Successful Aging in China: Is It Who They Are, or Where They Live

Background and Purpose: Promoting successful aging benefits both older people and the society. Frequently at the core of research on successful aging is the notion of personal responsibility (e.g. avoiding smoking, exercising regularly and following a healthy diet). However, whether macro issues beyond personal control affect individual's opportunity to age well is rarely investigated. This study tries to expand this body of literature by identifying individual-level and macro-level factors associated with successful aging among older people in a non-Western developing society – China. Specifically, this study seeks to improve the understanding of the ways in which the ongoing Chinese reform experience plays a role in older people's aging experiences, over and above well-studied individual-level predictors.

Methods: Data for this study comes from the 2005 Chinese Longitudinal Healthy Longevity Survey and the 2005 China Provincial Statistical Yearbook. The sample consists of 15,638 older adults (average age: 86) from 22 provinces across China. Drawing from Rowe and Kahn's framework, I classify respondents as successful agers if they (1) having no cognitive impairment; (2) having no ADL limitations; (3) having no serious chronic diseases; and (4) are actively engaged in life. Individual-level factors include: (1) demographics; (2) lifestyle; (3) social support, and (4) psychological disposition. Macro-level factors include province-level GDP per capita and income inequality (calculated as log wage differentials between the 80th and 20th percentiles), given the fact that rapid economic growth and fast-growing income inequalities are the two most prominent issues in China since its economic reform. A two-level logistic random intercept multilevel model is employed for this study.

Results: Results show an independent effect of macro-level factors on successful aging after adjusting for individual variables. Individual-level factors still matter in terms of successful aging among Chinese older people: having high individual SES, following a good lifestyle, having positive attitude towards life, and having frequent sibling visits increase the likelihood of successful aging. Income inequality has a quadratic effect on successful aging. The likelihood of successful aging increases (at a decreasing rate) at first as income inequality increases from low values toward higher values, however, as income inequality continues to increase beyond a certain point, the likelihood of successful aging declines (at an increasing rate).

Conclusions and Implications: This study indicates individuals have the ability to promote successful aging, but achieving successful aging is not limited to individual responsibility. It thus suggests that promoting successful aging should be a joint effort from individual and local government.