Community Effects on Elderly Health

Evidence from CHARLS National Baseline

Published in: The Journal of the Economics of Ageing, v. 1-2, Nov. 2013, p. 50-59

Posted on on February 04, 2016

by James P. Smith, Meng Tian, Yaohui Zhao

Read More

Access further information on this document at The Journal of the Economics of Ageing

This article was published outside of RAND. The full text of the article can be found at the link above.

There is increasing interest in neighborhood or area effects on health and individual development. China, due to its vast regional variations in health infrastructure and geography and relative immobility of older residents, provides a rare opportunity to study such effects. Utilizing China Health and Retirement Longitudinal Study (CHARLS) baseline survey 2011-2012 which covered over 17,000 individuals in 450 randomly selected communities/villages, this paper addresses two questions: whether community/village characteristics matter for individual health and SES (Socio-Economic Status), and why they matter. Our statistical results indicate that community/village characteristics have strong associations with individual health and SES. We find that health infrastructure is important even after controlling for community income level. Using surface water increases the likelihood of worse health compared to tap water and even underground water. Compared to moving away by trucks, non-management of waste, and other management such as dump in local site or nearby water body are associated with worse health and SES outcomes. Toileting system without water has the worst influence on individual health and education achievements. Using hay or coal as cooking fuel has the largest negative effect on health and SES outcomes. Geography also plays a role. Extreme weather conditions cause people to be more depressed, and face severe difficulties in ADL (Activities of Daily Living) or IADL (Instrumental Activities of Daily Living) and other negative health conditions. Local landscapes also affect individual health and SES outcomes as mountainous and hilly areas exacerbate individual health status and SES outcomes.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.