Determining the effect of air quality on activities of daily living disability: using tracking survey data from 122 cities in China

Abstract

Background Current research on activities of daily living (ADLs) disability has mostly focused on the analysis of demographic characteristics, while research on the microcharacteristics of individuals and the macroenvironment is relatively limited, and these studies solely concern the impact of air quality on individual health. Methods This study innovatively investigated the impact of air quality on ADL disability by matching micro data of individuals from the China Health and Retirement Longitudinal Study with data of urban environmental quality from 122 cities. In this study, an ordered panel logit model was adopted for the benchmark test, and the two-stage ordered probit model with IV was used for endogenous treatment. Results This innovative study investigated the impact of air quality on ADL disability by matching individual micro data from the China Health and Retirement Longitudinal Study with urban environmental quality data for 122 cities. The results showed that air quality significantly increased the probability of ADL disability. The positive and marginal effect of air quality on moderate and mild disability was higher. Generally, the marginal effect of air quality on residents’ health was negative. In terms of group heterogeneity, the ADL disability of individuals aged over 60 years, those in the high Gross Domestic Product (GDP) group, females, and those in the nonpilot long-term care insurance group was more affected by air quality, and the interaction between air quality and serious illness showed that the deterioration of air quality exacerbated the ADL disability caused by serious illness; that is, the moderating effect was significant. Conclusions According to the equilibrium condition of the individual health production function, the ADL disability caused by a 1% improvement in air quality is equivalent to the ADL disability caused by an 89.9652% reduction in serious illness, indicating that the effect of improved air quality is difficult to replace by any other method. Therefore, good air quality can not only reduce ADL disability directly but also reduce serious illness indirectly, which is equivalent to the reduction of ADL disability. This is called the health impact.

Exploring the relationship between air quality and health shocks to the elderly: A retrospective cross-sectional study in China

“…It is worth noting that the effect of AP on health shocks in older people shows some heterogeneity, with the effect of AP on health shocks in older people being more pronounced in the 60-69 year age group, the eastern/central regions with better economic development, and in areas with high concentrations of NO 2 and O 3 in the air. AP damages both physical and mental health (15-17), especially affecting the self-rated health of low socio-economic groups (13) and increasing the probability of ADL disability (18,19). Previous studies concerning older age groups mostly concentrated on the effects on mortality but did not assess the extent to which AP affects negative health events among residents in an aging society.…”

“…AP damages both physical and mental health ( 15 – 17 ), especially affecting the self-rated health of low socio-economic groups ( 13 ) and increasing the probability of ADL disability ( 18 , 19 ). Previous studies concerning older age groups mostly concentrated on the effects on mortality but did not assess the extent to which AP affects negative health events among residents in an aging society.…”

“…Previous analyses of age and gender heterogeneity have not come to a consensus owing to the complexity of the source of contaminants ( 13 , 18 , 43 ). Compared with women, men are more likely to work outside and are susceptible to AP for a longer period of time ( 13 ), their health is thereby more negatively affected ( 43 ); nevertheless, female residents have the traits of a long life expectancy but greater inhalation of cooking fumes at home, which leads to ADL disability ( 18 ). Based on biophysical differences in vulnerability (age or baseline health) ( 46 ), it can be considered that people over 60 years old have a more significant and negative ADL disability ( 18 ).…”

“…Group differences have been confirmed by research on population health and air quality, and the elderly are particularly vulnerable to the adverse effects of air pollution ( 13 , 14 ). Hence, some studies have specifically addressed health issues in older populations and found that air pollution has negative effects on health status and mental health ( 15 – 17 ), significantly increasing the probability of ADL disability ( 18 , 19 ). However, in an aging society, the sudden deterioration of health conditions suffered by the senior population should be more of a public concern.…”

Effects of pain and depression on the relationship between household solid fuel use and disability among middle-aged and older adults

“…Each answer for the ADL and IADL scales was divided into four levels, and the four answer options were as follows: "No, I do not have any difficulty", 1 point; "I have difficulty but can still do it", 2 points; "I have difficulty and need help", 3 points; and "I cannot do it", 4 points. In this analysis, we refer to previous studies with ADL scores ranging from 7 to 28 57 , and IADL scores ranging from 6 to 24 points 56 . Finally, we added the IADL disability and ADL disability scores together.…”