Older adults often have more health-care needs and higher financial burdens but fewer income resources compared to other age groups. In two new publications, the Columbia China Center for Social Policy research team examines the complex relationship pathways among health, work, and poverty in the older population in China.
In an article published in Ageing & Society, doctoral student Yalu Zhang and professor Qin Gao examined whether catastrophic health expenditure was associated with older adults’ physical and mental health in rural and urban China. They defined catastrophic health expenditure as over 20% of household disposable income spent on health-related goods and services. Using data from the 2011 and 2013 China Health and Retirement Longitudinal Study (CHARLS), they found that both urban and rural older adults were more likely to have poorer physical and mental health if they used to not have catastrophic health expenditure in 2011 but then had it in 2013.
“It is critical to understand the characteristics of the population that suffers from heavy health-care financial burdens and the potential influence on physical and mental health.” said Yalu Zhang, “The medical impoverishment that they face may not only affect their own wellbeing but also affect their younger generations.”
The authors also call for professional social work services to be implemented and expanded to improve older adults’ quality of life according to different demands in urban and rural settings. In particular, they argue that such services are more urgently needed in rural than in urban areas across healthcare and community settings to meet the needs of the rapidly growing aging population and their families in China.
In another article published in the Journal of the Economics of Ageing, Gao and Zhang used 2011, 2013, and 2015 waves of CHARLS data to examine changes in health experienced by middle-aged and older adults in China and the extent to which they are associated with changes in individual work and income outcomes. Their coauthors are two economists from Fordham University, Sophie Mitra and Wei Chen.
The team found significant health declines among women and those who resided in rural areas. The authors also found that health declines were significantly related to reduced work hours and income among middle-aged males in rural areas. In contrast, health declines were only associated with reduced work hours but not earnings or income among rural females.
The authors conclude that gender, residence location, and household registration status all play important roles in the associations between health and economic outcomes in China. “These results overall point towards a need in China for policies that support health, work, and income, and more broadly economic wellbeing among middle-aged and older adults in rural areas,” said Mitra, the lead author of the article.
