Mental Health Among Chinese Elders

The global aging population creates significant potential for social work research and practice. Depression is a global public health issue that is a pressing concern in China, where the aging population is growing rapidly. China has the third highest rate of suicide in its elderly population; suicide rates among Chinese elderly has been estimated to range from 44.3 to 200.0 per 100,000 individuals. Chinese suicide rates increases with age, especially among individuals over 55 in rural areas.  Stigma and social isolation due to migration have been theorized to influence emotional well-being through changing family dynamics and economic structures in Chinese society (Li et al., 2006).  This current study aims to examine the health and social factors associated among urban and rural Chinese elderly, and to specify the risk factors for suicide among Chinese elderly. 

The secondary research is based on the WAVE I (2010) of the WHO Study on Global AGEing and Adult Health (SAGE). This study analyzed a subset of the nationally representative sample aged 60 and older from China (N=7560). Further analysis focused on respondents to questions about suicidal thoughts and behaviors (n=194). 

Urban older adults accounted for 39% of the sample, while rural older adults comprised 25% of the sample.  Data showed that urban residents were older than their rural counterparts (mean age: 69.3 vs. 66.8).  There were more women in the rural setting than in the urban area (64.9% vs. 52.3%), and urban elders were more educated (high school or above schooling) than rural elders (35% vs. 3%). In terms of physical well-being, rural elders reported poorer health than urban elders.  Almost 26.2% of the rural elders reported poor to worse health conditions versus 16.3% of the urban elders.  However, rural elders reported fewer numbers of chronic illnesses than urban elders (1.0 vs. 1.6).

One-quarter of the study sample endorsed having suicidal thoughts and behaviors. Bivariate analyses showed depressed mood, hopelessness, financial satisfaction, self-rated health, and pension receipt were associated with suicidal thoughts and behaviors. When adjusting for covariates in a logistic regression analysis, feeling hopeless increased the risk for suicidal thoughts and behaviors (OR=4.95). Additionally, higher levels of self-rated health decreased the risk of having suicidal thoughts and behaviors (OR=0.25). 

Migration and changing family composition create risks for older adults’ mental health.  The differentiation of mental health risks between urban and rural Chinese older adults merit further research and practice.  Further, suicidal thoughts and behaviors are mental health issues that need to be addressed among Chinese elderly. Emotional and physical well-being, as well as financial security are important foci for Chinese elderly in this study. Culturally appropriate social gerontological approaches are needed to improve the well-being of Chinese elderly globally.