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Background <p>Subjective life expectancy (SLE) is a critical predictor of health risks and care needs among middle-aged and elderly adults, playing a vital role in guiding social security policies. Despite increasing research attention to SLE, few studies have explicitly investigated how place of residence influences SLE. This study aims to explore the association between place of residence (urban, town, and rural) and SLE among middle-aged and elderly adults.</p> Methods <p>12,907 participants aged 45 to 89 from the China Health and Retirement Longitudinal Study (CHARLS) 2020 were included in this study. Kruskal-Wallis and Chi-square tests were utilized for continuous and categorical variables, respectively, and the multinomial logistic regression was conducted to analyze the association between residence and SLE. The SLE was estimated using the Likert-scale method, while the conditional survival probability was calculated based on data from the China Population Census 2020. The similarities and differences between SLE and the conditional survival probability were systematically compared.</p> Results <p>The majority of participants resided in rural areas (<i>n</i> = 8203, 63.6%), followed by cities (<i>n</i> = 3137, 24.3%) and towns (<i>n</i> = 1567, 12.1%). After adjusting for all covariables, multinomial logistic regression revealed that the likelihood of individuals reporting medium SLE (OR = 0.84, 95% CI: 0.79–0.89) and high SLE (OR = 0.81, 95% CI: 0.76–0.86) significantly decreased, as the residence variable changes from urban to town to rural. Stratified multinomial logistic regression further confirmed that rural residents had 16% lower odds of reporting medium SLE and 20% lower odds of reporting high SLE compared to urban residents. SLE in rural areas was consistently low, while it was moderate in towns and high in urban areas. Notably, women reported lower SLE than men residing in the same area, despite having a higher conditional survival probability, which potentially reflects Sex-specific perceptions of health and aging.</p> Conclusion <p>These findings highlight disparities in SLE across residences, which may contribute to discussions on policy development for healthy aging, particularly regarding equitable access to healthcare services, community-based elderly support programs, and health education initiatives in rural areas.</p>

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Urban-town-rural disparities in subjective life expectancy among middle-aged and elderly adults in China: evidence from the CHARLS 2020

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Yanlin Leng,
  • Zhitao Cheng,
  • Chenyan Jia,
  • Tingfang Wu,
  • Hao Liu,
  • Fan Li,
  • Junfeng Wang,
  • Yong Tang

摘要

Background

Subjective life expectancy (SLE) is a critical predictor of health risks and care needs among middle-aged and elderly adults, playing a vital role in guiding social security policies. Despite increasing research attention to SLE, few studies have explicitly investigated how place of residence influences SLE. This study aims to explore the association between place of residence (urban, town, and rural) and SLE among middle-aged and elderly adults.

Methods

12,907 participants aged 45 to 89 from the China Health and Retirement Longitudinal Study (CHARLS) 2020 were included in this study. Kruskal-Wallis and Chi-square tests were utilized for continuous and categorical variables, respectively, and the multinomial logistic regression was conducted to analyze the association between residence and SLE. The SLE was estimated using the Likert-scale method, while the conditional survival probability was calculated based on data from the China Population Census 2020. The similarities and differences between SLE and the conditional survival probability were systematically compared.

Results

The majority of participants resided in rural areas (n = 8203, 63.6%), followed by cities (n = 3137, 24.3%) and towns (n = 1567, 12.1%). After adjusting for all covariables, multinomial logistic regression revealed that the likelihood of individuals reporting medium SLE (OR = 0.84, 95% CI: 0.79–0.89) and high SLE (OR = 0.81, 95% CI: 0.76–0.86) significantly decreased, as the residence variable changes from urban to town to rural. Stratified multinomial logistic regression further confirmed that rural residents had 16% lower odds of reporting medium SLE and 20% lower odds of reporting high SLE compared to urban residents. SLE in rural areas was consistently low, while it was moderate in towns and high in urban areas. Notably, women reported lower SLE than men residing in the same area, despite having a higher conditional survival probability, which potentially reflects Sex-specific perceptions of health and aging.

Conclusion

These findings highlight disparities in SLE across residences, which may contribute to discussions on policy development for healthy aging, particularly regarding equitable access to healthcare services, community-based elderly support programs, and health education initiatives in rural areas.