Understanding Rural–Urban Differences in Depressive Symptoms Among Older Adults in China

Li, Lydia W.; Liu, Jinyu; Xu, Hongwei; Zhang, Zhenmei

doi:10.1177/0898264315591003

Cited by 184 publications

(171 citation statements)

References 51 publications

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“…The higher the income and the medical condition, the better their health condition [38]. As some researchers point out, children's migration contributes to the material well-being of their parents and better economic status is associated with less adverse health outcomes [7,39]. Some studies also show that heavy living burden and shortage of available medical service resources lead to higher incidence of stroke and heart disease for the left behind elderly.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the elderly also face many social challenges besides physical and mental health problems [6].The health condition of the left-behind elderly in rural areas is generally low in China, which is caused by low children support, high living pressure, low utilization rate of health resources, and incomplete low level of rural pension security in rural areas and so on. Chinese scholars generally believe that health is the most important problem to solve for the left-behind elderly in rural areas [7][8][9]. A survey of 1811 left-behind elderly in Thailand found that the health of the left-behind elderly in rural Thailand is poor.…”

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confidence: 99%

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Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study

Luo

Zhang

Liu

2020

IJERPH

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In China, many young and middle-aged rural residents move to urban areas each year. The rural elderly are left behind. The number of the rural left-behind elderly is increasing with urbanization, but it is unclear which indicators can be used to assess their health condition. The health risk assessment index system was developed to improve the health level of the rural left-behind elderly. A two-round web-based Delphi process was used to organize the recommendations from fifteen Chinese experts in geriatrics, health management, social psychology who participated in this study. Meaningfulness, importance, modifiability, and comprehensive value of the health risk assessment indicators in the index system were evaluated. The effective recovery rates of the two-round Delphi were 86.67% and 92.31%, respectively. The judgement coefficient and the authority coefficient were 0.87 and 0.82, respectively. The expert familiarity was 0.76. Ultimately, the health risk assessment index system for the rural left-behind elderly consisted of five first-level indicators, thirteen second-level indicators, and sixty-six third-level indicators. The final indicators can be used to evaluate the health of the rural left-behind elderly and provide the basis for additional health risk interventions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study

Luo

Zhang

Liu

2020

IJERPH

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“…The elderly between the ages of 80 and 84 described their health as worse, while 85-89 year olds reported their health as excellent 30 . Area of residence may be related to improved health perception 12,13 . In the present study, many of the caregivers reported being satisfied with their health, life and the care they took of themselves.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the findings of studies comparing rural and urban contexts do not corroborate. The rural population has been described as suffering due to the distance from health equipment 12 , while the high crime rates, dense, populous and polluted environments that are typical of urban areas increase the risk of health problems 13 . There are often no differences between urban and rural caregivers, making it difficult to characterize the epidemiological profile of these specific populations 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Health profile of family caregivers of the elderly and its association with variables of care: a rural study

Brígola

Luchesi

Rossetti

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: to analyze the profile of a population of caregivers from a city in a rural area of the state of São Paulo, Brazil, and identify their health complaints and the characteristics of care provided. Method: a prospective cross-sectional study was performed based on a domicile survey of 99 caregivers and their elderly care recipients. Information about the profile, context of care and health complaints of the caregivers was collected. The caregivers responded to the Zarit Burden Inventory and the Geriatric Depression Scale-15 and the elderly underwent a cognition and functionality assessment. The chi-squared test with odds ratio (OR) was performed to test associations. Result: the majority of the caregivers were women (n=76), elderly (n=83), with a median age 65.8 (±10.4) years and 4.9 (±4.2) years of formal schooling. The most frequent health complaints were pain, systemic hypertension, insomnia, back problems and vision problems. The elderly care recipients were men (n=75), with an average age of 72.0 (±8.2) years. Analysis of associations revealed that caregivers who received emotional support had a lower chance of being highly overburdened (OR=0.37; CI95% 0.15-0.90). Caring for over five years was associated with arthritis (OR=2.50; CI95% 1.0-6.56). Caring of an elderly person with cognitive impairment was strongly associated with peripheral vascular diseases (OR=2.70; CI95% 1.11-6.85) and other diseases (OR=6.94; CI95% 1.43-33.63). Conclusion: A better understanding of the reality of care in rural and remote areas and the identification of factors related to the health care of caregivers provides better care management for the elderly and caregivers, who themselves are aging.

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“…Additionally, rural and urban China represent two distinctive classes (Yip et al, 2007). For instance, due to the household registration (Hukou or "户口" in Chinese) system, compared with their urban counterparts, rural residents are more likely to be farmers with lower level of education and income (Gu et al, 2019), fewer community infrastructures (Li et al, 2015), and also less access to government-sponsored public resources or healthcare services (Li et al, 2016). This is especially true among elderly.…”

Section: Introductionmentioning

confidence: 99%

Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis

Wang

Chen

Zhou

et al. 2019

Social Science & Medicine

120

103

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The potential benefit of social participation (SP) to one's mental health has been widely acknowledged. Nevertheless, the specific type and amount of SP that is associated with improved depressive symptoms in middle-and old-aged Chinese awaits further investigation. This study aimed to understand the patterns of depression and SP by comparing urban vs rural China, and according to which, measure the associations between changes in SP and that in depressive symptoms. A total of 10,988 community residents aged 45 years and above were selected from wave 1 (2011), wave 2 (2013), and wave 4 (2015) of the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative survey. The fixed-effects analysis was used to explore the association between the changes in diversity, frequency, and type of SP and the changes in depressive symptoms. The results indicated that rural respondents suffered from a significantly higher risk of depression and took less SP than their urban counterparts. Transitioning from no SP to 1 or more types of SP or to a once a week or higher frequency was associated with a decline in depressive symptoms. For urban respondents, playing mah-jong or cards and joining sports or social clubs predicted a decline in depressive symptoms. For rural residents, interacting with friends regularly was associated with fewer depressive symptoms. In conclusion, more diverse and higher frequency of SP was associated with better mental health, while the social significance of SP varied across different types of SP and between rural and urban areas.

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Understanding Rural–Urban Differences in Depressive Symptoms Among Older Adults in China

Cited by 184 publications

References 51 publications

Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study

Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study

Health profile of family caregivers of the elderly and its association with variables of care: a rural study

Melancholy or mahjong? Diversity, frequency, type, and rural-urban divide of social participation and depression in middle- and old-aged Chinese: A fixed-effects analysis

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