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Rural–Urban Inequalities in Poor Self-Rated Health, Self-Reported Functional Disabilities, and Depression among Chinese Older Adults: Evidence from the China Health and Retirement Longitudinal Study 2011 and 2015

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  • Haiting Jiang

    (School of Health Policy and Management, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Centre for Health Policy Studies, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 17177 Stockholm, Sweden)

  • Bo Burström

    (Centre for Health Policy Studies, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden)

  • Jiaying Chen

    (School of Health Policy and Management, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Centre for Health Policy Studies, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Institute of Healthy Jiangsu Development, No.101 Longmian Avenue, Nanjing 211166, China)

  • Kristina Burström

    (Centre for Health Policy Studies, Nanjing Medical University, No.101 Longmian Avenue, Nanjing 211166, China
    Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 17177 Stockholm, Sweden
    Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden)

Abstract

The household registration system (Hukou) in China classifies persons into rural or urban citizens and determines eligibility for state-provided services and welfare. Not taking actual residence into account may underestimate rural–urban differences. This study investigates rural–urban inequalities in self-reported health outcomes among older adults aged 60+, taking into account both Hukou and actual residence, adjusting for sociodemographic determinants, based on the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Self-Rated Health (SRH) was assessed with a single question, functional abilities were assessed with the Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs) scales, and depression was assessed with the 10-item version of the Center for Epidemiologic Studies Depression Scale. Rural respondents had poorer socioeconomic status and higher prevalence of poor SRH, functional disabilities, and depression than urban respondents in both years, which were closely related to rural–urban differences in educational level and income. Impairments appeared at a younger age among rural respondents. Analyses using only Hukou registration and not actual residence resulted in underestimation of rural–urban differences. This study may serve as a basis for interventions to address rural–urban differences in health and social services and reduce health inequalities among Chinese older adults.

Suggested Citation

  • Haiting Jiang & Bo Burström & Jiaying Chen & Kristina Burström, 2021. "Rural–Urban Inequalities in Poor Self-Rated Health, Self-Reported Functional Disabilities, and Depression among Chinese Older Adults: Evidence from the China Health and Retirement Longitudinal Study 2," IJERPH, MDPI, vol. 18(12), pages 1-15, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:12:p:6557-:d:577205
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    References listed on IDEAS

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