Life Course Socioeconomic Status and Healthy Longevity in China

Abstract

In 2020, China’s population aged 60 or older exceeded 264 million, representing 25% of the global population in that age-group. Older adults in China experienced periods of dramatic political and social unrest in early life, as well as economic transformations leading to drastic improvements in living standards during adulthood and older age. However, the implications of life course socioeconomic status (SES) trajectories for healthy longevity in later life have not been systematically studied in China. We utilize data from the China Health and Retirement Longitudinal Study (CHARLS) to comprehensively investigate how early-life conditions and adult SES com­bine to influ­ence healthy lon­gev­ity in later life. We find that both child­hood and adulthood SES are associated with late-life health. The largest disparities in life expectancy (LE) and disability-free LE are found between those with persistently low SES throughout life and those with consistently high SES. At age 45, the gap in total LE between the most advan­taged and least advan­taged groups is six years for men and five years for women. Despite China’s major policy changes prioritizing equity in income and health care in recent decades, our find­ings sug­gest that dra­matic health inequalities among older adults remain. Our find­ings extend the lit­er­a­ture on the effect of socioeco nomic patterns across the life course on gradients in later-life health and highlight continuing disparities in healthy longevity among older adults in China.