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Walking to the same winter: Urban-rural disparities in pain among middle-aged and older Chinese

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  • Chen, Siyuan
  • Bracke, Piet
  • Delaruelle, Katrijn

Abstract

Chronic pain, as a barometer of population health, remains understudied from a socio-structural lens. This study adopts a life course perspective and integrates hukou as a potential institutional arrangement shaping pain, aiming to advance the understanding of health inequalities in China. Specifically, we examine urban-rural disparities in pain prevalence and investigate how these disparities evolve across the life course by using generalized estimating equations and the China Health and Retirement Longitudinal Study 2011–2020 (N = 16479). Our findings indicate that rural hukou holders experience more pain than their urban counterparts. Among rural hukou holders, urban dwelling is associated with a reduced pain risk. Furthermore, we observe that pain prevalence increases with age, yet such pain trajectories vary across urban and rural populations, showing a converging trend in pain over the life course. This study extends the literature on health inequalities by demonstrating how institutional and geographic characteristics jointly shape urban-rural gradients in pain prevalence. Moreover, it provides novel evidence for the age-as-leveler hypothesis in a non-Western context.

Suggested Citation

  • Chen, Siyuan & Bracke, Piet & Delaruelle, Katrijn, 2025. "Walking to the same winter: Urban-rural disparities in pain among middle-aged and older Chinese," Social Science & Medicine, Elsevier, vol. 366(C).
    • Handle: RePEc:eee:socmed:v:366:y:2025:i:c:s0277953625000486
    DOI: 10.1016/j.socscimed.2025.117719
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