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Gu D, Feng Q, Sautter JM and Qiu L

welfare systems compared to rural areas. The following three selected theoretical
approaches could be used to explain the association between urban life exposure and
health/mortality at older ages.
1.1.1 Socio-Ecological Theory

The socio-ecological model argues that contextual factors play a vital role in a wide
range of individual outcomes (e.g., Kawachi and Berkman, 2000; Wen, Hawkley
and Cacioppo, 2006; Zimmer, Wen and Kaneda, 2010). These contextual factors
include physical environments, such as natural and built environments, and social
environments consisting of socioeconomic status, social support, social networks,
social cohesion, social capital, culture, and so forth (Engel, Chudyk, Ashe, et al.,
2016).
Socio-ecological theory conceptualizes urban life exposure as an experience of
living in an urban physical environment. For example, one study using data from
Beijing, China showed that advantages in life expectancy and functional independence
among older urban residents were largely attributable to differences in resources and
health insurance coverage (Zimmer, Wen and Kaneda, 2010). Another China-based
study reported that the nature of daily life activities and surrounding environments in
rural settings contributed to rural residents being more likely than urban residents to do
physical activities (Zhu, Chi and Sun, 2016).
Empirical evidence also suggests that distinct social environments in rural and
urban areas may influence health. For example, urban residents are less helpful
toward strangers and their social networks contain fewer kin compared to people in
rural settings (Yang and Zeng, 2016). These characteristics of urban and rural social
networks could lead to differences in interpersonal relationships, which may better
buffer psychological distress among rural residents. Culture is another important
component of social environment that plays a pivotal role in shaping individual
attitudes and health behaviors (Grossmann, Karasawa, Kan, et al., 2014; Jopp,
Wozniak, Damarin, et al., 2015; Löckenhoff, De Fruyt, Terracciano, et al., 2009), and
in turn influences psychological and physiological well-being (Baum, 2017). Because
rural areas are more likely to retain traditional culture than urban areas (Hu and Scott,
2016), rural residents may follow different attitudinal and behavioral norms. For
example, due to traditional norms of filial piety and family care, Chinese rural older
adults with physical limitation are less likely than their urban counterparts to report
dependency in daily life (Purser, Feng, Zeng, et al., 2012).

1.1.2 Life Course Approach
The life course approach investigates how environmental exposures and conditions
in earlier life stages affect health and wellbeing at later ages (Ben-Shlomo and Kuh,
2002; Cable, 2014; Eriksson, 2005; Hallqvist, Lynch, Bartley, et al., 2004; Lynch and
Smith, 2005). It consists of three main conceptual models: the critical (or sensitive)
period model, the cumulative risk model, and the social mobility model (Hallqvist
Lynch, Bartley, et al., 2004). The critical period model emphasizes the importance
of timing, with the effect of exposures or conditions being stronger during certain
sensitive life course periods compared to other periods. The cumulative risk model
highlights the direct and indirect effects of early-life exposures accumulated over
time throughout the life course. The social mobility model focuses on trajectories of
exposures or conditions in early-life, mid-life, and late-life; specifically, it argues that
there would be a compensation effect if a person moved from a disadvantaged status in
earlier life to an advantaged status in later life (upward mobility) and that there would
be a penalty effect if a person moved from a higher status to a lower status in the life
course. For example, Wen and Gu (2011) showed that upward mobility (measured by
a transition from a lower socioeconomic status in early-life to a better socioeconomic
status in mid-life) is associated with lower mortality and lower risk of cognitive
impairment compared to persistently low social status among Chinese older adults. A
U.S. study also reached a similar conclusion (Luo and Waite, 2005).

International Journal of Population Studies 2017, Volume 3, Issue 1 3