The effects of time and space on health status of older adults in China

UnrestrictedThis dissertation consists of two independent studies and one conceptual paper, addressing one overarching question: how changes in socioeconomic status (SES) based social stratification and changes in social environment affect the health status of older adults in China across time and space. In the two empirical studies, analyses were performed using the four waves of data from the China Health and Nutrition Survey (CHNS), a longitudinal survey of nine provinces in China. Latent growth curve analyses from the first study (2,345 individuals aged 55 and above) show that the health of older Chinese adults continued to be shaped by individual education, occupational class, and income. Cumulative advantage hypotheses are supported by the findings that higher education predicts both better self-rated health and cognitive function at baseline and slower declines over time. Higher income is associated with better functional health at baseline as well as a more gradual decline over time. In addition, this study reveals that the relationship between occupational class and cognitive function as well as between income and self-rated health do not support the cumulative advantage hypothesis.; In the second study, multi-level growth curve analyses (2,345 individuals age 55 and above from 191 communities) show that social environment exerted independent effects on health outcomes over and beyond the effects of individual-level factors. Social environment, particularly household median income, communication development, and time needed for accessing healthcare affected initial health status but not the rate of change in health status. The effects of social environment on health differ by individual education and income. This study suggests that continuing improvement on economic and social environment could potentially improve the health status of older adults in China.; Following the two empirical papers is one conceptual paper, addressing the conceptual and methodological challenges of studying the effects of social environment on health. Adopting the political economy perspective as its theoretical framework, this paper describes social environment as being composed of economic development and social development. It is suggested in this paper that changes in social environment should be taken into account while studying the ecological effects of social environment on health. In the end, an integrated life course and ecological perspective is proposed to study the dynamic relationship between social environment and health.; In summary, this dissertation demonstrates that changes in individual socioeconomic status as well as in macro-socioeconomic development had substantial influences on health status among older Chinese adults