The Impact of Economic Factors on Mortality and Health at Oldest-Old Ages in

China

Zhong Zhao

China Center for Economic Research

Peking University

August 2, 2004

Prepared forThe workshop on “Determinants of Health Longevity in China”

at Max Planck Institute for Demographic Research (MPIDR),

Rostock, Germany, August 2-4, 2004

Outline

• I. Introduction

• II. Relevant Studies

• III. Data Set and Description Statistics

• IV. Estimations and Findings

• V. Conclusions

I. Introduction

• The percentage of population over 65– 1982: 4.91%– 1990: 5.57%– 2000: 6.96%– Aging Society: 7%

• Population of the Oldest-Old (age over 80)– 2000: 13 millions– 2050: 114-168 millions (projected by Han and

Yao, 2001)

II. Relevant Studies• Economists: Clark et al. (1978), Hurd (1990) • Vaupel (1998): Overview• Chinese Journal of Population Science, 2001• Analysis of the Determinants of Healthy Longevity, eds.

Zeng et al. 2004 • Xu and Gu (2001): Rural-urban difference• Wang and Zeng (2001): Gender and Activities of Daily

Living (ADL)• Lu and Chu (2004): Economic factors and ADL• Wu and Zhan (2004): Diet and Health• Gu (2004): Smoking, drinking and longevity• This paper : Economic factors, health and longevity

III. Data Set and Description Statistics

• Data Set– Chinese Longitudinal Healthy Longevity

Survey (CLHLS)

• Description Statistics– Table 1. Characteristics by Health Status– Table 2. Characteristics by Health Status and

Gender– Table 3. Characteristics by Life Status

Table 1. Characteristics by Health Status (ADL)(%)

Variables WholeSample

Active Mild Disability Severe Disability

Female 0.5812 0.5376 0.6388 0.7054

Han Nationality 0.9514 0.9446 0.9593 0.9726

Born in Urban 0.1741 0.1745 0.1696 0.1803

Boiling Water 0.9469 0.9445 0.9482 0.9600

Finance-Self 0.2106 0.2288 0.1997 0.1438

Finance-Government 0.0716 0.0723 0.0669 0.0696

Enough Money 0.7273 0.7313 0.7408 0.6851

Adequate Med. Service Now

0.9435 0.9427 0.9498 0.9374

Adequate Med. Service in Childhood

0.4488 0.4688 0.4485 0.3641

Gov. Pay Med. Cost 0.1434 0.1527 0.1383 0.1101

Hungry in Childhood 0.5992 0.5996 0.5809 0.6224

Table 2. Characteristics by Health Status and Gender (%)

Variables Male Female

All Active Mild Dis

.

Severe Dis.

All Active Mild Dis

.

Severe Dis.

Han Nationality 0.9516 0.9435 0.9692 0.9805 0.9512 0.9455 0.9538 0.9693

Born in Urban 0.1859 0.1886 0.1690 0.1953 0.1656 0.1624 0.1696 0.1740

Boiling Water 0.9486 0.9467 0.9537 0.9609 0.9456 0.9426 0.9451 0.9595

Finance-Self 0.3912 0.3830 0.4427 0.3721 0.0805 0.0962 0.0623 0.0485

Finance-Government

0.0660 0.0678 0.0595 0.0659 0.0756 0.0761 0.0747 0.0712

Enough Money 0.7358 0.7440 0.7330 0.6723 0.7211 0.7203 0.7452 0.6905

Adequate Med. Service Now

0.9461 0.9464 0.9547 0.9276 0.9417 0.9394 0.9470 0.9415

Adequate Med. Service in Childhood

0.4765 0.4960 0.4742 0.3483 0.4288 0.4454 0.4330 0.3706

Gov. Pay Med. Cost

0.2549 0.2449 0.2942 0.2656 0.0634 0.0738 0.0493 0.0455

Hungry in Childhood

0.5927 0.5927 0.5907 0.5889 0.6040 0.6055 0.5752 0.6364

Table 3. Characteristics by Life Status (%)

