Alleviating Socioeconomic Disparities in Disability Progression through Healthy Lifestyle: Prospective Cohort Studies in China and South Korea

Chengxu Long , King's College London
Shangfeng Tang, Huazhong University of Science and Technology

Objective To examine socioeconomic disparities in the association between lifestyles and disability progression. Research Design and Methods Data are derived from the Korean Longitudinal Study of Aging (N=2,924) and the Chinese Longitudinal Healthy Longevity Survey (N=4,351) from 2008 to 2018. Disability progression was identified based on activities of daily living limitations. A healthy lifestyle score was created using information on non-current smoking, non-current drinking, regular exercise, and weekly social contact. Logistic regression models were built to identify risk factors. Results In South Korea, adopting healthier lifestyles was significantly associated with 39% lower odds of accelerated disability among low-income older adults (OR 0.71, 95%CI 0.53-0.96) and those without formal education (OR 0.71, 95%CI 0.52-0.98), but not among higher-income or educated individuals. In contrast, in China, this association was more pronounced among higher-income individuals (low-income: OR 0.77, 95%CI 0.60-0.98; middle-income: OR 0.58, 95%CI 0.46-0.73; high-income: OR 0.64, 95%CI 0.51-0.81; Chow test, p<0.001) and those with higher educational attainments (no formal education: OR 0.78, 95%CI 0.64-0.96; primary/secondary education: OR 0.65, 95%CI 0.53-0.81; =high school: OR 0.64, 95%CI 0.43-0.94; Chou test, P<0.05). Discussion Healthier lifestyles may act as a protective factor against accelerated disability among socioeconomic disadvantaged older adults in South Korea. In China, socioeconomically advantaged older adults may derive more benefits from the adoption of healthier lifestyles. These findings underscore the potential of promoting healthy lifestyles to address socioeconomic inequalities in disability within developed aged societies and emphasize the importance of promoting healthy lifestyles among marginalized populations in rapidly aging developing nations.

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 Presented in Session 110. Social Inequalities in Health, Wellbeing and Morbidity