Socioeconomic gradient in old age mortality in Wuhan, China

Objectives. The vast majority of studies on socioeconomic status (SES) and old age mortality are based on data derived from developed nations. This research examined the SES differentials in old age mortality in China, a developing nation. Methods. Hazard rate models in conjunction with ordinary least squares and logistic regression analyses were used to ascertain the gross, direct, indirect, and interaction effects of SES on mortality during a 3-year period in a probability sample of 2,943 persons aged 60 years or older in Wuhan, China. Results. Education, household economic well being, and urban-rural residence showed statistically significant gross effects on old age mortality. Education influenced mortality directly and indirectly. Household economic well being and urbanicity exerted indirect effects on mortality through mediating variables such as stress, social relations, and baseline health status. The mechanism through which education affected mortality differed between men and women, but SES differentials in mortality did not interact with age. Discussion. SES differentials in old age mortality may be extended to a developing nation such as China. The observed gender by SES interaction effect on old age mortality has important implications for intervention. In particular, improving education among women in underdeveloped areas must remain a high priority, for policy makers in efforts to extend the life expectancy of women.