Variables All Male Female

Live in 02

Dead in 02

All Live in 02

Dead in 02

All Live in 02

Dead in 02

Female 0.5699 0.5855 0.0000 0.0000 0.0000 1.0000 1.0000 1.0000

Han Nationality 0.9485 0.9526 0.9516 0.9484 0.9525 0.9512 0.9484 0.9526

Born in Urban 0.1764 0.1447 0.1859 0.1929 0.1494 0.1656 0.1649 0.1413

Boiling Water 0.9442 0.9399 0.9486 0.9459 0.9399 0.9456 0.9429 0.9398

Finance-Self 0.2259 0.1542 0.3912 0.4081 0.2994 0.0805 0.0883 0.0513

Finance-Government 0.0736 0.0722 0.0660 0.0661 0.0724 0.0756 0.0792 0.0720

Enough Money 0.7350 0.7075 0.7358 0.7500 0.6957 0.7211 0.7235 0.7159

Adequate Med. Service Now

0.9424 0.9428 0.9461 0.9486 0.9325 0.9417 0.9377 0.9498

Adequate Med. Service in Childhood

0.4612 0.4288 0.4765 0.5005 0.4410 0.4288 0.4311 0.4204

Gov. Pay Med. Cost 0.1497 0.1100 0.2549 0.2599 0.1946 0.0634 0.0666 0.0509

Hungry in Childhood 0.6015 0.6131 0.5927 0.5904 0.6092 0.6040 0.6099 0.6158

IV. Estimations and Findings

• Health Outcome: Multivariate Regression – Dependent variables: Activities of Daily Living

(ADL). Three categories: active, mild disability and severe disability

• Mortality: Probit Model – Dependent variables: binary indictor-survival in

2002 or not

Table 4. Multivariate Regression for Health Status Variables All Male Female

Coeff. P-Value Coeff. P-Value Coeff. P-Value

Constant 2.73151 <.0001 2.71706 <.0001 2.56433 <.0001

Female -0.16934 <.0001

Han Nationality -0.17462 0.0055 -0.18033 0.0391 -0.15087 0.0872

Born in Urban -0.03558 0.2988 0.00103 0.9824 -0.0743 0.1282

Boiling Water -0.05034 0.4293 -0.05479 0.5746 -0.04852 0.5625

Finance-Self 0.04263 0.2873 -0.03045 0.5105 0.21368 0.0029

Finance-Government 0.07916 0.1331 0.14881 0.0514 -0.00609 0.9335

Enough Money 0.07762 0.0094 0.1081 0.0106 0.06711 0.1052

Adequate Med. Service Now

-0.04952 0.3744 -0.0104 0.898 -0.08057 0.2882

Adequate Med. Service in Childhood

0.09103 0.001 0.11419 0.0029 0.07201 0.0625

Gov. Pay Med. Cost -0.05182 0.2501 -0.11171 0.0281 0.08571 0.3018

Hungry in Childhood 0.0614 0.0302 0.03978 0.3119 0.07361 0.064

Table 5. Mortality Analysis by Probit Model

Variables All Male Female

Coeff. P-Value Coeff. P-Value Coeff. P-Value

Constant -0.4001 0.0339 -0.3065 0.2989 -0.4572 0.0566

Female 0.0106 0.8445

Han Nationality -0.1021 0.3987 -0.0739 0.6908 -0.1334 0.4049

Born in Urban -0.0038 0.9557 -0.0652 0.5326 0.0426 0.6446

Boiling Water 0.1852 0.1357 0.2607 0.1966 0.1263 0.4235

Finance-Self -0.2566 0.0016 -0.2252 0.0259 -0.2981 0.0378

Finance-Government -0.0514 0.6145 -0.0389 0.8117 -0.0733 0.5817

Enough Money -0.0807 0.1692 -0.1442 0.1106 -0.0393 0.6121

Adequate Med. Service Now

-0.023 0.83 -0.1888 0.2521 0.106 0.4562

Adequate Med. Service in Childhood

-0.0734 0.1745 -0.0914 0.2691 -0.0609 0.3959

Gov. Pay Med. Cost 0.0301 0.7411 0.0096 0.9334 0.1302 0.4042

Hungry in Childhood -0.0362 0.5172 -0.0019 0.9825 -0.0547 0.4584

V. Conclusions• Health care condition at childhood has no

significant effect on the mortality, but has significant effect on the health of the oldest-old.

• Financial self sufficiency is beneficial for the successful aging and health of the oldest-old, but not for the survival of the oldest-old.

• Though there are more female oldest-olds than male oldest-olds, the health of female oldest-olds are worse than the health of the male oldest-old.

• Gender has a significant effect on health status, but not on mortality.