Socioeconomic Disparities in Disability-Free Life Expectancy and Life Expectancy Among Older Chinese Adults From a 7-Year Prospective Cohort Study

Abstract

Objectives: We examined the magnitude and determinants of socioeconomic disparities in disability-free life expectancy and life expectancy at age 65 (DFLE₆₅ and LE₆₅) in China. Methods: Data from Chinese Longitudinal Healthy Longevity Survey collected during 2011-2018 (8,184 participants aged ≥65) were used. Socioeconomic status (SES) was measured by economic status (ES), and education, respectively. Multistate Markov models and microsimulations were fitted to estimate DFLE₆₅ and LE₆₅. Results: LE₆₅ between high- and low-ES groups differed by 2.20 years for males and 2.04 years for females. The DFLE₆₅ disparity in ES was 1.51 and 1.29 years for males and females, respectively. Not undergoing physical examinations, inadequate fruit/vegetable intake, and stress contributed to 35.10% and 57.36% of DFLE₆₅ disparity in ES, as well as 26.36% and 42.65% of LE₆₅ disparity for males and females, respectively. These disparities in education and ES were of a similar magnitude, while the above factors contributed little to education disparity. Conclusion: Socioeconomic disparities in DFLE₆₅ and LE₆₅ existed in China. Physical examination, fruit/vegetable intake and stress partly explained these disparities.

Keywords: disability-free life expectancy; economic status; education; life expectancy; occupation; older adults; socioeconomic disparities.

FIGURE 1

Prevalence of risk factors according to socioeconomic status for older males and females aged 65 years and over, based on the Chinese Longitudinal Healthy Longevity Survey, 2011–2018 (China, 2011–2018).

FIGURE 2

Observed and scenario socioeconomic disparities in disability-free life expectancy and life expectancy, based on the Chinese Longitudinal Healthy Longevity Survey, 2011–2018 (China, 2011–2018).