Associations of Environmental Factors with Older Adults’ Health and Mortality in China

We analyzed data from a nationally representative sample of 15973 elderly residents of 866 counties and cities in 2002 and the follow-ups in 2005 with multilevel logistic regression models in which individuals were nested within each county or city to investigate how the environmental factors are associated with health outcomes and mortality risk. After control for individual-level factors, communities' gross domestic product per capita, adult labor force participation rate, and illiteracy rate were significantly associated with physical, mental, and overall health and mortality among the elderly in China. We also found that air pollution increased the odds of disability in activities of daily living (ADL), cognitive impairment, and health deficits index; more rainfall was protective, reducing the odds of ADL disability and cognitive impairment; extremely low seasonal temperatures increased the odds of ADL disability and mortality; extremely high seasonal temperatures increased the odds of cognitive impairment and health deficits index; and living in mountain areas decreased the odds of ADL disability and health deficits. Our conclusion is that efforts to reduce environmental pollution and improve socioeconomic conditions could significantly improve elderly health and survival.