Urban Versus Rural Mortality among Older Adults in China
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Urban versus rural place of residence has proven to be a critical health determinant over
time and across countries. Several studies have demonstrated an urban advantage in mortality in
China. This variation by place of residence could be a function of differences in characteristics of
individuals, differences in urban and rural communities, or a combination of individual and
community factors. Population aging, coupled with a growing distinction between urban and
rural life, is creating some urgency in the effort to determine the magnitude of the urban
advantage among older adults and to ascertain the mechanisms responsible for the association.
Using data from the China Health and Nutrition Survey, with additional information from the
2000 Chinese Census, the current study examines urban/rural variation in mortality of adults
aged 50 and older. The analysis describes differences in mortality and examines the extent to
which variations are accounted for by socioeconomic and health-access and health-availability
characteristics that are measured at individual and community levels. Age-specific mortality
rates across regions and Cox proportional hazard model ratios are provided using mortality data
from 1989 to 2000. Results show unadjusted rural mortality to be 30 percent higher than urban
mortality. Adjusting for cadre status and number of amenities within the community reduces the
difference to about 18 percent, so that these two covariates account for about 40 percent of the
baseline urban advantage.
BOOK
Working Papers: Policy Research Division
Zimmer, Zachary
Kaneda, Toshiko
Spess, Laura
Council, Population
2006
214
21
The Population Council
New York
ISSN: 1554-8538
572