TABLE 2.
Associations of Community-Level Factors With Elderly Health Indicators and Mortality Risk After Adjustment for Individual-Level Confounding Factors: Chinese Longitudinal Healthy Longevity Survey, 2002–2005
| Health indicators |
||||
| Variables (Refa) | ADL Disability, OR (95% CI) or % | Cognitive Impairment, OR (95% CI) or % | Deficits Index > 0.45, OR (95% CI) or % | Mortality, OR (95% CI) or % |
| Community-level variables | ||||
| Labor force participation rate ≥ 70%b (< 70%) | 0.74*** (0.62, 0.89) | 0.80** (0.65, 0.99) | 0.60† (0.49, 0.75) | 0.84** (0.72, 0.99) |
| Per capita GDP ≥ $2000 (< $2000) | 1.26** (1.00, 1.58) | 0.67*** (0.53, 0.87) | 1.04 (0.79, 1.36) | 1.01 (0.84, 1.21) |
| Illiteracy rate < 5% (≥ 5%) | 0.87 (0.72, 1.05) | 0.82* (0.67, 1.00) | 1.20 (0.96, 1.52) | 1.04 (0.89, 1.20) |
| Average temperature in January < −10°C (≥ −10°C) | 1.44** (1.06, 1.94) | 0.83 (0.61, 1.14) | 1.08 (0.77, 1.53) | 1.32* (1.03, 1.70) |
| Average temperature in July ≥ 29°C (< 29°C) | 1.18 (0.94, 1.49) | 1.41*** (1.09, 1.81) | 1.92† (1.41, 2.63) | 1.06 (0.85, 1.32) |
| Yearly rainfall ≥ 800 mm (< 800 mm) | 0.59† (0.48, 0.73) | 0.84* (0.68, 1.03) | 0.91 (0.73, 1.12) | 1.09 (0.92, 1.28) |
| Hills or mountains covering ≥ 70% of local area (< 70%) | 0.48† (0.35, 0.67) | 1.12 (0.83, 1.51) | 0.68** (0.49, 0.94) | 0.94 (0.73, 1.22) |
| Air pollution index | 1.25† (1.18, 1.34) | 1.09** (1.01, 1.18) | 1.08** (1.01, 1.16) | 1.02 (0.97, 1.07) |
| Individual-level variables | ||||
| Demographic characteristics | ||||
| Age, y | 1.07† (1.06, 1.07) | 1.08† (1.08, 1.09) | 1.03† (1.02, 1.03) | 1.08† (1.07, 1.08) |
| Male (female) | 0.77† (0.69, 0.86) | 0.74† (0.67, 0.81) | 0.95 (0.82, 1.10) | 1.50† (1.35, 1.66) |
| Ethnic group other than Han (Han) | 0.88 (0.69, 1.12) | 0.98 (0.75, 1.27) | 0.94 (0.68, 1.29) | 0.91 (0.71, 1.16) |
| Childhood SES | ||||
| Born in urban area (rural) | 1.20*** (1.06, 1.37) | 0.92 (0.82, 1.04) | 1.25** (1.05, 1.50) | 1.14* (0.99, 1.29) |
| Father had white-collar occupation (no) | 0.94 (0.76, 1.15) | 0.92 (0.75, 1.14) | 0.94 (0.69, 1.30) | 1.04 (0.83, 1.31) |
| Both parents alive when respondent was aged 10 y (no) | 0.93 (0.86, 1.02) | 0.75† (0.69, 0.81) | 0.85*** (0.76, 0.95) | 0.88*** (0.81, 0.97) |
| Received adequate medication for illness (no) | 1.03 (0.94, 1.14) | 1.04 (0.96, 1.13) | 0.93 (0.83, 1.04) | 0.98 (0.90, 1.07) |
| Frequently went to bed hungry (no) | 0.92* (0.84, 1.00) | 1.16*** (1.07, 1.27) | 1.05 (0.92, 1.21) | 1.00 (0.92, 1.09) |
| First birth in family (no) | 0.95 (0.88, 1.03) | 1.06 (0.98, 1.14) | 1.00 (0.90, 1.12) | 0.96* (0.89, 1.04) |
