Heterogeneous Effects of Socioeconomic Status on Health Outcomes among Middle-Aged and Older Adults: Evidence from Five Waves of CHARLS

Main Article Content

Yuhan Xie
School of Pharmaceutical Business, Guangdong Pharmaceutical University, Zhongshan, 528453, China

DOI: https://doi.org/10.70267/ijassr.v3n5.3550

Keywords

socioeconomic status, health of middle-aged and older adults, health inequality, urban–rural disparities, gender differences

Abstract

This paper uses data from five waves of the China Health and Retirement Longitudinal Study (CHARLS) (N = 37,710) to measure the health of middle-aged and older adults from the four dimensions of Activities of Daily Living (ADL), self-rated health, mental health, and the number of chronic diseases. It uses principal component analysis to construct a comprehensive socioeconomic status (SES) index, and uses negative binomial regression model, generalized ordered logit and linear regression model to test the impact of SES on health and its urban-rural and gender heterogeneity. The study found that SES has a significant positive protective effect on health. High-SES groups have stronger Activities of Daily Living (ADL), better mental health, and better self-rated health, but it is positively related to the number of chronic diseases, mainly reflecting the higher detection rate of high-SES groups; There are significant urban-rural and gender differences in this effect, which has a greater impact on rural and female groups, especially in the mental health dimension. The conclusion of the robustness test is established. This article provides vertical evidence for understanding the health inequality of middle-aged and older adults in China, and then puts forward suggestions in terms of improving rural health security, formulating gender differentiation strategies, and improving screening fairness to promote healthy aging.

