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Community effects on elderly health: Evidence from CHARLS national baseline


  • Smith, James P.
  • Tian, Meng
  • Zhao, Yaohui


There is increasing interest in neighborhood or area effects on health and individual development. China, due to its vast regional variations in health infrastructure and geography and relative immobility of older residents, provides a rare opportunity to study such effects. Utilizing China Health and Retirement Longitudinal Study (CHARLS) baseline survey 2011–2012 which covered over 17,000 individuals in 450 randomly selected communities/villages, this paper addresses two questions: whether community/village characteristics matter for individual health and SES (Socio-Economic Status), and why they matter. Our statistical results indicate that community/village characteristics have strong associations with individual health and SES. We find that health infrastructure is important even after controlling for community income level. Using surface water increases the likelihood of worse health compared to tap water and even underground water. Compared to moving away by trucks, non-management of waste, and other management such as dump in local site or nearby water body are associated with worse health and SES outcomes. Toileting system without water has the worst influence on individual health and education achievements. Using hay or coal as cooking fuel has the largest negative effect on health and SES outcomes. Geography also plays a role. Extreme weather conditions cause people to be more depressed, and face severe difficulties in ADL (Activities of Daily Living) or IADL (Instrumental Activities of Daily Living) and other negative health conditions. Local landscapes also affect individual health and SES outcomes as mountainous and hilly areas exacerbate individual health status and SES outcomes.

Suggested Citation

  • Smith, James P. & Tian, Meng & Zhao, Yaohui, 2013. "Community effects on elderly health: Evidence from CHARLS national baseline," The Journal of the Economics of Ageing, Elsevier, vol. 1, pages 50-59.
  • Handle: RePEc:eee:joecag:v:1-2:y:2013:i::p:50-59
    DOI: 10.1016/j.jeoa.2013.07.001

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    References listed on IDEAS

    1. Winkleby, M.A. & Jatulis, D.E. & Frank, E. & Fortmann, S.P., 1992. "Socioeconomic status and health: How education, income, and occupation contribute to risk factors for cardiovascular disease," American Journal of Public Health, American Public Health Association, vol. 82(6), pages 816-820.
    2. Terry Sicular & Yue Ximing & Björn Gustafsson & Li Shi, 2007. "The Urban–Rural Income Gap And Inequality In China," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 53(1), pages 93-126, March.
    3. Zhang, Xiaobo & Kanbur, Ravi, 2005. "Spatial inequality in education and health care in China," China Economic Review, Elsevier, vol. 16(2), pages 189-204.
    4. James Smith & Raynard Kington, 1997. "Demographic and economic correlates of health in old age," Demography, Springer;Population Association of America (PAA), vol. 34(1), pages 159-170, February.
    5. Strauss, John & Lei, Xiaoyan & Park, Albert & Shen, Yan & Smith, James P. & Yang, Zhe & Zhao, Yaohui, 2010. "Health Outcomes and Socio-Economic Status among the Elderly in China: Evidence from the CHARLS Pilot," IZA Discussion Papers 5152, Institute of Labor Economics (IZA).
    6. repec:ran:wpaper:774 is not listed on IDEAS
    7. James P. Smith & Yan Shen & John Strauss & Yang Zhe & Yaohui Zhao, 2012. "The Effects of Childhood Health on Adult Health and SES in China," Economic Development and Cultural Change, University of Chicago Press, vol. 61(1), pages 127-156.
    8. Strauss, John & Thomas, Duncan, 2008. "Health over the Life Course," Handbook of Development Economics, in: T. Paul Schultz & John A. Strauss (ed.), Handbook of Development Economics, edition 1, volume 4, chapter 54, pages 3375-3474, Elsevier.
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    Cited by:

    1. Lei, Xiaoyan & Sun, Xiaoting & Strauss, John & Zhao, Yaohui & Yang, Gonghuan & Hu, Perry & Hu, Yisong & Yin, Xiangjun, 2014. "Health outcomes and socio-economic status among the mid-aged and elderly in China: Evidence from the CHARLS national baseline data," The Journal of the Economics of Ageing, Elsevier, vol. 3(C), pages 29-43.
    2. Ma, Mingming, 2019. "Does children's education matter for parents’ health and cognition? Evidence from China," Journal of Health Economics, Elsevier, vol. 66(C), pages 222-240.
    3. Yuan S. Zhang & Eileen M. Crimmins, 2019. "Urban–rural differentials in age-related biological risk among middle-aged and older Chinese," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(6), pages 831-839, July.
    4. Lei, Xiaoyan & Sun, Xiaoting & Strauss, John & Zhao, Yaohui & Yang, Gonghuan & Hu, Perry & Hu, Yisong & Yin, Xiangjun, 2014. "Reprint of: Health outcomes and socio-economic status among the mid-aged and elderly in China: Evidence from the CHARLS national baseline data," The Journal of the Economics of Ageing, Elsevier, vol. 4(C), pages 59-73.
    5. Yiwei Chen & Hui Ding & Min Yu & Jieming Zhong & Ruying Hu & Xiangyu Chen & Chunmei Wang & Kaixu Xie & Karen Eggleston, 2019. "The Effects of Primary Care Chronic-Disease Management in Rural China," NBER Working Papers 26100, National Bureau of Economic Research, Inc.

    More about this item


    Community effects; Elderly health; SES; CHARLS;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality


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