Trends and Determinants of Health Status of Chronically Ill Older Adults In China 2013–2020: A National Panel Data Analysis

Hongyan Wang; Cai Liu

doi:10.54691/mj0gzz53

Authors

Hongyan Wang School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Cai Liu School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China

DOI:

https://doi.org/10.54691/mj0gzz53

Keywords:

Older people;Physical health; Mental health; Social participation.

Abstract

Background: With the accelerating ageing of the population and changes in the disease spectrum, demand for elderly care and healthcare continues to rise, placing significant pressure on public finances. Exploring the factors influencing the health of older people and identifying emerging trends has therefore become essential for improving their health and reducing expenditure on healthcare.Objective: Drawing on the CHARLS database, this study analyses differences in the health status of middle-aged and older adults across age groups from temporal, spatial and health measurement perspectives, with a view to providing new insights for improving the health of older people.Methods: By constructing panel data and employing a fixed-effects model, with ADL, CESD and SP designated as the three explanatory variables, this study examined the factors influencing the physical and mental health as well as social participation of older adults.Results: Regarding trends in the physical health status of middle-aged and older adults between 2013 and 2020, ADL scores were inversely correlated with physical health status; higher scores indicated poorer health. Regarding the mental health status of middle-aged and young older adults from 2013 to 2020, CESD scores were inversely proportional to mental health status; the higher the CESD score, the poorer the mental health status. With regard to social participation among this group during the same period, social participation scores were directly proportional to health status; the higher the score, the greater the level of social participation.Conclusion: This study examines the factors influencing the health of older adults from three dimensions, whilst also conducting a comparative analysis of the health status of older adults across different age groups. To improve the physical and mental health and social participation of older adults, efforts should be made to develop education for older adults, prioritise emotional communication and social recognition among them, and alleviate the psychological stress associated with loneliness.

Downloads

Download data is not yet available.

References

[1] Fang, E. F., Scheibye Knudsen, M., Jahn, H. J., & Brüßel, I. (2015). A research agenda for aging in China in the 21st century. Ageing Research Reviews, 24(Pt B), 197 205. https://doi.org/10.1016/j.arr.2015.08.002.

[2] National Bureau of Statistics of China. (2021, May 11). Main data of the seventh national population census. https://www.stats.gov.cn/english/PressRelease/202105/t20210510_1817185.html

[3] United Nations. (2019). World population prospects 2019: Highlights. Statistical Papers United Nations (Ser. A), Population and Vital Statistics Report. https://doi.org/10.18356/84571eae en

[4] Liu, L., Wu, F., Tong, H., & He, Q. (2021). The digital divide and active aging in China. International Journal of Environmental Research and Public Health, 18(23), 12675. https://doi.org/10.3390/ijerph182312675

[5] Liu, Y., Wu, Y., Chen, Y., & Wang, H. (2024). Projection for dementia burden in China to 2050: A macro simulation study by scenarios of dementia incidence trends. The Lancet Regional Health Western Pacific, 50, 101158. https://doi.org/10.1016/j.lanwpc.2024.101158

[6] Chesnaye, N. C., Ortiz, A., Zoccali, C., & Jager, K. J. (2024). The impact of population ageing on the burden of chronic kidney disease. Nature Reviews Nephrology, 20(9), 569 585. https://doi.org/10.1038/s41581 024 00832 8

[7] Chen, X., Giles, J., Yao, Y., Wang, Y., & Yip, W. (2022). The path to healthy ageing in China: A Peking University Lancet Commission. The Lancet, 400(10367), 1967 2006. https://doi.org/10.1016/S0140 6736(22)01546 2

[8] Li, S., Jia, S., Liu, Y., & Fan, Z. (2024). The degree of population aging and carbon emissions: Analysis of mediation effect and multi scenario simulation. Journal of Environmental Management, 367, 121982. https://doi.org/10.1016/j.jenvman.2024.121982

[9] Lubitz, J., Cai, L., Kramarow, E., & Lentzner, H. (2003). Health, life expectancy, and health care spending among the elderly. The New England Journal of Medicine, 349(11), 1048 1055. https://doi.org/10.1056/NEJMsa022604

[10] Marengoni, A., Winblad, B., Karp, A., & Fratiglioni, L. (2008). Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. American Journal of Public Health, 98(7), 1198 1200. https://doi.org/10.2105/AJPH.2007.121100

