Three Papers on Social Contexts and Older Adult Health in China

China is a country with vast contextual heterogeneity and a growingly aging population. Against this backdrop, this dissertation seeks to understand how regional contexts shape public health challenges faced by China’s older population, using the data from the China Health and Retirement Longitudinal Study (CHARLS). Specifically, Chapter 2 and 3 explore the link of urbanization with health and physical functioning. By constructing a multi-component-based index that measures urbanicity at the neighborhood level, I show that for both men and women, urbanization is conducive to fewer physical function impairments yet a higher prevalence of metabolic syndrome (MS), a common pathophysiological pathway to many chronic diseases. Further stratifying by rural/urban location finds the association between urbanicity and MS significant only among rural women and urban men. These findings reveal that the “urban health penalty” and “urban health advantage” thesis can be both true depending on the health outcome of interest and highlight a gender- and context-specific effect of urban living on metabolic health among older adults. Chapter 4 shifts focus from structural to cultural context and examines the link between the ingrained culture of son preference and gender inequality in cognitive functioning. My analysis shows that the early exposure to local practices of son preference may significantly increase the women’s relative disadvantage in mental capacity to reason and perform basic cognitive tasks in later life. This widened gender gap can be partially explained by the fact that son preference tends to create more gender disparity in education. Taken together, my dissertation contributes to the understanding of how social contexts get under the skin to affect the health of older Chinese adults by showing the role of urbanization and son preference in health and functioning. This work is guided by and contributes to research influenced by nutrition transition and fundamental cause theories, and research about the role of sexism in gendered health inequalities based on the life course perspective. Findings from my studies are also relevant to other low- and middle-income countries with health burdens brought by accelerating population aging, urbanization, and the need to further improve gender equality.PHDSociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/174590/1/sxwang_1.pd