Regional differences and determinants of self-rated health in a lower middle income rural Society of China

Wang, Lidan; Dong, Wang; Ou, Yunqing; Chen, Shuting; Chen, Jingjing; Jiang, Qichen

doi:10.1186/s12939-018-0875-0

Cited by 11 publications

(20 citation statements)

References 27 publications

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“…The higher the medical insurance levels for the elderly, the higher the SRH. This outcome differs from an early study that reported no relationship between health insurance and SRH [31]. However, a prior finding similar to our study noted that health insurance does improve health status, as it enhances access to health services, especially for the elderly [32].…”

Section: Discussioncontrasting

confidence: 99%

Measurement and decomposition of income-related inequality in self-rated health among the elderly in China

Kou

You

et al. 2019

Int J Equity Health

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BackgroundPopulation ageing in China has brought increasing attention to the health inequalities of the elderly. The purpose of this paper is to measure income-related health inequality among the elderly in China and decompose its causes.MethodsThe data are from the China Health and Retirement Longitudinal Study (CHARLS) survey in 2013, which contains 6176 individuals aged 60 years and above. A multiple linear regression model was used to analyze the influencing factors of self-rated health (SRH) among the elder people. Furthermore, the corrected concentration index were used to measure income-related health inequality. Wagstaff-type decomposition analysis was employed to explore the cause of inequality. The measurement and decomposition of health inequality was also performed separately in the male and female subgroups.ResultsMost elderly declared their health status as “fair” (51.33%) or “poor” (21.88%). Income, gender, residence, region, health insurance and other factors had significant association with SRH (P < 0.05). The corrected concentration index (CCI) was 0.06, indicating pro-rich inequality in health among the elderly. Decomposition analyses revealed that the main contributors to health inequality included income, residence, region, health insurance, and employment. For female elderly, most of the inequality was due to residence (50.78%) and income (49.51%); for male elderly, most of the inequality was due to insurance (38.65%) and income (22.26%); for the total sample, employment had a negative contribution to health inequality (− 25.83%).ConclusionThe findings confirm a high proportion of elderly with poor SRH, and health inequality in the Chinese. Some socioeconomic strategies should be conducted to reduce this health inequality among the elderly, such as reducing income disparities, consolidating health insurance schemes, and narrowing urban-rural and regional gaps. Older females with low incomes in rural areas are a vulnerable subgroup and warrant targeted policy attention.

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Section: Discussioncontrasting

confidence: 99%

Measurement and decomposition of income-related inequality in self-rated health among the elderly in China

Kou

You

et al. 2019

Int J Equity Health

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“…Self-rated health is a simple and inexpensive measure that places lower demands on the assessor and allows evaluation even from a distance (Wang et al, 2018), which can be advantageous for low-income and rural communities. On the other hand, it may be influenced by sociocultural background and education and some individuals may consider different constructs of health with it, such as a specific health condition rather than their overall health (Krause & Jay, 1994).…”

Section: Introductionmentioning

confidence: 99%

Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil

Fernandes

Pirkle

Sentell

et al. 2020

PeerJ

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Background Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings. Objective Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil. Methods This is a cross-sectional study of 571 middle-aged (40–59 years old) and older (60–80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the “SRH good” or “SRH poor” groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity). Results Middle-aged women from the “SRH good” group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47–3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00–2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18–0.94]; p = 0.009) than those who reported “SRH poor”. No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH. Conclusion This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities.

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“…The transformation of household structure and the emergence of non-traditional households are the visible changes in this project's sample sites. Outmigration has impact on all aspects of rural residents' life, and it has become a challenging issue for elderly care in rural China (Wang et al 2018). Table 9 shows a detailed household structure counts from the study's sample counties.…”

Section: Srh and Gender: Women Perceive Their Own Health As Poorer Thmentioning

confidence: 99%

Self-rated health among elders in different outmigration areas—a case study of rural Anhui, China

Dong

2019

J. Chin. Sociol.

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China has been a rapid growing economy in recent decades. Part of its economic development engine comes from internal rural-urban migration. The decades-long rural-urban migration is the result of China's long-lasting uneven development between its urban and rural areas and its income and resource distribution inequality. Rural Anhui is one of the most affected outmigration regions of China. The absence of young and middle-aged villagers changed its natural villages' demographics. It broke the self-sufficient rural family structure and their traditional lifestyle with no societal infrastructure to replace family support. Meanwhile, it created aging communities-particularly in relatively poorer villages. This study investigates rural elder villagers' perception of their physical health in the context of rural-urban migration. It explores the reality of the left-behind rural aging population-their real life challenges and regional disparities reflected in their selfrated health status: those who are living in a relatively poorer region (county) tend to have significantly lower self-rated health (SRH) scores than their counterparts in wealthier areas. Women tend to have lower SRH scores than men, and living alone elders tend to perceive their own physical health to be poorer than others. These findings also show that regional economic condition affect individual lives, women are more vulnerable, and healthy personal interaction is an essential element for wellbeing.

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Regional differences and determinants of self-rated health in a lower middle income rural Society of China

Cited by 11 publications

References 27 publications

Measurement and decomposition of income-related inequality in self-rated health among the elderly in China

Measurement and decomposition of income-related inequality in self-rated health among the elderly in China

Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil

Self-rated health among elders in different outmigration areas—a case study of rural Anhui, China

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