Inequalities in successful aging among the older adults in China: A decomposition study based on a gender perspective

Studies have shown that gender is associated with inequalities in successful aging. However, little is known about the trends in gender gaps in successful aging and the factors contributing to these disparities. This study aims to provide evidence of gender inequalities in successful aging and to identify the contributing factors to inform targeted policy development. Using the data of China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, a total of 21,718 older adults (60+) were enrolled in this study. Successful aging was assessed by successful aging index covering absence of disease, physical functioning, psychological functioning, activity of daily living, physical activity functioning, cognitive functioning, and interpersonal social engagement. We employed Shapley decomposition to examine factors contributing to successful aging inequalities and further analyzed gender-specific disparities using Oaxaca-Blinder decomposition. Results indicate an upward trend in successful aging inequalities. The most significant contributors to such inequalities are gender, education, age, residential area, drinking, and smoking, which span across the dimensions of personal characteristics, family characteristics, regional factors, and lifestyle. Under the gender perspective, education emerged as the most influential factor, while other characteristics like smoking, drinking, age, marital status, and residential area also matter. Over time, the contribution of education is more stable, whereas the influence of smoking and drinking increased. Gender inequalities in successful aging in China are generally increasing, with a continuous expansion over time. To mitigate these disparities, gender-specific geriatric care policies are needed to ensure equitable and inclusive aging opportunities for both men and women.