Health among the oldest-old in China: which living arrangements make a difference?
Health among the oldest-old in China: which living arrangements make a difference?
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DOI：
10.1016/j.socscimed.2008.10.013
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Liang J
中科院分区：
文献类型：
--
作者：
Li LW;Zhang J;Liang J
本研究旨在(1)探讨中国高龄老人生活安排与健康的关联性，(2)探讨生活安排与健康关联性的性别差异。数据来自前两波中国人纵向健康长寿调查，其中包括9093名中国人的平均年龄为92岁。生活安排有六个相互排斥的类别：独居、与配偶、与子女、与配偶和子女、与其他人和在机构中。使用多项Logistic回归，我们发现基线生活安排与死亡率、日常生活能力(ADL)残疾和第二波时的自我评估健康显著相关，控制了基线健康、社会人口特征和儿童的可获得性。此外，生活安排与死亡率之间的联系因性别而异。在不同的居住安排中，有配偶的家庭(要么只与配偶一起生活，要么与配偶和子女一起)提供最好的健康保障。独居和与孩子一起生活对健康既有好处也有坏处。机构生活降低了男性的死亡风险，但没有降低女性的死亡风险。与他人生活在一起带来的健康益处最少。我们的研究将居住安排与健康的研究扩展到一个独特的人群--中国的高龄老人--并阐明了不同居住安排的健康利弊。未来的研究应该考察生活安排与健康之间的联系机制，以及中国男女机构生活的经历。
This study aims to (1) examine the association of living arrangements and health among oldest-old Chinese, and (2) investigate gender differences in the association of living arrangements and health. Data were from the first two waves of the Chinese Longitudinal Healthy Longevity Survey, which included 9,093 Chinese averaging 92 years old. Living arrangements had six mutually exclusive categories: living alone, with spouse, with children, with spouse and children, with others and in institutions. Using multinomial logistic regression, we found that baseline living arrangements are significantly associated with mortality, activities of daily living (ADL) disability, and self-rated health at Wave 2, controlling for baseline health, sociodemographic characteristics and availability of children. Further, the linkages between living arrangements and mortality vary by gender. Among the different living arrangements, having a spouse in the household (either with a spouse only or with both a spouse and children) provides the best health protection. Living alone and living with children are associated with both health advantages and disadvantages. Institutional living lowers mortality risk for men but not women. Living with others provides the least health benefits. Our study has extended the research on living arrangements and health to a unique population—the oldest-old in China—and clarified the health advantages and disadvantages of different living arrangements. Future research should examine the mechanisms linking living arrangements and health, and the experience of institutional living for men and women in China.