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

  • Author Footnotes
    # Equal first authors.
    Sasha Yuanjie Deng
    Footnotes
    # Equal first authors.
    Affiliations
    School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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  • Author Footnotes
    # Equal first authors.
    Ivy Yan Zhao
    Footnotes
    # Equal first authors.
    Affiliations
    School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China

    WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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  • Mu-Hsing Ho
    Affiliations
    School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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  • Priya Saravanakumar
    Affiliations
    School of Nursing and Midwifery, University of Technology Sydney, Australia
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  • Alex Molassiotis
    Affiliations
    School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China

    WHO Collaborating Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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  • Jed Montayre
    Correspondence
    Corresponding author at: New South Wales Centre for Evidence-Based Health Care- JBI affiliated group, School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
    Affiliations
    New South Wales Centre for Evidence-Based Health Care - JBI affiliated group, School of Nursing and Midwifery, Western Sydney University, Sydney, Australia
    Search for articles by this author
  • Author Footnotes
    # Equal first authors.

      Abstract

      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.

      Summary of Relevance Problem

      Little is known about the rural-urban differences on the healthy ageing domains of functional ability among older people in China.

      What is Already Known

      Essential needs of older Chinese were largely unmet in rural areas when policies favoured the urban areas.

      What this Paper Adds

      Older Chinese people living in rural areas were less likely to fulfil all five healthy ageing domains of functional ability. The self-perceived poor health status, difficulties in mobility and abilities to learn, grow and make decisions, the lack of retirement pension support, and limited chance of contributing to society should be recognised and be addressed in the provision of nursing and healthcare services.

      Keywords

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