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

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.