Examining the dynamics between economic development, tourism, renewable energy and life expectancy in the Nordic economies.

As the world struggles with pressing issues like climate change and sustainable development, affecting health outcomes and environmental quality, the Nordic regionsare at the forefront of major global challenges. This paper investigates the role of human capital, renewable energy use, tourism, natural resources, and economic growth in shaping life in the Nordic region i.e., Denmark, Norway, Sweden, Finland, and Iceland).Utilizing panel data spanning from 1990 to 2020, the Driscoll and Kraay standard error (DSK) technique is employed to analyze this intricate interplay. The study reveals that in the Nordic context, sustainable economic growth, bolstered by investments in human capital and the widespread acceptance of renewable energy sources, has been positively associated with increased life expectancies. Furthermore, prudent management of natural resources has helped mitigate adverse health effects related to depletion, maintaining environmental and public health standards. The thriving tourism industry has also been shown to influence lifespan in this region positively. On the contrary, the empirical finding contended that an adverse correlation exists between carbon emissions and LEX. This research underscores the importance of a comprehensive and balanced approach that considers economic development, sustainable development, and public health in pursuing longer and healthier lives, providing valuable insights for policymakers and regions seeking to replicate these positive outcomes.The findings of this study are both conceptually reliable and empirically robust, providing important insights for the formulation of environmental and health policy.

The Effect of Social Determinants of Health on Psychological Health Among Older Adults in Ghana.

This study examines the effects of various factors, including socioeconomic status, built environment, access to healthcare, educational level, social participation, and economic stability, on older adults' psychological health. The current study analyzed a nationally representative sub-sample of 2,577 respondents aged 50 and above from the World Health Organization's Study on Global AGEing and Adult Health (WHO SAGE) Wave 2. WHO SAGE Wave 2 is cross-sectional data collected via in-person structured interviews. Ordinal least square (OLS) was used to measure the average effect of social determinants of health (SDoH), and quantile regression analysis was used to determine the effects of SDoH on older adults' psychological health at different quantiles, specifically 10th, 50th, and 90th percentiles. Significant determinants of psychological health across all quantiles included age, healthcare access, marital status, economic stability, and neighborhood and built environment. However, the degrees of significance for residence, gender, educational level, chronic diseases, and social participation varied between quantiles, showing differing effects on older adults with high or low psychological health. Religion was insignificant across all quantiles. This study highlights the need for governments and public health agencies to develop targeted interventions and strategies that support the psychological well-being of older adults in the country.

Rethinking frontline health workers' safety performance in times of pandemic: the role of spiritual leadership.

This study examined the impact of spiritual leadership style on frontline health workers' safety performance through the mediating role of safety climate. Also, leader-member exchange (LMX) was examined as a moderator of the safety climate and safety performance relationship. Survey data from 582 frontline health workers in Ghana's Greater Accra and Ashanti regions were analyzed using AMOS version 23. Findings showed that spiritual leadership dimensions significantly influenced health workers' safety performance. Altruistic love and vision also significantly influenced safety climate. However, hope did not influenced safety climate. Moreover, safety climate had an impact onsafety performance dimensions. Furthermore, safety climate mediated the relationship between altruistic love, vision, and safety performance. However, safety climate did not mediate the relationship between hope and safety performance. Lastly, LMX moderated the positive effect of safety climate on safety compliance but not on safety participation. This study offers valuable insights for improving frontline health workers' safety performance during pandemics.

A step towards food security: The effect of carbon emission and the moderating influence of human capital. Evidence from Anglophone countries.

This study evaluated the influence of carbon emission, population growth, economic growth and human capital on food security (FOS) among five selected African nations (Nigeria, Ghana, Kenya, Zimbabwe, and Tanzania) by analyzing panel data from 1990 to 2021. Moreover, the study evaluated the moderation effect of human capital on the connection between carbon emission and food security. The study's initial findings confirm that the countries selected were interdependent, and the models' parameters were stationary and co-integrated. The empirical analysis from the cross-sectionally augmented autoregressive distributed lag (CS-ARDL) indicated that (1) carbon emission and population growth have an inverse connection with FOS. (2) In contrast, the results revealed that human capital and economic growth improve FOS. (3) The study outcome proved that human capital moderates the interplay between carbon emission and food security. This result means that the association between carbon emission and food security can be enhanced through the iterative role of human capital. (4) The causality analysis revealed a unidirectional connection between economic growth, population growth, human capital and food security. (5) A bidirectional causality exists between carbon emission and food security. The current analysis enriches literature studies on FOS and environment nexus by providing new insight from the five selected African countries. The study proposes an investment into human capital by African countries because it can complement and solidify the interaction between carbon emissions and food security.

