Exposure to urban life and mortality risk among older adults in China

We examined whether exposure to urban environments was linked with mortality in a longitudinal survey dataset of nearly 28,000 Chinese adults who were 65 years of age or older in the years 2002–2014. Urban life exposure was measured by residential status at birth, current residential status, and urban-related primary lifetime occupation, which generated eight different categories of urban life exposure: no exposure, mid-life-only exposure, late-life-only exposure, mid-late-life exposure, early-life-only exposure, early-mid-life exposure, early- & late-life exposure, and full life exposure. We also included a measure of migration, whether the respondent lived in the same county/city at birth and at first interview, to further classify these eight categories. Overall, we found that when demographics were controlled for, compared to those with no urban life exposure and no migration, mortality risk was lower for older adults with mid-late life exposure with or without migration and for older adults with full-life exposure with migration; mortality risk was higher for older adults with early-life-only exposure. Once socioeconomic status, family/social support, health behaviors, and baseline health were simultaneously controlled for, only the higher mortality risk for older adults with early-life-only exposure was still significant. Our findings provided valuable information about how urban life exposure at different life stages was associated with elderly mortality in China.