The impact of childhood experience of starvations on the health of older adults: Evidence from China

Reporting heterogeneity and health measurement bias in older adults: nationwide cross-sectional study

PURPOSE

To examine reporting heterogeneity in self-rated health (SRH) among middle-aged and older adults using anchoring vignettes, and evaluate the impact of reporting heterogeneity on further measures of health inequalities.

METHODS

Data on a sample of 13,323 respondents aged 45 years and over from the China Family Panel Studies (CFPS) were used. An ordered probit model and the hierarchical ordered probit (HOPIT) model were used to compare the estimated differences in pre- and post-adjusted SRH, and the concentration index was applied to measure health inequalities.

RESULTS

After correcting for reporting heterogeneity, the health advantage of these middle-aged and older adults was further expanded to varying degrees, and those living in urban areas had better health compared to those living in rural areas (β = 0.057, P = 0.046). In addition, respondents with a high school education or higher and in urban areas use a lower cut-off point when rating a given health condition as poor and a higher cut-off point when rating a given health condition as good. Significant increases in the inequalities in SRH between urban and rural areas and across regions after adjustment for reporting heterogeneity. In comparison to urban areas, the trend that higher SRH was more concentrated among the better educated is more pronounced in rural areas.

CONCLUSION

These findings highlight the importance of addressing reporting heterogeneity in SRH to ensure equitable healthcare interventions and resource allocation, particularly to underserved regions and populations.

The association between childhood hunger experiences and health in middle and old age: a longitudinal study over 10 years

BACKGROUND

A significant relationship is present between childhood hunger experiences (CHEs) and health, but explorations of the longitudinal persistence of this relationship and its mediating mechanisms are still lacking. This study aims to evaluate the effects of CHEs on health in middle and old age and determine the underlying mechanisms.

METHODS

Using data from the five 2011-2020 China Health and Retirement Longitudinal Study (CHARLS) and the 2014 China Life History Survey Questionnaire, a sample of 9,909 individuals aged 45 years and older who participated in all six surveys was obtained. We conducted panel analyses, used Probit and ordinary least squares regression models to analyze the effects of CHEs on the health in middle and old age, and used stepwise regression tests to analyze the mediators of the relationship.

RESULTS

CHEs significantly predicted self-assessment of health (β = -0.18; 95% CI: -0.23, -0.12), the probability of receiving medical treatment (β = -0.09; 95% CI: -0.13, -0.05), depression (β = -0.30; 95% CI: -0.35, -0.25), memory (β = -0.13; 95% CI: -0.18, -0.07), and cognitive function (β = -0.13; 95% CI: -0.26, -0.00). The effects of CHEs showed an aggravating trend regarding depression and cognitive function, and a mitigating trend regarding self-assessed health and memory. Smoking, exercising, and sleep duration were revealed as transmitting factors of the effects of CHEs on health.

CONCLUSION

CHEs had a negative impact on the health of middle and old age. While their effects on depression and cognitive function gradually worsen, the effects on self-assessed health and memory were mitigated over time. Lifestyle factors such as smoking, exercising, and sleep duration were transmitting factors of the health effects of CHEs. Thus, the health status of individuals who experience childhood hunger warrants attention.

Parental preference for boys in childhood and the health of the elderly: Evidence from China

OBJECTIVE

This study analyzed the relationship between parents' son preference in a person's childhood and their health when they become older, and tested whether childhood educational opportunities, health level, and care resources play mediating roles in this relationship.

BACKGROUND

China has entered a stage of aging population. The health of the elderly determines whether the government can successfully cope with the challenges brought about by the aging of the population. Chinese people are deeply influenced by Confucianism. The concept of "son preference" is related to residents' parenting strategies. Then, if one's parents exhibit a son preference in their childhood, will it affect one's health in old age?

METHOD

Based on the data of China Health and Retirement Longitudinal Study collected in 2014, this paper uses the least square method to analyze the impact of parents' preference in childhood for boys on the health of the elderly, and uses Karlson-Holm-Breen (KHB) to analyze the mediating effects of childhood educational opportunities, health level and care resources.

RESULTS

This study found that parents' preference for boys had a positive impact on the health of male children when they became elderly but had a negative impact on the health of female children when they became elderly. Childhood educational opportunities, health level, and care resources mediated this relationship.

CONCLUSION

It is necessary to analyze the impact of parents' preference for sons in one's childhood on the health of elderly, and intervene the adverse factors affecting the health, to improve the health level and quality of life of the elderly.

The Higher the Children's Achievements, the Better the Elderly Health? Evidence From China

Health, an important indicator for measuring the elderly's life and wellbeing, is an important part of positive and healthy aging. Children's achievements are closely linked to their parents' health. However, existing literature does not cover how children's achievements impact the health of their elderly parents. Data were derived from the 2014 Chinese Longitudinal Aging Social Survey; this study includes 6,793 elderly people ages 60 and older as samples. A multiple linear regression model was used to analyze the correlation between children's achievements and their elderly parents' health statuses in China. The results show that the higher the children's income and education, the better their health of their elderly parents. Living patterns, children' financial support to their parents, and social capital play a mediating role in the relationship between children and their elderly parents. These findings provide further insight into potential factors associated with the children's achievements and elderly health.

Are there gender differences in the trajectories of self-rated health among chinese older adults? an analysis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

BACKGROUND

Self-rated health (SRH) is a good predictor of morbidity and mortality. Extensive research has shown that females generally report poorer SRH than males but still tend to live longer. Previous studies used cross-sectional or pooled data for their analyses while ignoring the dynamic changes in males' and females' SRH statuses over time. Furthermore, longitudinal studies, especially those that focus on older adults, typically suffer from the incompleteness of data. As such, the effect of dropout data on the trajectories of SRH is still unknown. Our objective is to examine whether there are any gender differences in the trajectories of SRH statuses in Chinese older adults.

METHODS

The trajectories of SRH were estimated using the pattern-mixture model (PMM), a special latent growth model, under non-ignorable dropout data assumption. We analyzed the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data of 15,613 older adults aged 65 years and above, collected from 2005 to 2014.

RESULTS

The results demonstrated the effect of non-ignorable dropout data assumptions in this study. The previous SRH score was negatively associated with the likelihood of dropping out of the study at the next follow-up survey. Our results showed that both males and females in China perceive their SRH as decreasing over time. A significant gender difference was found in the average SRH score (female SRH was lower than male SRH) in this study. Nonetheless, based on the results obtained using the PMM, there are no gender differences in the trajectories of SRH at baseline as well as in the rate of decline among the total sample. The results also show that males and females respond to SRH predictors similarly, except that current drinking has a more pronounced positive effect on males and healthcare accessibility has a more pronounced positive effect on females.

CONCLUSIONS

Our results suggest that missing data have an impact on the trajectory of SRH among Chinese older adults. Under the non-ignorable dropout data assumptions, no gender differences were found in trajectories of SRH among Chinese older adults. Males and females respond to SRH predictors similarly, except for current drinking habit and healthcare accessibility.