[11] Watkinson, R. E., Sutton, M., & Turner, A. J. (2021). Ethnic inequalities in health related quality of life among older adults in England: Secondary analysis of a national cross sectional survey. The Lancet Public Health, 6(3), e145 e154. https://doi.org/10.1016/S2468 2667(20)30287 8

[12] Piber, D., Cho, J. H., Lee, O., & Irwin, M. R. (2022). Sleep disturbance and activation of cellular and transcriptional mechanisms of inflammation in older adults. Brain, Behavior, and Immunity, 106, 67 75. https://doi.org/10.1016/j.bbi.2022.07.012

[13] Zhang, Y., Fu, Y., Guan, X., & Guo, Y. (2024). Associations of ambient air pollution exposure and lifestyle factors with incident dementia in the elderly: A prospective study in the UK Biobank. Environment International, 190, 108870. https://doi.org/10.1016/j.envint.2024.108870

[14] World Health Organization. (2002). Active ageing: A policy framework. The Aging Male, 5(1), 1 37. https://doi.org/10.3109/13685530209150421

[15] Beard, J. R., Officer, A., de Carvalho, I. A., & Sadana, R. (2016). The World report on ageing and health: A policy framework for healthy ageing. The Lancet, 387(10033), 2145 2154. https://doi.org/10.1016/S0140 6736(16)00510 0

[16] Beard, J. R., Officer, A. M., & Cassels, A. K. (2016). The World Report on Ageing and Health. The Gerontologist, 56(Suppl 2), S163 S166. https://doi.org/10.1093/geront/gnw008

[17] Kalache, A. (1999). Active ageing makes the difference. Bulletin of the World Health Organization, 77(4), 299.

[18] Abdullah, B., & Wolbring, G. (2013). Analysis of newspaper coverage of active aging through the lens of the 2002 World Health Organization Active Ageing Report: A Policy Framework and the 2010 Toronto Charter for Physical Activity: A Global Call for Action. International Journal of Environmental Research and Public Health, 10(12), 6799 6819. https://doi.org/10.3390/ijerph10126799

[19] Dziechciaż, M., & Filip, R. (2014). Biological psychological and social determinants of old age: Bio psycho social aspects of human aging. Annals of Agricultural and Environmental Medicine, 21(4), 835 838.

[20] Bauman, A., Merom, D., Bull, F. C., & Blair, S. N. (2016). Updating the evidence for physical activity: Summative reviews of the epidemiological evidence, prevalence, and interventions to promote "active aging". The Gerontologist, 56(Suppl 2), S268 S280. https://doi.org/10.1093/geront/gnw039

[21] Harmell, A. L., Jeste, D. V., & Depp, C. A. (2014). Strategies for successful aging: A research update. Current Psychiatry Reports, 16(10), 476. https://doi.org/10.1007/s11920 014 0476 6

[22] Zapparoli, L., Mariano, M., & Paule su, E. (2022). How the motor system copes with aging: A quantitative meta analysis of the effect of aging on motor function control. Communications Biology, 5(1), 79. https://doi.org/10.1038/s42003 022 03010 z

[23] Leopold, L., & Engelhardt, H. (2013). Education and physical health trajectories in old age. Evidence from the Survey of Health, Ageing and Retirement in Europe (SHARE). International Journal of Public Health, 58(1), 23 31. https://doi.org/10.1007/s00038 012 0377 x

[24] Gibney, S., Delaney, L., Codd, M., & Fahey, T. (2017). Lifetime childlessness, depressive mood and quality of life among older Europeans. Social Indicators Research, 130(3), 1075 1094. https://doi.org/10.1007/s11205 015 1213 1

[25] Chao, J., Li, Y., Xu, H., & Yu, Q. (2013). Health status and associated factors among the community dwelling elderly in China. Archives of Gerontology and Geriatrics, 56(1), 199 204. https://doi.org/10.1016/j.archger.2012.08.010

[26] Scott, K. M., Von Korff, M., Alonso, J., & Angermeyer, M. C. (2008). Age patterns in the prevalence of DSM IV depressive/anxiety disorders with and without physical co morbidity. Psychological Medicine, 38(11), 1659 1669. https://doi.org/10.1017/S0033291708003514

[27] Cotter, D. L., Walters, S. M., Fonseca, C., & Buckley, R. F. (2020). Aging and positive mood: Longitudinal neurobiological and cognitive correlates. The American Journal of Geriatric Psychiatry, 28(9), 946 956. https://doi.org/10.1016/j.jagp.2020.02.014

