Exploring association between urbanization and self-rated health of elderly Chinese: Evidence from national population sample survey

Authors: Baishi Huang*, School of Geography and Planning, SUN Yat-sen University, Ye Liu, School of Geography and Planning, SUN Yat-sen University, Ruoyu Wang, School of Geography and Planning, Sun Yat-sen University, Zhixin Feng, Centre for Research on Ageing, School of Social Sciences, University of Southampton, Yuqi Liu, Bartlett School of Planning, University College London, Rong Wu, School of Geography and Planning, Sun Yat-sen University
Topics: Medical and Health Geography
Keywords: urbanization, self-rated health, older people, national population sample survey, China
Session Type: Paper
Day: 4/6/2019
Start / End Time: 9:55 AM / 11:35 AM
Room: Marshall South, Marriott, Mezzanine Level
Presentation File: No File Uploaded


This study investigated associations between urbanization and self-rated health of elderly Chinese, particularly how dimensions of urbanization and level/rate of urbanization relate to older people’s health. We analyzed data from 236,030 individuals (aged 60–79 years) nested within 267 prefecture-level cities from China’s 2005 one-percent population sample survey. Self-rated health was the outcome variable. Four predictor groups assessed prefectures’ level/rate of urbanization (land-use conversion, economic growth, population concentration, health services). Multilevel logistic regression examined associations between self-rated health and level/rate of urbanization, after adjusting for individual-level covariates. Multiplicative interactions explored variations by education. Odds of reporting fair or poor health was negatively associated with level/rate of population concentration and positively with level of health services. Land use conversion, economic growth, and health service improvements (forms of rate of urbanization) were not significantly associated with self-rated health. Education had a moderating effect on associations between urbanization and older people’s self-rated health. Older people in more densely-populated and rapidly expanding areas were less likely to report fair/poor health. This supports healthy migration and “salmon bias” hypotheses. No urban health penalty was observed for Chinese elderly; therefore, these pathways linking urbanization to health are unclear: lifestyle changes, environmental pollution, and cultivated land reduction.

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