Renewable energy, technological innovation, carbon emission, and life expectancy nexus: experience from the NAFTA economies.

One essential component that reflects the development of society and the economy of most countries is life expectancy (LEXP). Nevertheless, LEXP can be influenced by varying factors, including socioeconomic and medical factors. Therefore, this analysis's focal point and motivation is to explore how socioeconomic factors such as economic growth, technological innovation, carbon emission, human capital, and renewable energy affect LEXP. The study utilized panel data from 1990 to 2020 from the North American Free Trade Agreement (NAFTA), which consists of the USA, Mexico, and Canada. The initial test confirmed that the research series were stationary and cointegrated. Therefore, the research applied the cross-sectional autoregressive distributed lag (CS-ARDL) model to predict the paper's short- and long-term estimates. The empirical estimated model concluded that human capital, renewable energy, technological innovation, and economic growth boost life expectancy. Contrarily, the outcome espoused that carbon emission has an inverse association with LEXP. The causality test confirmed a unidirectional interaction between human capital, economic growth, technological innovation, and life expectancy. On the other hand, there is a bidirectional connection between carbon emission, renewable energy, and life expectancy. The research suggests that stakeholders and policy-makers strengthen and enforce air quality standards to reduce pollution from industrial emissions and vehicle exhaust and encourage using cleaner technologies to promote LEXP. The research outcome is empirically and theoretically consistent, providing an essential breakthrough for environment-health-energy and economic development policies.

Global Health Security amid COVID-19: Tanzanian government's response to the COVID-19 Pandemic.

Several stakeholders assumed different responsibilities for global health security and safety during the COVID-19 pandemic. This study aims to highlight how the Tanzanian government, in collaboration with the international government, non-governmental organizations (NGOs), donor agencies, and stakeholders responded to the pandemic to improve health security and community well-being. This article analyzed secondary data sources from the World Health Organization's (WHO) country report and published reports from Tanzania's government to evaluate vaccine availability and health security. Findings from the data gathered indicate that the initial response from the Tanzanian government concerning the fight against the COVID-19 pandemic was rather abysmal due to the posture of the late President John Pombe Magufuli who at first downplayed the severity and seriousness of the COVID-19 pandemic. However, with the swearing-in of the new President, Samia Suluhu, there was a new approach and strategy instituted to deal with the pandemic which has resulted in the country making headway in containing the pandemic. Data gathered thus, indicate that, as of 11th February 2022, the total number of fully vaccinated individuals in the country as of 12th April 2022 stood at 3,435,513 from the total number of 2,205,815 reported on 11th February 2022. This study thus, concludes that there is a need for a strong stakeholder engagement with high-level political, community, and religious leaders and increased access to COVID-19 vaccination as well as a mass campaign to scale up vaccination activities with adequate resource mobilization and plan.

Predictors of Healthcare Utilization Among Older Adults with Moderate to Severe Cognitive Limitations in Ghana: A Cross-Sectional Analysis of the WHO Study on Global Ageing and Adult Health (SAGE) Wave 1.

BACKGROUND: As the number of older adults in Ghana keeps increasing, so does the prevalence of aging-related diseases and conditions that tend to lead to cognitive decline. However, knowledge on the predicting factors of healthcare utilization among older adults with cognitive limitations is still scarce. OBJECTIVE: This study examines the predictive factors of healthcare-seeking behavior among older adults with moderate-to-severe cognitive limitations in Ghana. METHODS: Based on Andersen's behavioral model of health service utilization, the study analyzed data from 3106 older adults with moderate to severe cognitive limitations in Ghana aged 50+ using Bivariate Probit Regression and the Heckman Selection Model. RESULTS: Results showed that individuals who were aged 75+, living in urban settlements, educated, higher income levels and parents who had some level of education, pension benefits, and both mandatory and voluntary health insurance were more likely to seek inpatient care. Enabling resources such as the national health insurance scheme and other types of medical insurance, household income, pension benefits, and predisposition factors like education influenced outpatient and inpatient healthcare consumption for older adults with moderate to severe cognitive limitations but had little influence on the choice of healthcare facility except for health insurance. CONCLUSION: Since the healthcare-seeking behavior of older adults with moderate-to-severe cognitive limitations is driven by an amalgamation of several internal and external factors, there is a need for policy change to understand and cautiously incorporate these factors into the decision to improve equitable access to healthcare services for these individuals, as not all sizes fit all in providing quality care for them.

Impact of Actual Use Behavior of Healthcare Wearable Devices on Quality of Life: A Cross-Sectional Survey of People with Dementia and Their Caregivers in Ghana.

The increasing prevalence of dementia has necessitated the introduction and use of healthcare wearable devices to augment the healthcare services delivered to people with dementia (PWDs). Unfortunately, evidence on user feedback and the real impact of the actual use of these devices on the quality of life of PWDs has not been fully explored, especially in the context of developing countries. This study, therefore, seeks to evaluate the impact of actual use behavior (AUB) of healthcare wearable devices on the quality of life (QoL) of PWDs in Ghana by using constructs from the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) model and the SF-36 quality of life instrument. Data were collected from people with dementia and, in some cases, caregivers (acting as proxies) in three administrative regions of Ghana using structured questionnaires. Of the 420 questionnaires distributed, 356 were returned, giving a response rate of (356/420, 84.8%). Three hundred and twenty (320) responses were used for further analysis, employing the Partial Least Squares based on Structural Equation Modeling. The results showed a significant positive relationship between AUB and QoL (p < 0.001). Other predictors such as behavioral intention, facilitating conditions, effort expectancy and social influence were also found to significantly impact the actual use behavior of healthcare wearable devices among PWDs. The study also revealed that 4% (14) of patients rated their reported health transition associated with the use of healthcare wearable devices as excellent, 42.5% (136) as very good, and 39.4% (126) as good, respectively at the time of the study compared to a year ago. This study provided empirical evidence of the positive impact of the actual use of healthcare wearable devices on the quality of life of PWDs and further highlighted the factors that drive actual use behavior among PWDs in Ghana. Based on the findings of this study, stakeholders need to create the necessary conditions that will facilitate the adoption and use of healthcare wearable devices, as this will help improve the quality of life, reduce the burden of the disease on caregivers, and enable independent living of PWDs.

The Mediating Effect of Healthcare Utilization on Livelihood Empowerment against Poverty (LEAP) and Health Security of Older Adults in Ghana: A Case Study on the Ga-West Municipality in Accra, Ghana.

The concept of health security has aroused several interpretations because of theoretical technique indifferences or academic methodology. The focus has been on human security, old age health security (OAHS), whereas there remain issues of low healthcare utilization by older people from rural Ghana while there are social assistance programs. The study aimed at investigating the mediating effect of healthcare utilization on Livelihood Empowerment against Poverty (LEAP) and old age health security OAHS. With purposive sampling technique, participants were selected to participate in the study with standardized quantitative questionnaire to measure the variables involved in the study and a regression technique to analyze the data. The result of the mediation analysis showed a partial mediation between LEAP and Healthcare Utilization (HU) was found to have bridged the gap between the LEAP and OAHS. The LEAP policy also caused an increase in Health Utilization and, subsequently, an increase in old age health security (OAHS). The study is essential to help the National Health Insurance Authority NHIA in restructuring health care premiums to incite utilization of health facilities by the aged.

Examining the impact of socioeconomic status, demographic characteristics, lifestyle and other risk factors on adults' cognitive functioning in developing countries: an analysis of five selected WHO SAGE Wave 1 Countries.

BACKGROUND: Though extensive studies have been conducted on assessing the predictors of cognitive functioning among older adults in small community-based samples, very few studies have focused on understanding the impact of socioeconomic status (SES), demographic characteristics and other risk factors such as lifestyle and chronic diseases on the cognitive functioning among adults of all ages in a nationally representative population-based sample across low- and middle-income countries. This study, therefore, seeks to evaluate the impact of SES, demographic characteristics and risk factors on the cognitive functioning of adults across all ages in five selected developing countries. METHODS: Data from 12,430 observations obtained from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1; consisting of 2,486 observations each for China, Ghana, India, the Russian Federation, and South Africa, were used for the study. A meta-regression and a five-step hierarchical linear regression were used to analyze the data, with cognitive functioning as the dependent variable. Independent variables used in this study include SES; assessed by household income and education, demographic characteristics, other risk factors such as lifestyle, self-reported memory difficulty and chronic diseases. RESULTS: This study found that SES and lifestyle significantly predicted cognitive functioning in all the five selected countries as obtained by the pooled results of the meta-regression analysis. The hierarchical linear regression results also revealed that demographic characteristics such as age, type of residency, and self-reported memory difficulty significantly impact cognitive functioning in China, Ghana, Russia, and South Africa. CONCLUSION: The findings in this study provide new insights for policymakers, caregivers, parents, and individuals, especially those in developing countries, to implement policies and actions targeted at improving SES and eliminating risk factors associated with cognitive decline, as these measures could help improve the cognitive functioning among their populations.

The prevalence of hypertension and its associated risk factors among older adults in Ghana.

Background: Hypertension is a worldwide health issue that primarily affects the elderly in our society. However, in comparison to the developed world, the prevalence of hypertension is higher in Sub-Saharan Africa. Objective: This paper examines the prevalence of hypertension and its associated risk factors among older adults in Ghana. Methods: Using the World Health Organization's study on global AGEing and adult health (WHO SAGE) Wave 1 cross-sectional data collected via in-person structured interviews; paper and pencil interviews (PAPI) from ten administrative regions of Ghana using stratified multistage cluster design from respondents aged 50+ grouped by decade, this study analyzed a nationally representative sub-sample of 3,997 respondents employing binary logistic regression. Odds ratios (OR) and 95% confidence intervals (95% CI) were used to estimate risk factors associated with hypertension (blood pressure ≥ 130/80 mm/Hg). Results: There was a 53.72% hypertension prevalence rate among older adults. Hypertension prevalence tends to increase with increasing age. The prevalence of hypertension was associated with residency (B = -0.18, OR = 0.84, p < 0.017), with urban residents being more at risk of hypertension than rural residents. The prevalence of hypertension increased with overweight (B = 0.66, OR = 1.94, p < 0.001) and obesity (B = 0.82, OR = 2.28, p < 0.001). The amount of fruit and vegetable intake was insignificant but had an inverse relationship with hypertension prevalence. Conclusion: This study has shown that demographic and lifestyle factors significantly affect and explain the hypertension risk among older adults. Medical factors, such as chronic diseases, were largely insignificant and accounted for less hypertension prevalence. Therefore, when interpreting test findings in clinical practice, such as hypertension, it is essential to consider demographic and lifestyle factors. In addition, health policies and primary interventions that seek to improve the standard of living, lifestyle, and wellbeing of older adults need to be critically considered moving forward to lower hypertension prevalence among older adults in Ghana.

Influence of Risk Perception on Task and Contextual Performance: A Case of Work-Related Musculoskeletal Disorders in Nurses.

Assessing the risk perception of workers can be very informative in predicting their behavioral outcomes, including task and contextual performance. Yet, research to assess the effect of risk perception on task performance and contextual performance remains scarce. Thus, this study explored the effect of risk perception of work-related musculoskeletal disorders on task and contextual performance in nurses. This study further examined safety behavior as a mediator of these relationships. Using structural equation modeling, the researchers examined these relationships by employing a cross-sectional survey with a quantitative approach. The data was collected via questionnaires from 382 nurses who work in three major hospitals in Accra Metropolis, Ghana. The results showed that nurses' risk perception positively influenced their task and contextual performance, and that safety behavior partially mediated the effects of risk perception on task and contextual performance. This study offers a theoretical framework and empirical evidence for the concept of risk perception and its association with safety behavior, task, and contextual performance. To the best of our knowledge, this is the first study to assess the relationships that exist among these variables. Thus, future studies are needed to verify the causality of the relationships.

Assessing the Impact of Social Media Use on Everyday Emotion in Health Crises: A Study of International Students in China during COVID-19.

Social media has become a valuable tool in providing an opportunity to stay in touch with one's social networks, providing reassurance and practical advice to individuals to pre-empt panic and rumors in COVID-19. However, the implications of social media use on the everyday emotion (anxiety and depression) of users especially, international students, are not well understood. Thus, this study sought to examine the impact of social media use on the everyday emotion of international students in China during COVID-19. Using a structured online questionnaire based on modified questions from the generalized anxiety disorder 7 (GAD-7) and the Patient Health Questionnaire 9 (PHQ-9) and social media use instruments, data were collected from 480 participants. Of the total responses received, 474 were further analyzed employing the Partial Least Squares Path Modelling (PLS-PM). This study showed a significant positive relationship between social media use and everyday emotion (B = 0.34, 95% CI (0.26, 0.44)). Additionally, self-rated anxiety and depression associated with social media use among international students were generally mild (n = 249, 52.50% and n = 350, 73.80%, respectively). Moderating effects revealed that age and sex do not significantly moderate the relationship between social media use and everyday emotion in COVID-19. Given the nature of social media among international students, who are also prone to suffering from anxiety and depression associated with social media use, the positive effect of social media use and everyday emotion, especially in COVID-19, has important implications for international students' education stakeholders. Thus, gaining a deeper understanding of this relationship could enable them to harness social media and use it as a valuable tool to overcome the social distancing constraints in COVID-19.

Association between socioeconomic status and cognitive functioning among older adults in Ghana.

OBJECTIVES: Extensive analysis of the associations between socioeconomic status and cognition has been conducted among older adults. However, it is not clear whether associations in high-income countries are similar in low-and middle-income countries. This research aims to investigate the association between the socioeconomic status of older adults in Ghana and their cognitive function by using a sample of older adults that is nationally representative. METHODS: Data were obtained from a sample of older Ghanaian adults (50+) from the Study of Global AGEing and Adult Health Wave 1 (n = 3710) of the World Health Organization. Objectively, cognition was measured by verbal recall, verbal fluency, forward digit span, and backward digit span, while variations in cognition overall were evaluated against socioeconomic factors using linear regression. RESULTS: Older age, older women, rural life, increasing memory difficulty, and being diagnosed with stroke were the most significant determinants of impaired cognitive function. Higher education and higher income were significantly associated with a better cognitive function than those with no formal education and low income. CONCLUSIONS: These results provide new evidence for public health programs in Ghana and other low-and middle-income countries to tackle cognitive impairments in growing populations.

The Influence of Managerial Psychology on Job Satisfaction among Healthcare Employees in Ghana.

Background: Employee job satisfaction has been established to be one of the important factors that work towards addressing the subject matter of productivity in organizations. Healthcare professionals deserve some level of basic psychological need satisfaction in the area of job autonomy. Reasons that lead to employees achieving job autonomy and job satisfaction have been researched by industrial and organizational psychologists but very few of such studies have directed their attention towards the role psychological capital can play. Therefore, this study sought to find out how much of an impact positive psychology can make on the job autonomy of healthcare employees leading to the fulfillment of job satisfaction. Methods: Data were collected from 385 healthcare professionals from the public sector. A structural equation model was performed to analyze the relationship that exists between the constructs of psychological capital and job autonomy leading to job satisfaction on the part of the employees. Results: Results showed both a direct and indirect positive relationship between hope and job satisfaction and indirect through job autonomy. Apart from self-efficacy, that had a very low positive relationship, optimism largely influenced job autonomy of healthcare professionals. Results also showed that psychological capital positively related to job autonomy while job autonomy minimally influenced job satisfaction. Conclusions: It is concluded from this study that healthcare professionals deserve some level of basic psychological need satisfaction in the area of job autonomy and that can stimulate positive work ethic.

The effect of risk communication on the nurses' task and contextual performance in disease outbreak control in Ghana: Application of the cause model.

BACKGROUND: The re-emerging of infectious disease outbreaks is a menace in Ghana. As the acceptance of risk communication rises, health workers are using it to control outbreaks. Yet, research in risk communication and health workers' performance remains unexplored in Ghana. OBJECTIVE: This study explores how risk communication works among nurses and its effect on their task (behaviors that are delineated based on role requirements and identified by a thorough analysis of the job) and contextual performance (behaviors that do not fall within the employee's assigned duties, but are a very important part of job performance). Thus, we adopted the CAUSE model, which proposes that effective risk communication creates five goals (Confidence, Awareness, Understanding, Satisfaction, and Enactment) amongst communicators. METHOD: This study involves a quantitative approach complemented with qualitative data. It was conducted in three hospitals in Ghana, from which a sample of 398 nurses were selected. RESULT: The result depicts that risk communication has a significant and positive effect on task performance (ß = .65; P < .001), and contextual performance (ß = .55; P < .001). CONCLUSION: Our study shows that confidence is the strongest predictor of risk communication in influencing task and contextual performance. Yet, risk communication overall improves nurses' task and contextual performance.

Relationship between chronic diseases and sleep duration among older adults in Ghana.

PURPOSE: Aging increases the prevalence of health problems that are often chronic, resulting in more sleep problems for people with poor health or chronic conditions. Relatively fewer studies have been conducted on the relationship between sleep duration and chronic conditions in Sub-Saharan Africa compared to Western or Asian populations. This study uses a nationally representative sample of older adults in Ghana to examine the association between sleep duration and chronic conditions. METHOD: Data were gathered from the World Health Organization Study on Global AGEing and Adult Health (SAGE) Wave 1 in Ghana (n = 3617). Data on duration of sleep and chronic conditions were derived from self-reported data and validated symptom reporting. Multinomial logistic regression was conducted to examine the association between sleep duration and chronic conditions. RESULTS: Women had a significantly longer period of sleep than men. Older people (> 60 years) were more likely than people under 60 years old to sleep for longer periods. The prevalence of stroke, depression, and chronic lung disease among long sleepers was high compared with short and medium sleepers. Our study found that respondents with stroke, arthritis, depression, chronic lung disease, asthma, and hypertension were likely to sleep for a long time. CONCLUSION: This study showed a significant association between long hours of sleep and chronic conditions. To health professionals, paying particular attention to this association among older adults is medically important.

Factors Affecting Caregivers' Acceptance of the Use of Wearable Devices by Patients With Dementia: An Extension of the Unified Theory of Acceptance and Use of Technology Model.

PURPOSE: This study aims to examine the factors affecting caregivers' acceptance of the use of wearable devices by patients with dementia by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model with 2 additional constructs: resistance to change (RC) and technology anxiety (TA). METHODS: A structured online questionnaire was developed and distributed to caregivers who have either dealt previously with or were currently taking care of patients with dementia in sub-Saharan Africa. The selection of countries for the study was purely based on the availability of caregivers of patients with dementia and their readiness to take part in the survey. Questionnaire data from 350 respondents were analyzed and the hypothesis tested using partial least squares based on structural equation modeling. RESULT: The results of the extended model show that social influence, effort expectancy, facilitating conditions, and behavioral intention (BI) all had P < .05, thus were statistically significant in explaining the perceived BI and actual use of health-care wearable devices among patients with dementia as reported by caregivers. However, P value for RC and TA was greater than .05, hence were insignificant.

Predictive factors of physicians' satisfaction with telemedicine services acceptance.

Despite the significant increase in telemedicine services technology, its adoption and use have been quite slow in some healthcare settings. It is generally accepted in today's globalizing world that the success of telemedicine services relies on users' satisfaction. Satisfying physicians and patients is one of the crucial objectives of telemedicine success. This study seeks to evaluate physicians' satisfaction with telemedicine services adoption and utilization using the technology acceptance model. A structured questionnaire based on the construct of technology acceptance model was used to solicit for data from participants in four different government health institutions. Purposive and convenience sampling techniques were employed to select healthcare professionals from various medical fields. Structural equation modeling was utilized in the data analysis. Perceived ease of use and perceived usefulness of telemedicine services were found to influence physicians' behavioral intentions. This resulted in increased efficiency, quality of services, quality patient care delivery, and satisfaction among physicians in using telemedicine services. We noted that the adoption of telemedicine services in clinical settings depends on physicians' and patients' satisfaction with the use of the service. The study contributes to empirical knowledge by identifying the vital predictive factors affecting telemedicine services satisfaction among physicians.

The old age health security in rural China: where to go?

INTRODUCTION: The huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. This study aims to provide information for policy-makers to develop effective measures for promoting rural elders' health care service access by examining the current developments and challenges confronted by the old age health security in rural China. METHODS: Search resources are electronic databases, web pages of the National Bureau of Statistics of China and the National Health and Family Planning Commission of China on the internet, China Population and Employment Statistics Yearbook, China Civil Affairs' Statistical Yearbook and China Health Statistics Yearbooks etc. Articles were identified from Elsevier, Wiley, EBSCO, EMBASE, PubMed, SCI Expanded, ProQuest, and National Knowledge Infrastructure of China (CNKI) which is the most informative database in Chinese. Search terms were "rural", "China", "health security", "cooperative medical scheme", "social medical assistance", "medical insurance" or "community based medical insurance", "old", or "elder", "elderly", or "aged", "aging". Google scholar was searched with the same combination of keywords. RESULTS: The results showed that old age health security in rural China had expanded to all rural elders and substantially improved health care service utilization among rural elders. Increasing chronic disease prevalence rates, pressing public health issues, inefficient rural health care service provision system and lack of sufficient financing challenged the old age health security in rural China. CONCLUSIONS: Increasing funds from the central and regional governments for old age health security in rural China will contribute to reducing urban-rural disparities in provision of old age health security and increasing health equity among rural elders between different regions. Meanwhile, initiating provider payment reform may contribute to improving the efficiency of rural health care service provision system and promoting health care service access among rural elders.