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Global Health Econ Sustain

ORIGINAL RESEARCH ARTICLE
Income-related inequality in health outcomes

among older individuals in China: A measurement
and decomposition analysis

Yixiao Wang*

Department of Sociology, School of Ethnology and Sociology, Minzu University of China, Beijing,
China

Abstract

Population aging in China presents a significant challenge, with projections indicating
that individuals aged 65 and above will exceed 30% of the total population by 2050,
thereby increasing health-care and long-term care (LTC) demands. Therefore, this study
aimed to examine income-related inequality in self-rated health (SRH) and functional
ability among older individuals in China while also examining the contribution of
socioeconomic factors to health inequality. Data were drawn from the 2018 wave
of the Chinese Longitudinal Healthy Longevity Survey. Well-established tools, such
as concentration curves, the Erreygers concentration index (EI), and decomposition
analysis, were employed to elucidate income-related inequality in health within the
sample. The results revealed that for SRH, both unstandardized and standardized
concentration curves were observed below the 45° line, with unstandardized EI
Academic editor:
Mihajlo Jakovljevic M.D. Ph.D. MAE at 0.068 and standardized EI at 0.033. For functional ability, both unstandardized
and standardized concentration curves were observed above the 45° line, with
*Corresponding author:
Yixiao Wang unstandardized EI at −0.016 and standardized EI at −0.003. These results suggest
(yixiao.wang@muc.edu.cn) that, after controlling for demographic factors, the better-off group is more likely to
Citation: Wang, Y. (2024). report better SRH and less likely to experience functional limitations compared to the
Income-related inequality in health worse-off group. Furthermore, this inequality in health outcomes is predominantly
outcomes among older individuals driven by socioeconomic factors rather than demographic factors. For SRH, income
in China: A measurement and emerges as the primary contributor to total inequality. Similarly, for functional ability,
decomposition analysis .Global
Health Econ Sustain, 2(1): 2243. income emerges as the key factor driving inequality, disproportionately affecting the
https://doi.org/10.36922/ghes.2243 less affluent population. Consequently, it is crucial for the government to protect older
Received: November 14, 2023 individuals with lower socioeconomic status to mitigate income-related inequality
in health by directly providing cash aids and formal LTC, which could contribute to
Accepted: January 8, 2024
promoting healthy aging in the context of global aging.
Published Online: March 20, 2024
Copyright: © 2024 Author(s). Keywords: Income-related inequality; Self-rated health; Activities of daily living; Older
This is an Open Access article
distributed under the terms of the individuals; China
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience Population aging presents an unprecedented challenge in China. By the end of 2019, 176
Publishing remains neutral with million individuals aged 65 years and above accounted for 12.6% of the total population
regard to jurisdictional claims in
published maps and institutional (National Bureau of Statistics, 2018). Furthermore, the rate of population aging is rapidly
affiliations. increasing. It is estimated that there will be more than 400 million older individuals

Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/ghes.2243