| Arm length in highest 20% (lowest 80%) | 0.94 (0.83, 1.06) | 0.83*** (0.73, 0.93) | 0.91 (0.78, 1.06) | 0.90 (0.80, 1.00) |
| Adult SES | ||||
| Urban resident (rural) | 1.23† (1.11, 1.36) | 0.90** (0.81, 1.00) | 1.09 (0.95, 1.24) | 0.94 (0.85, 1.04) |
| Primary lifetime occupation white collar (no) | 1.46† (1.22, 1.76) | 0.91 (0.76, 1.08) | 1.22 (0.93, 1.61) | 1.02 (0.86, 1.21) |
| Family economic condition good (no) | 1.06 (0.95, 1.18) | 0.71† (0.65, 0.79) | 0.86* (0.73, 1.01) | 1.07 (0.96, 1.19) |
| Financially independent (no) | 0.94 (0.83, 1.08) | 0.73† (0.65, 0.83) | 0.97 (0.82, 1.15) | 0.76† (0.67, 0.86) |
| Education ≥ 1 y (no) | 1.13** (1.02, 1.25) | 0.72† (0.65, 0.79) | 1.16** (1.01, 1.33) | 1.11** (1.00, 1.23) |
| Medical expenses covered primarily by public funds or insurance (no) | 1.22** (1.04, 1.43) | 1.06 (0.90, 1.24) | 1.51† (1.23, 1.89) | 1.08 (0.93, 1.27) |
| Family/social connection and support | ||||
| Currently married (no) | 1.03 (0.93, 1.15) | 0.91** (0.83, 1.00) | 1.36† (1.16, 1.57) | 0.81† (0730.90) |
| Living children (no) | 1.03** (1.01, 1.05) | 0.98** (0.96, 1.00) | 1.00 (0.97, 1.03) | 0.98* (0.96, 1.00) |
| Children living nearby or with respondent (no) | 1.13** (1.03, 1.25) | 1.03 (0.93, 1.13) | 0.89* (0.78, 1.01) | 1.08 (0.97, 1.20) |
| Social and leisure activity index | 0.49† (0.47, 0.51) | 0.66† (0.64, 0.68) | 0.34† (0.33, 0.37) | 0.78† (0.75, 0.81) |
| Participation in religious activities (no) | 0.83*** (0.74, 0.94) | 0.72† (0.63, 0.82) | 0.57† (0.48, 0.67) | 9.86*** (0.76, 0.96) |
| Health practices | ||||
| Smoked in past 5 y (no) | 0.92 (0.83, 1.02) | 1.00 (0.90, 1.12) | 0.87* (0.75, 1.00) | 1.09 (0.98, 1.20) |
| Consumed alcohol in past 5 y (no) | 0.97 (0.88, 1.07) | 0.91** (0.83, 0.99) | 0.81*** (0.69, 0.94) | 1.01 (0.92, 1.10) |
| Regularly exercised in past 5 y (no) | 0.82† (0.74, 0.90) | 0.74† (0.67, 0.81) | 0.60† (0.52, 0.69) | 0.93 (0.84, 1.03) |
| Health deficits index in 2002 | — | — | — | 2.11† (1.86, 2.38) |
| Variances | ||||
| Individual level, variance (SE) | 0.9435 (0.0108) | 0.8782 (0.0101) | 0.8631 (0.0099) | 0.9454 (0.0116) |
| Community level, variance | 0.7831 (0.0650) | 1.1664 (0.0837) | 0.8224 (0.0860) | 0.3756 (0.0391) |
| Total variance,c % | 45.3 | 57.1 | 49.8 | 28.4 |
Note. ADL = activities of daily living; OR = odds ratio; CI = confidence interval; GDP = gross domestic product; SES = socioeconomic status.
a
Values in parentheses represent the reference group of environmental factors.
b
Percentage of persons aged 15 to 64 years currently working for pay.
c
Variance at community level divided by the summation of variances at individual and community levels, then multiplied by 100.
*P < .1; **P < .05; ***P < .01; †P < .001.