Factors associated with healthy ageing: a comparative study between China and the United States

Abstract

This study compares the associators of healthy ageing in China and the United States, using the 2005–2014 Chinese Longitudinal Healthy Longevity Survey (CLHLS) and the 2004–2014 Health and Retirement Study (HRS). Health ageing is measured using an overall healthy ageing index (HAI), defined according to five dimensions: no major chronic diseases, free of physical functional impairment, free of cognitive impairment, no depressive symptoms, and socially active engagement. Multilevel logistic regression analysis is adopted to explore the association of demographic characteristics, socioeconomic status, and healthy lifestyles with the odds ratios of healthy ageing in China and the United States. Results indicate that the proportion of individuals experiencing healthy ageing is slightly higher in US than Chinese older adults aged 65–100 (25.67% vs 23.27%). Nevertheless, Chinese oldest-old (80–100) have a higher proportion of healthy ageing than American oldest-old (15.05% vs. 12.19%). Our results indicate that the odds of healthy ageing decrease with age, whereas they increase with education, income, marriage, and health behaviours. The odds of healthy ageing are lower for older Chinese women than men, whereas the odds are higher for older US women. Moreover, non-white elders in the United States have significantly lower odds of healthy ageing than their white counterparts. These findings suggest certain similar patterns of healthy ageing across two countries, but distinct patterns do exist. Promoting gender and racial equalities in healthy ageing are crucial for Chinese and American policymakers, respectively.