Rural-Urban Health Inequality among Chinese Elderly: A Gendered Life Course Perspective

• In Event: Sociology of Population Section Roundtables
  In Refereed Roundtable (60 minute): Table 8. Aging and Population Change

Abstract

Urban-rural health inequality among China’s elderly remains a subject of academic debate, with conflicting evidence regarding whether rural or urban populations maintain better health. Existing research often relies on cross-sectional data, failing to capture temporal trajectories or cohort heterogeneity. This study addresses these gaps by examining cognitive function trajectories through two theoretical lenses: Cumulative Advantage/Disadvantage (CAD) and the "Age-as-Leveler" perspective.
Utilizing six waves of data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and growth curve modeling, the research analyzes intra-cohort and inter-cohort variations in the urban-rural health gap. The study specifically investigates how historical societal changes and gender differences influence these health trajectories.
The results reveal that while rural elders exhibit lower initial levels of cognitive function, they experience a slower rate of decline compared to their urban counterparts. This pattern supports the "age-as-leveler" hypothesis, suggesting that disparities may narrow in very old age. Furthermore, the study identifies significant inter-cohort differences: the gap in both mean cognitive levels and the rate of decline is narrowing across successive cohorts, indicating a convergence in health trajectories between urban and rural populations over time.
Gender analysis further complicates these dynamics. For male elders, the urban-rural gap is most pronounced in initial cognitive function levels. In contrast, for female elders, the disparity is more evident in the rate of cognitive decline.
In conclusion, this study provides critical insights into the evolving nature of health inequalities amidst China’s rapid urbanization and aging. The findings underscore that urban-rural health disparities are not static; they are deeply influenced by cohort effects and gender. Consequently, public health interventions must be nuanced, addressing the specific longitudinal vulnerabilities of different demographic groups to effectively reduce inequality.

Authors

• Niantao Jiang, The Chinese University of Hong Kong

• Lei Jin, Chinese University of Hong Kong

• Haijing Dai, Department of Social Work, The Chinese University of Hong Kong

• Yuying Tong, The Chinese University of Hong Kong