Rural-urban disparities in healthy ageing: Evidence from a national study in China

Background: 

The Chinese government has adopted the WHO healthy ageing framework to guide the development of services and initiatives to promote older people's health. 

Aim: 

To examine the rural-urban disparities within the WHO healthy ageing domains of functional ability. 

Methods:

A secondary data analysis was conducted using a nationally representative survey from China Health and Retirement Longitudinal Study (CHARLS). 

Results: 

A total number of 10,746 older people were included, with the mean age of 69.10 years (SD = 7.15). More than 70% of older people lived in rural areas. Significant differences existed in all five domains of functional ability between rural and urban-dwelling older people, particularly in their ability to meet basic needs and in achieving psychosocial wellbeing. Urban respondents reported better self-perceived health status (2.95 ± 0.97) and had less functional difficulties. Rural respondents were more likely to have difficulties in making decisions for grocery shopping, taking medications and in managing finances (p < 0.001). Older people in urban areas were more supported with health insurance (97.4%) and retirement pension (57.3%) than rural residents, where only 554 (7.1%) received retirement pension (p < 0.001). In terms of contributing to society, urban respondents were more likely to participate in voluntary work, providing assistance to others, and were caregivers of individuals with disabilities than rural respondents (all p < 0.001). 

Conclusions: 

The rural-urban disparities in healthy ageing were prevalent in China. Further research and consideration toward health resource reallocation are needed to improve functional abilities of older people in rural areas.