Disability-Related Loss in Lifespan and Specific Social Determinants of Health Among Middle-Aged and Older Adults with Disabilities: Evidence from China's Aging Population.

Abstract

To fulfill the World Health Organization's (WHO) goal of active aging, it is essential to concentrate on the health of individuals with disabilities. However, there is a significant gap in research regarding the impact of disability on lifespan in low- and middle-income countries (LMICs). Additionally, the specific social determinants of health for middle-aged and older adults with disabilities are not well understood in LMICs. Our study aims to address these gaps by focusing on China's aging population. We utilized a Weibull regression model to predict individual lifespans and employed linear regression models to identify health determinants for people with disabilities. Our findings revealed that, compared to those without disability, the life expectancy of individuals with mild, moderate, and severe disabilities was reduced by 18%, 37%, and 53%, respectively, with even larger disparities in Quality-Adjusted Life Years (QALYs) at 19%, 39%, and 55%. Key determinants of health for middle-aged and older adults with disabilities included social contact, living areas, and labor market status. Consequently, we recommend three policy interventions: 1) improving access to social contact opportunities within communities; 2) reinforcing the pension system for both urban and rural residents; 3) expanding the elder care industry and enhancing fiscal transfers in rural regions.