Correlation Study of Community Social Environment and Self-Rated Health of Middle-Aged and Older Adults

  Objective   To analyze the impact of the social environment of a community on the self-rated health of middle-aged and older adults living in the community, and to provide a basis for building favorable community social environment that promotes the health of middle-aged and older adults.

  Methods   Using the community and individual survey data from China Health and Retirement Longitudinal Study (CHARLS) done in 2011, 7822 middle-aged and older adults living in 397 communities were selected as the subjects of the study. Community social environment under study included community socioeconomic status, community social security and community services. Self-rated health was measured with a five-level score. A three-level hierarchical generalized linear model (HGLM) was used to analyze the impact of community social environment on the self-rated health of middle-aged and older adults.

  Results   The proportion of subjects who reported self-rated poor health was 28.8%. According to the results of the three-level HGLM, the self-rated health of middle-aged and older adults showed differences at both the city and the community levels, and the variance reduction ratio reached 35.71% at the community level. The self-rated health status of residents in the communities with medium and high net per capita income was better than that in the communities with low net per capita income (OR=0.84, P<0.05;OR=0.70, P<0.05). The self-rated health status of residents in the communities with secondary and higher education levels was better than that in the communities with low education level (OR=0.78, P<0.05;OR=0.73, P<0.05). The self-rated health of middle-aged and older adults in the communities with unemployment subsidies was much better (OR=0.77, P<0.05). The self-rated health status of middle-aged and older adults with chronic diseases was worse (OR=4.46, P<0.05). Middle-aged and older adults living in cities had better self-rated health status (OR=0.67, P<0.05).

  Conclusion   Community socioeconomic status and community unemployment subsidy are positively correlated with the self-rated health of middle-aged and older adults living in the community. It is necessary to pay special attention to the health status of middle-aged and older adults in communities of low socioeconomic status, improve unemployment insurance policies, and promote the health of middle-aged and older adults.