Housing Poverty and Healthy Aging in China: Evidence from the China Health and Retirement Longitudinal Study.
Housing Poverty and Healthy Aging in China: Evidence from the China Health and Retirement Longitudinal Study.
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中国的住房贫困与健康老龄化：来自中国健康与退休纵向研究的证据
DOI：
10.3390/ijerph18189911
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发表时间：
2021-09-21
影响因子：
--
通讯作者：
Sousa-Poza A
中科院分区：
文献类型：
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作者：
Nie P;Li Y;Ding L;Sousa-Poza A
背景：虽然先前关于住房与健康关系的研究表明，住房条件差的人更有可能报告健康状况不佳，但这些研究以西方研究为主，几乎没有提供关于中国住房与健康关系的证据。无论是定性的还是定量的住房贫困对健康结果的潜在有害影响，特别是对中国的老年人来说，缺乏经验证据。本文旨在通过使用2011年至2015年中国健康与退休纵向研究的数据来填补这一空白，全面分析导致中国60岁及以上成年人健康老龄化变化的人口、社会经济和行为因素。方法：收集2011年和2015年CHARLS调查的8839名60岁及以上成年人(2011年3732名，2015年5107名)的数据。我们首先使用6个基于血液的生物标志物构建了中国人健康老龄化指数(CHAI，从0(最健康)到12(最不健康))的综合测量，然后评估了CHAI得分的心理测量学特性，包括可接受性、内部一致性、收敛效度、区分效度和精确度。此外，我们使用了基于均值的Blinder-Oaxaca分解和无条件分位数回归分解来分解2011-2015年间健康老龄化的变化。结果：我们总体上确认了Chai评分从2011年的5.69分下降到2015年的5.20分，这意味着在这段时间内健康老龄化的改善。我们的线性分解表明，根据所使用的衡量标准的类型(无论是质量、数量还是质量-数量的组合)，住房贫困解释了CHAI得分的4-8%的差异。我们的分布分解也强调了住房贫困在健康老龄化变化中的重要作用，约占解释部分的7%-23%。在后者中，住房数量和质量贫困的相对贡献在柴族分布的中端和上端更为明显。我们还发现，家庭支出与中国老年人的健康老龄化显著相关，随着时间的推移，家庭支出对健康老龄化的改善做出了最大贡献。结论：住房贫困与CHAI之间的关系与家庭支出无关。无论哪种类型，住房贫困都与健康老龄化的减少呈正相关。因此，改善住房条件促进健康老龄化，住房改善举措可能为中国增加健康老龄化提供最有效的解决方案。改进抽水马桶、获得饮用水和单独的厨房需要特别注意。由于高密度拥挤的住房对健康老龄化有负面影响，也可以更多地关注老年人可用空间的改善。特别是在制度层面，政府可以通过改善住房条件，将住房政策从居者有其屋计划扩展到住房升级计划。
Background: Although prior research on the housing–health linkage suggested that those with poor housing conditions are more likely to report poor health, it is dominated by Western studies and offers little evidence on the housing–health relation in China. Scarce is empirical evidence on the potentially detrimental impact of either qualitative or quantitative housing poverty on health outcomes, especially for seniors in China. This paper aims to fill this void by using data from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS) to provide a comprehensive analysis of the demographic, socioeconomic, and behavioral factors that contribute to changes in healthy aging among Chinese adults aged 60 and over. Methods: Data collected from 8839 adults aged 60 and over in the 2011 and 2015 CHARLS (3732 in 2011 and 5107 in 2015) were used. We first used six blood-based biomarkers to construct a composite measure of the Chinese Healthy Aging Index (CHAI, ranging from 0 (healthiest) to 12 (unhealthiest)) and then assessed the psychometric properties of the CHAI score, including acceptability, internal consistency, convergent validity, discriminative validity and precision. In addition, we employed both mean-based Blinder–Oaxaca and unconditional quantile regression decomposition to decompose the change in healthy aging within the 2011–2015 period. Results: We overall identified a decrease in CHAI score from 5.69 in 2011 to 5.20 in 2015, which implies an improvement in healthy aging during this period. Our linear decomposition revealed that dependent on the type of measure used (whether quality, quantity, or combined quality–quantity), housing poverty explained 4–8% of the differences in CHAI score. Our distributional decompositions also highlighted an important role for housing poverty in the change in healthy aging, accounting for approximately 7–23% of the explained portion. Within this latter, the relative contribution of housing quantity and quality poverty was more pronounced at the median and upper end of the CHAI distribution. We also found household expenditure to be significantly associated with healthy aging among older Chinese adults and made the largest contribution to the improvement in healthy aging over time. Conclusions: The association between housing poverty and CHAI is independent of household expenditure. Regardless of type, housing poverty is positively associated with a decrease in healthy aging. Thus, improved housing conditions boost healthy aging, and housing amelioration initiatives may offer the most effective solution for augmenting healthy aging in China. Improvement of flush toilets and the access to potable water and a separate kitchen require particular attention. Since high-density congested housing has a negative impact on healthy aging, more attention can also be paid to improvements in the available space for older people. Especially at an institutional level, the government may extend the housing policy from a homeownership scheme to a housing upgrading scheme by improving housing conditions.
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DOI：
10.1158/1055-9965.epi-14-0064
发表时间：
2014-09
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Brenner DR;Scherer D;Muir K;Schildkraut J;Boffetta P;Spitz MR;Le Marchand L;Chan AT;Goode EL;Ulrich CM;Hung RJ
通讯作者：
Hung RJ
影响因子：
6.7
作者：
Baker, Emma;Ngoc Thien Anh Pham;Bentley, Rebecca
通讯作者：
Bentley, Rebecca
影响因子：
5.4
作者：
Burgard, Sarah A.;Seefeldt, Kristin S.;Zelner, Sarah
通讯作者：
Zelner, Sarah
影响因子：
3.5
作者：
Baeten, Steef;Van Ourti, Tom;van Doorslaer, Eddy
通讯作者：
van Doorslaer, Eddy
影响因子：
2.9
作者：
Ellaway A;Macdonald L;Kearns A
通讯作者：
Kearns A