Living with a spouse can improve the health of Chinese elderly

February 5, 2009

(PhysOrg.com) -- Much older people in China—one of the world's largest populations—are healthier if they live with a spouse, a new University of Michigan study shows.

The study found that living arrangements can predict mortality, personal care ability and self-rated health among Chinese age 80 and older. In addition, living arrangements affect men and women differently, in terms of mortality.

"Our findings suggest that with whom older Chinese live (or do not live) matters to their health," said Lydia Li, an associate professor in the U-M School of Social Work and the study's lead author. "In the past decade, significant changes in living arrangements among older persons in China have been observed. Policymakers should keep close attention to these changes as they have implications for population health."

The study's sample began with more than 9,000 Chinese respondents whose ages ranged from 77 to 122 years old. More than half were re-interviewed two years after the baseline. In addition to reporting background information, such as age, ethnicity and gender, the respondents answered questions about their household composition, health and ability to perform personal care activities.

Relative to older Chinese who lived alone, those living with a spouse or with a spouse and children were less likely to die at follow-up. Men living in an institution also had lower mortality risk than men living alone, but this wasn't the case for women. Men probably benefited from the care and support provided by institutions more than women, Li says.

Respondents not living with a spouse, but living instead with children, others or in institutions were more likely to have problems in carrying out personal care activities, such as dressing, eating and using the toilet, compared with those living alone.

But older Chinese living with children had better self-rated health than those living alone. This may be related to the fulfillment of a cultural ideal as well as the receipt of support in an intergenerational household, Li says.

Li wrote the study with Jiaan Zhang, a U-M social work graduate student, and Jersey Liang, a professor in the School of Public Health. Their findings appear in the latest issue of Social Science & Medicine.

Provided by University of Michigan