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. 2022 Jul 23;22(1):1406.
doi: 10.1186/s12889-022-13757-x.

Urban-rural disparities in the healthy ageing trajectory in China: a population-based study

Haomiao Li #  1 , Yixin Zeng #  2 , Li Gan  2 , Yusupujiang Tuersun  2 , Jiao Yang  2 , Jing Liu  3 , Jiangyun Chen #  4   5
Affiliations

Urban-rural disparities in the healthy ageing trajectory in China: a population-based study

Haomiao Li et al. BMC Public Health. .

Abstract

Purpose: The aim of this study is to measure the trajectory of healthy ageing among Chinese middle-aged and older population, and explore the disparity of the trajectory, as well as contributing factors, between urban and rural areas in China.

Methods: A total of 9402 respondents aged 45 years and older interviewed in four waves (2011, 2013, 2015 and 2018) were selected from the China Health and Retirement Longitudinal Study. Healthy ageing score was calculated through item response theory. A latent growth mixture model (LGMM) was applied to distinguish the trajectory of healthy aging. A multinomial logistics regression model (MLRM) was used to explore the relationship between urban-rural areas and healthy aging trajectories, and further to explore associated factors in rural and urban areas separately.

Results: The healthy ageing score was lower in rural areas than urban areas in each survey wave. Five classes ("continuing-low", "continuing-middle", "continuing-middle-to-high", "significantly-declining", "continuing-high") were grouped through LGMM. The MLRM results showed that urban living was significantly associated with a higher likelihood of being healthy (for [continuing-low/continuing-high]: β = - 1.17, RRR = 0.31, P < 0.001, 95% CI = 0.18-0.53; and for [continuing-middle/continuing-high]: β = - 0.53, RRR = 0.59, P < 0.001, 95% CI = 0.49-0.71).

Conclusion: Healthy ageing is a prominent objective in the development of a country, and rural-urban disparities are an essential obstacle to overcome, with the rural population more likely to develop a low level of healthy ageing trajectory. Prevention and standardized management of chronic diseases should be enhanced, and social participation should be encouraged to promote healthy ageing. The policy inclination and resource investment should be enhanced to reduce disparity in healthy ageing between urban and rural areas in China.

Keywords: China; Health ageing; Urban and rural disparity; trajectory.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Smooth curve fitting for healthy ageing score across 4 waves based on generalized additive model. 0 = rural; 1 = urban
Fig. 2
Fig. 2
Trajectory of healthy ageing score by latent growth mixture model. The definition of the classes: Class 1, continuing-low; Class 2, continuing-middle; Class 3, continuing-middle-to-high; Class 4, significantly-declining; Class 5, continuing-high
See this image and copyright information in PMC

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