Details of Research Outputs

This study focuses on how municipal-level social environmental factors interact with individual-level factors to influence physical functioning [Activity of Daily Living (ADL)] among the oldest old in urban China. Methods: Data are drawn from the fourth wave of the Chinese Longitudinal Healthy Longevity Survey and the 2005 Chinese Statistical Yearbook. The sample consisted of 3,830 older adults from 131 cities across China. Participants were on average age 86.3 (SD=1.21) years old, and 56.4% were female. Analyses were conducted using hierarchical linear modeling strategy. Individual-level factors include demographics, cognitive status, and engagement in activities. Municipal-level factors include Gross Domestic Product (GDP) per capita, three pollution indexes (industrial waste water, dust, and sulfur dioxide), and three indicators of health service availability (doctors, beds, and hospitals). Results: Findings disclosed that poorer health, less engagement in activities, and lower levels of cognitive status statistically predict more ADL limitations (p<.01). Two municipal-level predictors (GDP per capita and concentration of dust) significantly interact with individual factors to influence physical functioning. Compared to those living in more developed areas, participants living in less developed areas have a greater increase in their ADL limitations when their engagement in activities decreases. Compared to participants living in areas with lower dust concentration, those living in areas with higher levels of dust concentration have a sharper increase in ADL limitations as their cognitive function decrease. Implications: Interventions at individual levels should plan more social activities among older adults, and macro-level policy initiatives should facilitate local economic development without generating pollution.