Disparity in self-rated health between urban and rural elderly: a Fairlie decomposition analysis

  Objective  To investigate the status of and urban-rural disparity in self-rated health among the elderly in China and to provide evidences for narrowing the disparity and promoting health equity in elderly population.

  Methods  We extracted data on self-rated health of 4 058 urban and rural elderly aged 65 and older from the dataset of Chinese Family Panel Study conducted in 2014 in 25 provinces/cities/autonomous regions of China. Fairlie decomposition was adopted to analyze the disparity in self-rated health between the urban and rural elderly.

  Results  Of all the elderly, 48.72% (1 977) reported good health status. The urban elderly reported a significantly higher ratio of good health than the rural elderly (51.40% vs. 46.37%, χ² = 10.21; P = 0.001). Logistic regression analyses demonstrated that the urban elderly having alcohol consumption and physical exercise and the rural elderly with high school education, tobacco smoking, alcohol drinking, and having physical exercise were more likely to report good health status; while the urban female elderly were more likely to report poor health status. Fairlie decomposition analysis revealed that 51.29% of the urban-rural disparity in the health of elderly could be explained by observable factors and 48.61% by regional characteristics of the elderly's residence. Lifestyle is a significant influencing factor for self-rated health (β = 0.016 4, P = 0.007), which could explain 32.6% of the overall disparity in self-rated health among the elderly.

  Conclusion  The self-rated health of urban elderly is better than that of rural elderly and lifestyle is the most important influencing factor of the disparity in self-rated health between urban and rural elderly.