, 2.52). However, among rural elderly males, neither MetS nor its components predicted new-onset CVD. Conclusions MetS is correlated with high incidence of CVD among rural elderly female, and only using the NCEP ATP III criteria to define MetS could make the incidence of CVD obvious difference. In order to reduce rural elderly CVD, effective measures to prevent, diagnose, and treat MetS should be enacted in a timely manner, especially among females.

Burden of Communicable and Non-Communicable Diseases Among Elderly in India: A Study Based on LASI Survey

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.

The Impact of Family Income on Body Mass Index and Self-Rated Health of Illiterate and Non-illiterate Rural Elderly in China: Evidence From a Fixed Effect Approach

Background: Rural communities worldwide are experiencing the most significant levels of aging. Most rural elderly have no stable pension, and leading family income plays an indispensable role in the life security of rural elderly. This study aims to investigate whether the association between annual family income per capita and body mass index (BMI) and self-rated health (SRH) in rural elderly is moderated by education during fast economic development.Methods: We chose the fixed-effects model to analyze the impact of the annual family income per capita change on BMI and SRH based on a large, nationally representative longitudinal dataset of rural respondents aged above 60 of the China Family Panel Studies (CFPS) from 2010 to 2018.Results: Six hundred and fifty-eight were eligible for inclusion in our analysis in CFPS. The median age of participants was 65 years in 2010, and 379 (57.60%) participants were male. Self-rated health increased with higher the logarithmized family income per capita among the rural illiterate elderly (β = 0.0770; 95% CI = 0.0065–0.1473). Body mass index increased with higher the logarithmized family income per capita among the rural elderly (β = 0.1614, 95% CI: 0.0325–0.2903), and it was more evident among the illiterate elderly (β = 0.2462, 95% CI: 0.05519–0.4372).Conclusion: Family income has an impact on BMI and SRH moderated by education level among rural elderly in China. These results contribute to developing more targeted strategies in the context of a developing country. In addition, it also reminds us to consider the differences in the educational level of the elderly in rural areas when examining the relationship between family income and health.