Urban–Rural Disparities in Longevity and Health among Older Adults in China: A Systematic Review

DOI

10.2991/978-94-6239-797-2_18How to use a DOI?

Keywords

Healthy Aging; Urban–rural Health Disparity; Longevity; Health-adjusted Life Expectancy; Social Determinants of Health; Ecological Systems Theory; Systematic Review; China

Abstract

Population aging and persistent urban–rural health disparities constitute dual challenges for public health in China. Despite nationwide improvements in life expectancy, deep inequalities remain between urban and rural older adults. This systematic review searched PubMed, Web of Science, CNKI, and Wanfang for peer-reviewed quantitative studies published between January 2018 and December 2024. Studies were included if they focused on adults aged 60 and older, reported urban–rural comparisons, and examined health outcomes. Sixty-eight studies met inclusion criteria. All included studies scored 6–8 stars on the Newcastle–Ottawa Scale, with 38.2% adequately adjusting for socioeconomic confounders. Urban older adults consistently demonstrated better outcomes across all health domains. Only 12.20% of rural older adults achieved successful aging compared to 27.25% in urban areas. Rural older adults showed higher rates of poor self-rated health (20.26%, 95% CI: 19.8–20.7%), with similar disparities observed across chronic disease, disability, cognitive function, and mental health outcomes. Selective survival bias and inconsistent urban–rural classification likely lead to underestimation of true disparities. Coordinated policy interventions targeting health insurance unification, rural primary care strengthening, and social support infrastructure are needed.

Copyright

© 2026 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Zhaoyi Wang
AU  - Jing Li
AU  - Xueqing Zhang
AU  - Dan Huang
AU  - Lan Xiang
AU  - Jing Wang
PY  - 2026
DA  - 2026/10/14
TI  - Urban–Rural Disparities in Longevity and Health among Older Adults in China: A Systematic Review
BT  - Proceedings of the 2nd International Conference on Lifespan Innovation (ICLI 2026) national Conference on Lifespan Innovation
PB  - Atlantis Press
SP  - 161
EP  - 174
SN  - 2352-5398
UR  - https://doi.org/10.2991/978-94-6239-797-2_18
DO  - 10.2991/978-94-6239-797-2_18
ID  - Wang2026
ER  -