Are there gender differences in the trajectories of self-rated health among chinese older adults? an analysis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS)

Abstract

Background Self-rated health (SRH) is a good predictor of morbidity and mortality. Extensive research has shown that females generally report poorer SRH than males but still tend to live longer. Previous studies used cross-sectional or pooled data for their analyses while ignoring the dynamic changes in males’ and females’ SRH statuses over time. Furthermore, longitudinal studies, especially those that focus on older adults, typically suffer from the incompleteness of data. As such, the effect of dropout data on the trajectories of SRH is still unknown. Our objective is to examine whether there are any gender differences in the trajectories of SRH statuses in Chinese older adults. Methods The trajectories of SRH were estimated using the pattern-mixture model (PMM), a special latent growth model, under non-ignorable dropout data assumption. We analyzed the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data of 15,613 older adults aged 65 years and above, collected from 2005 to 2014. Results The results demonstrated the effect of non-ignorable dropout data assumptions in this study. The previous SRH score was negatively associated with the likelihood of dropping out of the study at the next follow-up survey. Our results showed that both males and females in China perceive their SRH as decreasing over time. A significant gender difference was found in the average SRH score (female SRH was lower than male SRH) in this study. Nonetheless, based on the results obtained using the PMM, there are no gender differences in the trajectories of SRH at baseline as well as in the rate of decline among the total sample. The results also show that males and females respond to SRH predictors similarly, except that current drinking has a more pronounced positive effect on males and healthcare accessibility has a more pronounced positive effect on females. Conclusions Our results suggest that missing data have an impact on the trajectory of SRH among Chinese older adults. Under the non-ignorable dropout data assumptions, no gender differences were found in trajectories of SRH among Chinese older adults. Males and females respond to SRH predictors similarly, except for current drinking habit and healthcare accessibility.

Socioeconomic determinants of gender differences in self-reported health status among older population

“…Previous studies have shown that self-reported health among older men and women is a valid measure of the objective health status of respondents, a significant predictor of survival in advanced age along with being a powerful predictor of healthy longevity (4,6). The perception of health status varies in different cultures and countries.…”

“…The nature of inequalities between men and women based on their gender and age indicates that age is considered a more cultural and socio-historical category, being less perceived as a biological and natural process by itself. Gender is regarded as a significant health determinant which additionally shapes the patterns of developing diseases, approach to health protection, and medical treatment availability as well (4). The roots of inequalities in health related to gender are numerous, mutually intertwined, and complex.…”

Independent and joint effects of sleep duration and sleep quality on suboptimal self-rated health in medical students: A cross-sectional study

“…In addition, sleep duration, sleep quality, and other variables were collected through questionnaires. Although we designed the SRH questionnaire with reference to many large cohort studies ( 6 , 18 , 36 ), and conducted detailed reliability and validity assessments on variables such as sleep duration, sleep quality, and self-rated health, the variable acquisition method was relatively subjective, and the information was not as accurate as the objective evaluation method. We also did not monitor other residual confounding such as sleep duration variability, social jetleg, the number of wake-ups from sleep, fatigue and stress.…”

“…This cross-sectional study was performed in a medical university in eastern China, from April to September 2021. The questionnaire was designed by experts in the fields of epidemiology, medical statistics, and sociology according to other large-scale cohort studies (6,(16)(17)(18)(19), including basic demographics, sleeping behaviors, other lifestyle factors, biorhythm variables, and health status. We used proportional stratified cluster random sampling method to recruit undergraduates of various majors.…”

Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China?

“…This study aims to explore the mediating effect of health performance ( Health ) between basic medical insurance and elderly family income inequality. We measure the health performance of the elderly based on the question of “Health status.” Referring to the previous literature ( 40 ), we assign 1 to Health if the elderly answer unhealthy, 2 for fair, and 3 for healthy.…”