Urban versus rural mortality among older adults in China

Journal ArticleUrban versus rural place of residence has proven to be a critical health determinant over time and across countries. Several studies have demonstrated an urban advantage in mortality in China. This variation by place of residence could be a function of differences in characteristics of individuals, differences in urban and rural communities, or a combination of individual and community factors. Population aging, coupled with a growing distinction between urban and rural life, is creating some urgency in the effort to determine the magnitude of the urban advantage among older adults and to ascertain the mechanisms responsible for the association. Using data from the China Health and Nutrition Survey, with additional information from the 2000 Chinese Census, the current study examines urban/rural variation in mortality of adults aged 50 and older. The analysis describes differences in mortality and examines the extent to which variations are accounted for by socioeconomic and health-access and health-availability characteristics that are measured at individual and community levels. Age-specific mortality rates across regions and Cox proportional hazard model ratios are provided using mortality data from 1989 to 2000. Results show unadjusted rural mortality to be 30 percent higher than urban mortality. Adjusting for cadre status and number of amenities within the community reduces the difference to about 18 percent, so that these two covariates account for about 40 percent of the baseline urban advantage

Differentials in life expectancy and active life expectancy by socioeconomic status among older adults in Beijing

Journal ArticleThe study compares estimates of life expectancy and active life expectancy across indicators of socioeconomic status for a cohort of older adults in Beijing Municipality. Our aim is to determine whether associations found are consistent across indicators and with those typically observed in Western industrialized countries. A multistate life table method is used to estimate expected years of total and active life, defined as life spent without limitation in functions necessary for performing daily tasks. We find that men of higher status experience advantages with respect to life and active life expectancies. Among women, only active life expectancy is significantly greater for those of higher status, but the difference by income is not statistically significant. With respect to the proportion of life spent in an active state, both men and women of higher status benefit in comparison to their lower status counterparts. Finally, we find that disparities by socioeconomic status generally increase with age. Despite several inconsistencies across socioeconomic status indicators by sex, findings generally confirm inequalities within a society that is organized very differently socially, economically, and politically from countries in the West

Accounting for urban versus rural discrepancies in mortality and functional health among older adults in China

Working PaperBroad differences exist in social and economic life between residents living in urban versus rural areas of China. To study the health implications of these differences, the current study employs data from a longitudinal study of older adults in the Beijing municipality, a region of China that has witnessed very rapid socio-economic growth coupled with widening rural/urban gaps in development and health service provision. Life expectancy and active life expectancy, the latter referring to expected years in a functionally healthy state, is estimated for rural and urban samples in a two-step process that involves first, the estimation of hazard rates considering transitions in functional health and mortality and next, the conversion of these rates into transition probabilities for the construction of multi-state life-tables. Estimates reveal a distinct urban advantage in both mortality and functional health. At age 55, urban elders live about 4½ years longer and 5½ more functionally active years than do their rural counterparts, and an advantage is maintained with increasing age. Covariates representing five domains are considered to determine factors that underlie the urban advantage. Socioeconomic status and access to health service indicators account for a good deal of the association, social support and health behaviors account for very little, while chronic disease acts as a suppressor. The results have obvious policy implications regarding the need for increasing education, better work opportunities, wider insurance coverage and easier access to health facilities for rural residents of China

Urban versus rural mortality among older adults in China

For some time, Chinese government policies have treated rural and urban areas very differently, and a by-product of China’s rapid development seems to be an even greater differentiation between urban and rural social and economic life. Over the next several decades, in part because of rapid fertility declines and in part as a result of mortality declines at older ages, China and other developing countries will experience enormous increases in the proportion of older adults and the proportion of the “oldest-old.” It is reasonable to expect that these age structure changes will alter the provision of health care, making an understanding of the determinants of health at older ages critical for the development and implementation of policy. The analysis in this Population Council working paper describes differences in mortality and examines the extent to which variations are accounted for by socioeconomic and health-access and health-availability characteristics that are measured at individual and community levels. On the individual level, cadre status is influential and at the community level, the important measure is the number of amenities available to residents

Differentials in life expectancy and active life expectancy by socioeconomic status among older adults in Beijing

This Population Council working paper compares estimates of life expectancy and active life expectancy across indicators of socioeconomic status for a cohort of older adults in Beijing Municipality. The aim is to determine whether associations are consistent across indicators and with those typically observed in Western industrialized countries. The research finds that men of higher status experience advantages with respect to life and active life expectancies. Among women, only active life expectancy is significantly greater for those of higher status, but the difference by income is not statistically significant. With respect to the proportion of life spent in an active state, both men and women of higher status benefit in comparison to their lower status counterparts. Finally, we find that disparities by socioeconomic status generally increase with age. Despite several inconsistencies across socioeconomic status indicators by sex, findings generally confirm inequalities within a society that is organized very differently socially, economically, and politically from countries in the West

Networks and Contexts: Variation in the Structure of Social Ties

A core axiom of sociology is that social structure affects and is affected by human behavior. The term "social structure" conveys two quite different meanings. One meaning is relational, involving networks of ties between individuals or groups of individuals. A second meaning refers to the contexts containing these individuals. Studies of neighborhood and community effects depend on variability in both types of social structure. Using data from multiple villages in Nang Rong, Thailand, this article documents substantial variability in network structure and shows that network structure covaries with context in meaningful ways, suggesting reciprocal effects of changes in both. Finally, it considers implications of variability in network structure, showing that social cohesion affects the likelihood of finding and interviewing former village residents

Trends and transitions in children\u27s coresidence with older adults in Beijing municipality

The reduction in family size in China and concurrent social and economic change are raising concerns that traditional sources of support may be eroding. This Population Council working paper paper examines a) whether rates of coresidence between older adults and their adult children in the Beijing municipality of China have been declining, and b) the determinants of coresidence and coresidence transitions. Results suggest that family support structures for the elderly, when they are facilitated through coresidence, remain basically intact, particularly for those who require the greatest amount of support. Further assessment is required to elucidate the effects of availability, need, and demographic characteristics on the provision of support regardless of coresidence status