健康社会决定因素对成功老龄化的影响OA

Objective To systematically explore the social determinants of health that promote and im-pede successful aging,and to provide scientific basis for actively addressing population aging in China.Methods Using a case-control study design,data from the China Health and Retirement Longitudinal Study(CHARLS)in 2015 and 2018 were selected.Based on the Rowe and Kahn model,individuals aged 60 and above in 2018 were classified as either successfully aging or not.The successful aging group in 2018 was matched by 1∶4 according to age,gender,rural or urban areas as matching conditions to obtain the control group of unsuccessful aging,and their personal lifestyle,health status,and socioeconomic environment in 2015 were reviewed.Conditional logistic regression model was used to explore the health and social determinants that affected successful aging.Results In 2018,the rate of successful aging in China was 15.3％(995 people).After matching,5 073 elderly people were ultimately included.After controlling for other confounding factors,at the individual level of demographic charac-teristics,the elderly of ethnic minorities(AOR:0.70,95％CI:0.50-0.99)were less likely to age successful-ly.The odds of successful aging were higher for those with a primary school education or above(AOR:1.28,95％CI:1.09-1.50).In terms of health behavior,sleeping less than 5 hours(AOR:0.54,95％CI:0.39-0.75),obesity(BMI≥28)(AOR:0.73,95％CI:0.61-0.88),accidental fall(AOR:0.65,95％CI:0.53-0.82)were obstacles to successful aging;Physical activity(AOR:1.54,95％CI:1.13-2.10)could promote successful aging in older adults.In terms of social environment,the elderly who were satisfied with local medical services(AOR:1.29,95％CI:1.06-1.56),who had an annual personal income＞12 000 Chinese yuan(AOR:1.42,95％CI:1.11-1.81),and who had bathing facilities at home(AOR:1.33,95％CI:1.11-1.59)had greater chances of successful aging;Compared with the old people who used firewood and straw for cooking fuel,the seniors who used coal(AOR:1.45,95％CI:1.08-1.95)and electric(AOR:1.34,95％CI:1.08-1.67)for cooking were more likely to be successful aging.The probability of successful aging in western China was lower than that in eastern China(AOR:0.76,95％CI:0.64-0.92).Conclusions China has a rel-atively low level of successful aging,and special attention should be paid to elderly people from minority groups,low-income households,illiterates or those who did not complete primary school education,and those with poor hearing or vision.Measures to address population aging include promoting proper sleep,controlling weight,exerci-sing,preventing falls,improving bathing facilities in living areas,increasing satisfaction with medical services,and improving cooking methods.Additionally,efforts are needed to coordinate regional development to improve health inequality among the elderly.