Peng Nie1,2,3, Yan Li4, Nan Zhang5, Xiaomin Sun6, Bao Xin7, Youfa Wang6. 1. School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China. Peng_Nie@uni-hohenheim.de. 2. Institute for Health Care & Public Management, University of Hohenheim, 70599, Stuttgart, Germany. Peng_Nie@uni-hohenheim.de. 3. Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. Peng_Nie@uni-hohenheim.de. 4. School of Economics and Finance, Xi'an Jiaotong University, Xi'an, China. 5. Manchester Institute for Collaborative Research on Ageing (MICRA), Social Statistics, School of Social Sciences, The University of Manchester, Manchester, UK. 6. Global Health Institute, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China. 7. Department of Food Hygiene and Nutrition, School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Abstract
BACKGROUND: This study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011-2015 and its association with sociodemographic characteristics. METHODS: Data collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0-12, 0-2 = healthiest, 7-12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score. RESULTS: Mean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0-2) increased from 5.6 to 9.4% during 2011-2015, indicating an improvement in healthy ageing over time. During 2011-2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status. CONCLUSIONS: In China healthy ageing has improved during 2011-2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.
BACKGROUND: This study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011-2015 and its association with sociodemographic characteristics. METHODS: Data collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0-12, 0-2 = healthiest, 7-12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score. RESULTS: Mean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0-2) increased from 5.6 to 9.4% during 2011-2015, indicating an improvement in healthy ageing over time. During 2011-2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status. CONCLUSIONS: In China healthy ageing has improved during 2011-2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.
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