Adding Health to Years: Essays on Mental Health and Wellbeing of Older People in China

Abstract

We are living in an ageing world. It is estimated that by 2050, the proportion of the population aged 65 and older will increase by more than 60 per cent, rising from 16 to 26 per cent of the total population in developed countries. While the figure will witness a 300 per cent increase, rising from 5.8 to 15 per cent of the total population in developing countries. Therefore, the WHO has demonstrated that population ageing is one of the main challenges of the 21st century and called for devoted actions and resources to improving the health of the greying population. To address such challenges, the WHO has proposed to achieve healthy age- ing and wellbeing of the older population as the core strategy. Healthy Ageing is defined as the process of developing and maintaining the functional ability that enables health and wellbeing in older age. Functional ability indicates the health- related properties that enable people to be and do what they have reason to value. It consists of individuals' intrinsic capacities and surrounding environments with which they interact. The purpose of maintaining the functional ability of older adults is to promote the wellbeing of the ageing population. Wellbeing is considered in the broadest sense and includes domains such as happiness, satisfaction and fulfillment. Wellbeing is the key to achieving health ageing. In the context of population ageing, China, the largest developing country and most rapidly ageing society in the world, has witnessed a demographic shift and epidemiologic transition in the past decades, which is characterised by its lower mortality, higher life expectancy, decreasing prevalence of communicable diseases and climbing prevalence of non-communicable and chronic diseases. Guided by the WHO functional ability and wellbeing pathway, the thesis aims to explore the factors related to the health ageing and wellbeing of older adults in China from the viewpoint of health characteristics, personal characteristics, and broader socio-economic environment. The thesis also used multiple advanced statistical techniques to overcome challenges facing in longitudinal analyses. This thesis is presented as a volume of three self-contained essays that can be read independently of one another. The first essay (Chapter 2) explored the sex-specific trajectories of allostatic load (AL), a holistic measure of physiological risk factors, and their affecting factors. The second essay (Chapter 3) seeks to know how injuries, measured by experiences of falls, affect Chinese older adults' depressive status. The third essay (Chapter 4) explores how broader macro socio-economic factors affect individual-level mental health and wellbeing. Finally, Chapter 5 summarises the findings and drew a conclusion of the thesis.

Date of Award	31 Dec 2023
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Gindo Tampubolon (Supervisor) & Asri Maharani (Supervisor)