Effects of Individual, Spousal, and Offspring Socioeconomic Status on Mortality Among Elderly People in China

Abstract

BackgroundThe relationship between socio-economic status and health among elderly people has been well studied, but less is known about how spousal or offspring’s education affects mortality, especially in non-Western countries. We investigated these associations using a large sample of Chinese elderly.MethodsThe data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from the years 2005 to 2011 (n = 15 355, aged 65–105 years at baseline; 5046 died in 2008, and 2224 died in 2011). Educational attainment, occupational status, and household income per capita were used as indicators of socio-economic status. Spousal and offspring’s education were added into the final models. The Cox proportional hazards model was used to study mortality risk by gender.ResultsAdjusted for age, highly educated males and females had, on average, 29% and 37% lower mortality risk, respectively, than those with a lower education. Particularly among men, this effect was observed among those whose children had intermediate education only. A higher household income was also associated with lower mortality risk among the elderly. Male elderly living with a well-educated spouse (HR 0.79; 95% CI, 0.64–0.99) had a lower mortality risk than those living with a low-educated spouse.ConclusionsBoth the socio-economic status of the individual and the educational level of a co-resident spouse or child are associated with mortality risk in elderly people. The socio-economic position of family members plays an important role in producing health inequality among elderly people.

Adult children's education and changes to parents' physical health in Mexico

“…The negative association between the share of children who attended college and the timing of parents’ death appears to be robust to the inclusion of children’s transfers and financial status, which are likely mediators in the case of Mexico. These findings broadly support previous studies, citing the advantages of children’s higher education for parental longevity (Friedman and Mare, 2014; Sabater and Graham, 2016; Torssander, 2013; Yang et al, 2016; Zimmer et al, 2007). Indeed, the results underscore how offspring education may matter most for older parents at the most extreme end of the health continuum.…”

“…Despite these supports, the Taiwanese studies show that schooling of the most well-educated child is negatively correlated with the severity of parents’ functional limitations (Zimmer et al, 2002) and positively associated with parental longevity (Zimmer et al, 2007). A more recent study from China found similar results, where the education of co-resident children is positively associated with parental longevity (Yang et al, 2016). Even in contexts where norms of intergenerational obligation are not as strong and older adults often rely on non-familial resources to maintain their well-being, having better-educated children also delays parents’ mortality.…”

“…An emerging body of research also documents how the educational resources of family members may shape individual health outcomes. With regards to the health of older persons, recent work points to the positive association between adult offspring education and their parents’ longevity (Friedman and Mare, 2014; Lundborg and Majlesi, 2015; Sabater and Graham, 2016; Torssander, 2013; Yang et al, 2016; Zimmer et al, 2007). …”

“…A growing share of this work investigates whether these patterns exist in low- and middle-income countries (De Neve and Harling, 2017; Yahirun et al, 2016; Yang et al, 2016; Zimmer et al, 2002, 2007). These contexts differ from high-income countries because they are characterized by more recent and rapid educational expansion.…”

Healthy Ageing and Biomarkers Cohort Study (HABCS): a cohort profile

“…The CLHLS is a community-based longitudinal cohort with the aim of examining factors that promote longevity and quality of life among the older adults. However, we have noticed that the CLHLS study has been limited principally to social science research,3–18 whereas other objective medical aspects such as biomarkers are not available. As a result, such a major obstacle has been preventing us from developing a complete understanding of the determinants of healthy aging.…”