Impact of Household Income Levels on Successful Aging of the Elderly

Abstract

Background Successful aging can help to alleviate the aging process, but may be affected by household income. Objective To explore the impact of household income on successful aging and provide fundamental data for improving health equity for the elderly in China. Methods Data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) were used to select participants aged 60 and above. The older adults were categorized into the high-income (≤33.33%) , middle-income (33.34%-66.66%) , and low-income (≥66.67%) groups based on the annual household income levels within each province. Successful aging was measured based on the Rowe and Kahn models and the multivariate Logistic regression was conducted to identify the effects of different levels of household income on successful aging. Results A total of 7 741 subjects were finally included with 2 192 (28.32%) , 2 680 (34.62%) and 2 869 (37.06%) in the low-income group, middle-income group and high-income group, respectively. The proportion of successful aging was 15.55% (1 204/7 741) among Chinese older adults in 2018, with 21.02% (603/2 869) for high-income group, 13.62% (365/2 680) for middle-income group, and 10.77% (236/2 192) for low-income group (P<0.05) . Older adults in the low-income group performed worse than those in the middle-income and high-income groups in daily function loss, cognitive function, no depression, and active social participation (P<0.05) . However, there was no statistically significant difference in the prevalence of major chronic diseases among the three groups (P>0.05) . The results of multivariate Logistic regression analysis showed that after controlling for demographic characteristics (age, gender, ethnicity, education level, and region of residence) , the proportion of successful aging in the middle-income and high-income groups was 1.226 times (OR=1.226, 95%CI=1.028-1.463) and 1.721 times (OR=1.721, 95%CI=1.450-2.044) as high as those in the low-income group; after controlling for health status and behavioral factors (night sleep duration, accidental falls, hospitalization in the past year, hearing, and masticatory function) , the proportion of successful aging in the high-income group was 1.559 times higher than that in the low-income group (OR=1.559, 95%CI=1.300-1.882) ; after controlling for home living environment (bathing facilities, home hygiene) , the proportion of successful aging in the high-income group was 1.461 times higher than that in the low-income group (OR=1.461, 95%CI=1.207-1.770) (P<0.05) . Conclusion The proportion of successful aging in China is low, and the level of household income is an independent influencing factor for successful aging. Focus on the improvement of physical and mental health and function, increasing the social participation of older adults might be important measures to promote the construction of Healthy China and active responding to population aging.

Keywords

• successful aging|healthy ageing|income|aged|china|root cause analysis