Effects of Individual, Spousal, and Offspring Socioeconomic Status on Mortality Among Elderly People in China

BACKGROUND The relationship between socio-economic status and health among elderly people has been well studied, but less is known about how spousal or offspring's education affects mortality, especially in non-Western countries. We investigated these associations using a large sample of Chinese elderly. METHODS The data came from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from the years 2005 to 2011 (n = 15 355, aged 65-105 years at baseline; 5046 died in 2008, and 2224 died in 2011). Educational attainment, occupational status, and household income per capita were used as indicators of socio-economic status. Spousal and offspring's education were added into the final models. The Cox proportional hazards model was used to study mortality risk by gender. RESULTS Adjusted for age, highly educated males and females had, on average, 29% and 37% lower mortality risk, respectively, than those with a lower education. Particularly among men, this effect was observed among those whose children had intermediate education only. A higher household income was also associated with lower mortality risk among the elderly. Male elderly living with a well-educated spouse (HR 0.79; 95% CI, 0.64-0.99) had a lower mortality risk than those living with a low-educated spouse. CONCLUSIONS Both the socio-economic status of the individual and the educational level of a co-resident spouse or child are associated with mortality risk in elderly people. The socio-economic position of family members plays an important role in producing health inequality among elderly people.