Tropical Geography ›› 2021, Vol. 41 ›› Issue (5): 906-917.doi: 10.13284/j.cnki.rddl.003387

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The Effects of Urbanization on Older Adults' Health: Evidence from 2,805 Counties in China

Baishi Huang1,2,3(), Ye Liu1,2,3(), Zehan Pan4   

  1. 1.School of Geography and Planning, Sun Yat-sen University, Guangzhou 510275, China
    2.Guangdong Key Laboratory for Urbanization and Geo-simulation, Guangzhou 510275, China
    3.Guangdong Provincial Engineering Research Center for Public Security and Disaster, Guangzhou 510275, China
    4.Institute of Population Research, Fudan University, Shanghai 200433, China
  • Received:2021-01-06 Revised:2021-06-03 Online:2021-09-05 Published:2021-09-22
  • Contact: Ye Liu;


China's rapid urbanization has contributed to an epidemiological transition from infectious diseases to chronic diseases over the last four decades. The aging of the population has also raised considerable challenges for the sustainable development of China's economy and society. Determining the effects of urbanization on older adults' general health in China is helpful for a more comprehensive assessment of current development in urbanization and to find active interventions to achieve healthy aging. Based on a micro-data sample from the 2010 China population census, nighttime light data, and other statistical data, this study employed two-level logistic regression models to estimate the relationships of the level and rate of urbanization with self-rated health among older Chinese adults on the county-level geographic scale and explore the differences in the health effects of urbanization in different groups of older people. We applied propensity score matching to control for self-selection bias. This study found that (1) the level and rate of China's urbanization have a significant positive correlation with older adults' self-reported health, such that older people living in areas with moderate urbanization and experiencing rapid urbanization are more likely to report good health; (2) those with junior high school education or below and those with local hukou benefit more from urbanization development; (3) after controlling for self-selection bias, the level and rate of urbanization are still positively associated with the self-reported health of older adults. In summary, this study used nationally representative census data covering 2805 counties across 31 provinces to provide a more comprehensive picture of urbanization-health relationships across the country. Longitudinal studies are warranted to determine causality, which may help policymakers and practitioners develop effective interventions to promote older adults' health and healthy aging.

Key words: urbanization, self-rated general health, older adults, multilevel logistic regression models, propensity score matching, China

CLC Number: 

  • R12