Abstract 39 | PDF Downloads 17

References

  • [1] Liu, C. P., & Wang, L. J. (2017). The impact of socioeconomic status on the health status of older adults. Chinese Journal of Population Science, (5), 40–50+127.
  • [2] Sun, Z. F., & Tan, Z. J. (2022). Healthy China in the aging era: Socioeconomic status and health status of older adults—An empirical analysis based on CGSS 2017 data. Journal of Fujian Agriculture and Forestry University (Philosophy and Social Sciences Edition), 25(6), 68–79.
  • [3] Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223–255.
  • [4] Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 80–94.
  • [5] Qi, L. S. (2006). Income, income inequality, and health: The effects of urban–rural differences and occupational status. Economic Research Journal, (11), 16–26.
  • [6] Cheng, L. G., Zhang, Y., & Shen, K. (2015). How does education affect health? Evidence from older adults in China. China Economic Quarterly, 14(1), 305–330.
  • [7] Xue, X. D., & Ge, K. X. (2017). The impact of socioeconomic status on the health status of older adults in China: Evidence from the Chinese Longitudinal Healthy Longevity Survey. Population and Development, 23*(2), 61–69.
  • [8] Jiao, K. S. (2018). Inequality in healthy life expectancy among older adults in China. Sociological Studies, 33(1), 116–141+244–245.
  • [9] Huang, R., & Grol-Prokopczyk, H. (2022). Health and health behaviors in China: Anomalies in the SES-health gradient? SSM—Population Health, 17, 101069.
  • [10] Du, B. F., & Wang, X. (2013). The evolution, regional differences, and influencing factors of health inequality among older adults. Population Research, 37(5), 81–90.
  • [11] Zimmer, Z., Kaneda, T., & Spess, L. (2007). An examination of urban versus rural mortality in China using community and individual data. The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 62(5), S349–S357.
  • [12] Su, Y. Y. (2022). The impact of socioeconomic status on multidimensional health among urban and rural older adults. Advances in Applied Mathematics, 11, 5015.
  • [13] Liu, X. T. (2014). The impact of social medical insurance on the health status of older adults: Evidence from Zhejiang Province. Society, 34(2), 193–214.
  • [14] Ran, X. X., & Hu, H. W. (2022). Urban–rural differences, digital divide, and health inequality among older adults. Population Journal, 44(3), 46–58.
  • [15] Read, J. N. G., & Gorman, B. K. (2010). Gender and health inequality. Annual Review of Sociology, 36(1), 371–386.
  • [16] Matthews, S., Manor, O., & Power, C. (1999). Social inequalities in health: Are there gender differences? Social Science & Medicine, 48(1), 49–60.
  • [17] Zheng, L., & Zeng, X. H. (2016). Social stratification and gender differences in health inequality: A longitudinal analysis from a life-course perspective. Society, 36(6), 209–237.
  • [18] Beckett, M. (2000). Converging health inequalities in later life—An artifact of mortality selection? Journal of Health and Social Behavior, 106–119.
  • [19] Wang, P., & Wu, Y. X. (2019). Socioeconomic status, gender inequality, and gender role attitudes. Sociological Review of China, 7(2), 55–70.
  • [20] Xue, X. D. (2015). Trends and determinants of health inequality among older adults in China. Population and Development, 21(2), 84–92.
  • [21] Nocera, S., & Zweifel, P. (1998). The demand for health: An empirical test of the Grossman model using panel data. In Developments in Health Economics and Public Policy (Vol. 6, pp. 35–49).
  • [22] Bolin, K., & Caputo, M. R. (2020). Consumption and investment demand when health evolves stochastically. Journal of Economic Dynamics and Control, 114, 103893.
  • [23] Masters, R. K., Link, B. G., & Phelan, J. C. (2015). Trends in education gradients of “preventable” mortality: A test of fundamental cause theory. Social Science & Medicine, 127, 19–28.
  • [24] Marmot, M. (2002). The influence of income on health: Views of an epidemiologist. Health Affairs, 21(2), 31–46.
  • [25] Wu, B. Y., Dong, H. L., Yu, Q., et al. (2021). Social stratification analysis of healthy life expectancy among older adults in China. Population and Development, 27(5), 2–11.
  • [26] Hu, R., & Duan, X. X. (2024). Community characteristics, individual socioeconomic status, and health and health inequality among older adults. Journal of Guizhou University of Finance and Economics, (3), 72–80.
  • [27] Zhao, Y. H., Chen, X. X., Wang, Y. F., Meng, Q. Q., Bo, H., Chen, C., Chen, Y. F., Gong, J. Q., Jia, Y., Wang, G. W., Wu, X. Y., Yan, L., & Yang, P. (2023). China Health and Retirement Longitudinal Study (CHARLS): Wave 5 (2020) user’s manual. National School of Development, Peking University.
  • [28] Zhao, Y., Hu, Y., Smith, J. P., Strauss, J., & Yang, G. (2014). Cohort profile: The China Health and Retirement Longitudinal Study (CHARLS). International Journal of Epidemiology, 43(1), 61–68.
  • [29] Zhao, Y., Strauss, J., Yang, G., Giles, J., Hu, P. P., Hu, Y., Lei, X., Liu, M., Park, A., Smith, J. P., & Wang, Y. (2013). China Health and Retirement Longitudinal Study: 2011–2012 national baseline user’s guide. National School of Development, Peking University.
  • [30] Qin, Z. Y. (2017). An empirical study on health differences and influencing factors among urban and rural middle-aged and older residents: Evidence from CHARLS data (Master’s thesis, Nanjing University).
  • [31] Zhou, B. (2020). Socioeconomic status and health disparities among middle-aged and older adults (Master’s thesis, Southwestern University of Finance and Economics). https://doi.org/10.27412/d.cnki.gxncu.2020.000828
  • [32] Han, T. T. (2017). The impact of socioeconomic status on the health of middle-aged and older adults in China (Master’s thesis, Shandong University).

Article Sidebar

PDF
Published
Sep 3, 2026
Issue
Vol. 3 No. 5 (2026)
Section
Research Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Xie, Y. (2026). Heterogeneous Effects of Socioeconomic Status on Health Outcomes among Middle-Aged and Older Adults: Evidence from Five Waves of CHARLS. International Journal of Asian Social Science Research , 3(5), 35-50. https://doi.org/10.70267/ijassr.v3n5.3550