Urban–rural differentials in age-related biological risk among middle-aged and older Chinese

  • Yuan S. ZhangEmail author
  • Eileen M. Crimmins
Original Article



To assess urban–rural differentials in age-related biological risk among middle-aged and older Chinese and links to individual and community characteristics.


Data come from the national baseline survey of the China Health and Retirement Longitudinal Study. Biological risk is assessed using a set of measured biomarkers that reflect cardiovascular, metabolic, and inflammatory processes.


Urban residents who are officially registered in urban areas have greater biological risk than rural residents. Having junior school or higher education provides an independent and persistent protective effect against biological risk and eliminates the effect of community-level measures. The reduced physical activity of urban dwellers with urban origins explains a substantial part of the difference in risk.


Urban dwellers with urban household registration have elevated risk compared with their rural peers, indicating that lifetime exposure to urban areas is an important risk factor for increased biological risk in China. The urban–rural differential in risk is accounted for by adjusting for health behaviors, particularly physical activity. The reduced physical activity among urban dwellers with urban household registration appears to be highly related to their elevated risk. No significant associations between community-level characteristics and biological risk are found beyond individual characteristics.


Biomarkers China Health disparity Urban–rural difference CHARLS 


Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

38_2018_1189_MOESM1_ESM.docx (40 kb)
Supplementary material 1 (DOCX 40 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2018

Authors and Affiliations

  1. 1.Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesUSA

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