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Am J Public Health. 2010 Feb;100(2):298-305. doi: 10.2105/AJPH.2008.154971. Epub 2009 Dec 17.

Associations of environmental factors with elderly health and mortality in China.

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Correspondence can be sent to Prof Yi Zeng, Center for the Study of Aging and Human Development, Box 3003, Duke University, Durham, NC 27710. Reprints can be ordered at by clicking the "Reprints/Eprints" link.



We examined the effects of community socioeconomic conditions, air pollution, and the physical environment on elderly health and survival in China.


We analyzed data from a nationally representative sample of 15 973 elderly residents of 866 counties and cities with multilevel logistic regression models in which individuals were nested within each county or city.


After control for individual-level factors, communities' gross domestic product per capita, adult labor force participation rate, and illiteracy rate were significantly associated with physical, mental, and overall health and mortality among the elderly in China. We also found that air pollution increased the odds of disability in activities of daily living (ADLs), cognitive impairment, and health deficits; more rainfall was protective, reducing the odds of ADL disability and cognitive impairment; low seasonal temperatures increased the odds of ADL disability and mortality; high seasonal temperatures increased the odds of cognitive impairment and deficits; and living in hilly areas decreased the odds of ADL disability and health deficits.


Efforts to reduce pollution and improve socioeconomic conditions could significantly improve elderly health and survival.

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