Objective  To examine differences in health status and related factors among rural elderly in eastern, central and western regions of China and to provide evidences for promoting balanced implementation of healthy aging in various regions.

  Methods  We conducted a questionnaire survey among 3 053 rural residents (aged ≥ 60 years) recruited with purposive sampling in Hai'an county of Jiangsu province, Nanle county of Henan province, and Datong county of Qinghai province between March and May 2014.

  Results  There were differences in economic condition, provision demands, disease prevalence, and medical service utilization among the rural elderly in the three regions. Among the rural elderly, the most common diseases were hypertension, arthritis, and heart diseases, with the prevalence rates of 38.78% (1 184/3 053), 29.97% (915/3 053), and 16.80% (513/3 053), respectively. Higher hypertension prevalence rate (48.73%, 497/1 020) was reported by the elderly in the central region than that reported by the elderly in the eastern (34.33%, 344/1 002) and western region (33.27%, 343/1 031); higher prevalence rate of arthritis and heart diseases (42.48%, 438/1 031 and 25.90%, 267/1 031) were reported by the elderly in the western region than those reported by the elderly in central region (24.61%, 251/1 020 and 13.53%, 138/1 020) and eastern region (22.55%, 226/1 002 and 10.78%, 108/1 002); and the self-reported prevalence rate of diabetes was higher among the elderly in the eastern region (8.68%, 87/1 002) than among those in the western (6.30%, 65/1 031) and the central region (5.49%, 56/1 020). The number of elderly suffering from two or more chronic diseases was significantly higher in the central and western regions than in the eastern region (both P < 0.01).

  Conclusion  There are regional differences in health status among the elderly in rural China. The health status is better among the elderly in eastern region than among those in central and western regions; residential area, age, gender, family structure, and everyday life style are associated with health status among rural elderly in China.