Elderly Health Inequality in China and its Determinants: A Geographical Perspective

Int J Environ Res Public Health. 2019 Aug 16;16(16):2953. doi: 10.3390/ijerph16162953.

Abstract

Inter-regional health differences and apparent inequalities in China have recently received significant attention. By collecting health status data and individual socio-economic information from the 2015 fourth sampling survey of the elderly population in China (4th SSEP), this paper uses the geographical differentiation index to reveal the spatial differentiation of health inequality among Chinese provinces. We test the determinants of inequalities by multilevel regression models at the provincial and individual levels, and find three main conclusions: 1) There were significant health differences on an inter-provincial level. For example, provinces with a very good or good health rating formed a good health hot-spot region in the Yangtze River Delta, versus elderly people living in Gansu and Hainan provinces, who had a poor health status. 2) Nearly 2.4% of the health differences in the elderly population were caused by inter-provincial inequalities; access (or lack of access) to economic, medical and educational resources was the main reason for health inequalities. 3) At the individual level, inequalities in annual income served to deepen elderly health differences, and elderly living in less developed areas were more vulnerable to urban vs. rural-related health inequalities.

Keywords: Elderly health; geographical differentiation; health inequality; multilevel regression.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • China / epidemiology
  • Geography
  • Health Status Disparities*
  • Humans
  • Income / statistics & numerical data
  • Middle Aged
  • Rural Health / statistics & numerical data
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors*