Health disparity among older adults in urban China: The role of local fiscal conditions.

This study explores the disparities in older adults' self-rated health within the urban landscape of China. Drawing on the 1% national population survey of China in 2015, it highlights how variations in city development contribute to geographical health disparities among older residents. In the era of the decentralized fiscal system, a crucial mechanism identified is the role of cities' local fiscal revenue in connecting their socioeconomic development and the health status among older adults. Despite efforts by cities in lower socioeconomic positions to increase fiscal expenditure and address deficits through central transfer payments, they prove inadequate in effectively mitigating population health disparities. The prioritization of economic growth and neglect of public service provision responsibilities are fundamental causes within this fiscal framework. The findings underscore the urgent need for increased central transfer payments in public services to address the growing disparities in older adults' health.

Does the population size of a city matter to its older adults' self-rated health? Results of China data analysis.

Clarifying the association between city population size and older adults' health is vital in understanding the health disparity across different cities in China. Using a nationally representative dataset, this study employed Multilevel Mixed-effects Probit regression models and Sorting Analysis to elucidate this association, taking into account the sorting decisions made by older adults. The main results of the study include: (1) The association between city population size and the self-rated health of older adults shifts from a positive linear to an inverted U-shaped relationship once individual socioeconomic status is controlled for; the socioeconomic development of cities, intertwined with the growth of their populations, plays a pivotal role in yielding health benefits. (2) There is a sorting effect in older adults' residential decisions; compared to cities with over 5 million residents, unobserved factors result in smaller cities hosting more less-healthy older adults, which may cause overestimation of health benefits in cities with greater population size. (3) The evolving socioeconomic and human-made environment resulting from urban population growth introduces health risks for migratory older adults but yields benefits for those with local resident status who are male, aged over 70, and have lower living standards and socioeconomic status. And (4) The sorting effects are more pronounced among older adults with greater resources supporting their mobility or those without permanent local resident status. Thus, policymakers should adapt planning and development strategies to consider the intricate relationship between city population size and the health of older adults.

Spatial coupling relationship between older adults and elderly care resources in the Yangtze River Delta.

The imbalance between supply and demand of elderly care resources in the Yangtze River Delta is increasing. By the older adult agglomeration, spatial cluster analysis, hotspot analysis, and coupling coordination model, this study explores the spatial coupling relationship between older adults and elderly care resources in the Yangtze River Delta in 2020 from the perspective of a supply-and-demand balance. The results demonstrate that: (1) population aging is mainly in the moderate aging stage, followed by the primary aging stage; (2) there are significant spatial differences in elderly care resources on the urban scale in the Yangtze River Delta; and (3) elderly care resources and the older adults in the Yangtze River Delta are mostly highly coupled. However, Nantong, with the highest degree of aging, has a serious mismatch in life service resources and ecological environment resources. The social security resources and medical resources of provincial capital cities with low aging are mismatched. Medical and health resources in underdeveloped areas are seriously mismatched. The social security resources are barely matched in Shanghai. A path for optimizing the spatial allocation of elderly care resources is proposed. This research offers a decision-making reference for coordinating elderly care resources distribution.

The spatiality and driving forces of population ageing in China.

Studying the spatial characteristics of China's ageing and its influencing factors is of great practical significance because China has the largest elderly population in the world. Using 2000 and 2010 census data, this study explores the degree, pace, and pattern of population ageing and its driving mechanism using exploratory spatial data analysis and the geographically weighed regression model. Between 2000 and 2010, population ageing increased rapidly countrywide; yet, spatial differences between eastern and western China narrowed. The degree of provincial population ageing and its spatiality were determined by natural population growth, migration, and local economic development. Life expectancy and mortality were the primary long-term factors, and GDP per capita was the prime contributor in the early days of economic development; the migration rate was the dominant influence after 2010. China's overall spatial differentiation of population ageing shifted from a north-south to an east-west division.