[28] Dawson Townsend, K. (2019). Social participation patterns and their associations with health and well being for older adults. SSM Population Health, 8, 100424. https://doi.org/10.1016/j.ssmph.2019.100424

[29] He, T., Huang, C., Li, M., & Qian, Y. (2020). Social participation of the elderly in China: The roles of conventional media, digital access and social media engagement. Telematics and Informatics, 48, 101347. https://doi.org/10.1016/j.tele.2020.101347

[30] Liang, L. (2024). The impact of social participation on the quality of life among older adults in China: A chain mediation analysis of loneliness, depression, and anxiety. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1387242

[31] De Breij, S., Mäcken, J., Qvist, J. Y., & van der Velden, L. (2020). Educational differences in the influence of health on early work exit among older workers. Occupational and Environmental Medicine, 77(8), 568 575. https://doi.org/10.1136/oemed 2019 106231

[32] Sun, N., Jia, R., Guo, C., & Liu, X. (2021). Synergistic influence of education and marriage on the risk for cognition loss among the older people in China. Nursing Open, 8(5), 2616 2621. https://doi.org/10.1002/nop2.823

[33] Cheng, M., Su, W., Li, H., & Zhang, L. (2023). Factors influencing the social participation ability of rural older adults in China: A cross sectional study. Frontiers in Public Health, 10, 1001948. https://doi.org/10.3389/fpubh.2023.1001948

[34] Jiao, C., Leng, A., Nicholas, S., & He, Q. (2020). Multimorbidity and mental health: The role of gender among disease causing poverty, rural, aged households in China. International Journal of Environmental Research and Public Health, 17(23), 8855. https://doi.org/10.3390/ijerph17238855

[35] Zhou, J., & Hearst, N. (2016). Health related quality of life of among elders in rural China: The effect of widowhood. Quality of Life Research, 25(12), 3087 3095. https://doi.org/10.1007/s11136 016 1337 3

[36] Zhang, N., Zhang, Y., Zou, Y., & Li, X. (2023). The impact of spouse health on social participation of older adults in China: Evidence from the CLHLS. Journal of Affective Disorders, 324, 46 52. https://doi.org/10.1016/j.jad.2023.01.042

[37] Dong, W., Wan, J., Xu, Y., & Feng, D. (2017). Determinants of self rated health among shanghai elders: A cross sectional study. BMC Public Health, 17(1), 807. https://doi.org/10.1186/s12889 017 4811 2

[38] Song, T., Ding, Y., Sun, Y., & Zhang, H. (2015). A population based study on health related quality of life among urban community residents in Shenyang, Northeast of China. BMC Public Health, 15, 921. https://doi.org/10.1186/s12889 015 2261 2

[39] Liu, W., Zheng, R., Zhang, Y., & Wang, X. (2023). Differences in the influence of daily behavior on health among older adults in urban and rural areas: Evidence from China. Frontiers in Public Health, 11, 1259204. https://doi.org/10.3389/fpubh.2023.1259204

[40] Sonnega, A., Faul, J. D., Ofstedal, M. B., & Weir, D. R. (2014). Cohort profile: The Health and Retirement Study (HRS). International Journal of Epidemiology, 43(2), 576 585. https://doi.org/10.1093/ije/dyu067

[41] Jiang, N., & Lu, N. (2019). Correlates of mental illness and health categories among older adults in China: An empirical study based on the two continua model. Clinical Gerontologist, 42(1), 80 89. https://doi.org/10.1080/07317115.2018.1476175

[42] Chang, Y., Lee, Y., Chiang, T., & Chen, H. (2022). Associations of smoking and alcohol consumption with loneliness, depression, and loss of interest among Chinese older males and females. International Journal of Mental Health and Addiction, 20(6), 1 16. https://doi.org/10.1007/s11469 022 00827 3

[43] Meixia, Q., Baikady, R., Ali, I., & Li, J. (2025). The impact of socioeconomic status on the health of elderly individuals in China. Discover Global Society, 3, 1 17. https://doi.org/10.1007/s44328 025 00036 7

[44] Pu, X., He, S., & Lin, X. (2024). The effect of urban rural resident basic medical insurance on physical health of the rural older adult in China. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1360421

[45] Bai, J., & Li, H. (2024). Effects of urban rural medical insurance integration on health: Evidence from rural China. Journal of Asian Economics, 92, 102274. https://doi.org/10.1016/j.asieco.2024.102274