Globally, the burden of non-communicable diseases (NCDs) and multimorbidity continues to grow. This study aimed to uncover the changes in the prevalence and patterns of multimorbidity involving eight common NCDs across socioeconomic gradients in rural Southwest China. Data were collected through two waves of community-based, cross-sectional health interviews and physical examinations among individuals aged ≥ 35 years in rural Southwest China. Individual socioeconomic position (SEP) was constructed using principal component analysis. Association rule mining was employed to identify the NCD multimorbidity patterns of eight chronic conditions. Anthropometric measurements, blood pressure, fasting blood glucose, and post-bronchodilator spirometry were recorded for all participants. The survey’s response rates of 98.9

Background Existing literature suggests that school bullying can have long‐lasting effects on mental health, but its specific impact on late‐life depression remain underexplored. This study aims to investigate the association between early‐life school bullying experiences and depression symptoms in old age and the variations by sex, place of residence and educational level. Method Data were derived from the Life History Survey of the China Health and Retirement Longitudinal Study in 2014, including 4333 older adults aged ≥60 years. School bullying was assessed on the basis of self‐reported experiences during childhood. Depression symptoms were measured using the Center for Epidemiologic Studies Depression Scale‐10. Poisson regression analyses were performed to examine the relationship between early‐life school bullying experience and late‐life depression. Results Of the 4333 respondents, 607 (14%) reported being bullied during childhood, and 1274 (29.4%) exhibited symptoms of depression. Older adults who experienced school bullying were 1.17 times more likely to exhibit depression symptoms compared with those without such experiences (prevalence ratio [PR], 1.173; 95% confidence interval [CI], 1.027–1.3390). This association was more prominent among women (PR, 1.284; 95% CI, 1.093–1.475), rural residents (PR, 1.477; 95% CI, 1.210–1.803) and those with education at primary school level (PR, 1.172; 95% CI, 1.017–1.352). The results remained robust using an alternative school bullying cutoff and after imputing all missing data. Conclusion Early‐life school bullying is a significant risk factor for depression in later life, with its impact being particularly pronounced among women, rural residents and those with lower educational levels. These findings highlight the need for targeted mental health interventions for individuals with a history of early‐life school bullying to mitigate long‐term psychological effects. Geriatr Gerontol Int 2025; ••: ••–•• .

INTRODUCTION:This study examines how prevalence and behaviors of smoking differ by ethnicity and their associations with chronic obstructive pulmonary disease (COPD) among elderly people of four ethnicities in rural southwest China. METHODS:A cross-sectional survey of 5642 adults aged ≥60 years was conducted in rural southwest China. Data on the demographics, smoking habits, and post-bronchodilator spirometry were collected. RESULTS:Among the participants, the prevalence of current smoking (48.8% vs 0.8%) and COPD (12.7% vs 4.5%) was significantly higher in males compared to females (p<0.01). Filtered cigarettes were the most popular form of tobacco used, comprising 76.6% of tobacco consumed. Bai ethnic minority participants had the highest prevalence of current smoking and COPD, and the highest number of cigarettes smoked per day compared to the other three studied ethnicities (p<0.01). Ha Ni ethnic minority participants had the lowest rate of smoking cessation (8.7%) and the highest rate of smoking in public places (66.8%) (p<0.01). The results of multivariable logistic regression indicated that current smokers were more likely to suffer from COPD across all four studied ethnicities (p<0.05). Further, the association of current smoking with COPD in Bai ethnicity elderly participants was stronger compared to other ethnic groups (p<0.01). CONCLUSIONS:The present study shows that ethnicity plays a significant role in influencing both the prevalence and behaviors related to smoking among elderly people in rural southwest China. Future efforts to prevent and reduce tobacco use in rural China should consider ethnicity, as culturally tailored tobacco control strategies could help prevent and manage the COPD epidemic.

This study aimed to uncover the changing prevalence of pre-diabetes and diabetes as well as diabetes self-management behaviors across socioeconomic gradients in rural southwest China. A two-wave, community-based, cross-sectional survey was conducted. A total of 7,747 and 7,536 individuals aged ≥ 35 years, residing in rural southwest China, were selected using a three-stage stratified random sampling method. Demographic characteristics and self-management behaviors were collected through face-to-face interviews, and physical indicators were measured through on-site examinations. An individual socioeconomic position (SEP) index was constructed using principal component analysis based on three variables: education, annual household income, and access to medical services. In 2022, the overall prevalence of pre-diabetes and diabetes (15.7

Objective:This study aimed to uncover socioeconomic variations in the prevalence and patterns of noncommunicable disease (NCD) multimorbidity including seven common chronic conditions, and to investigate its association with depression symptoms. Methods:A cross-sectional survey was conducted including 7509 adults aged ≥35 years in rural Yunnan Province, China from 2023 to 2024. Association rule mining was used to identify the NCD multimorbidity patterns of seven common chronic conditions. Multivariable logistic regression analysis was employed to examine the relationship between NCD multimorbidity and depression symptoms. Results:The prevalence of NCD multimorbidity was 18.8 %. NCD multimorbidity was more prevalent among participants with lower education, lower annual household income, and better access to medical care (P < 0.05). NCD multimorbidity and their patterns of chronic obstructive pulmonary disease + asthma, diabetes + coronary heart disease, hypertension + stroke, and hypertension + coronary heart disease + diabetes were associated with a greater risk of depression symptoms (P < 0.05). Conclusions:There are socioeconomic disparities in prevalence and patterns of NCD multimorbidity across rural southwest China. NCD multimorbidity was positively associated with depressive symptoms. Future measures to prevention NCD multimorbidity should be strengthened and targeted at lower socioeconomic populations, with greater focus on managing depression in NCD multimorbid patients.

The status of family-based H. pylori infection in Yunnan Province is unknown. This study is the first family-based epidemiological survey of H. pylori in the province, aiming to provide new insights into the status of family-based H. pylori infections in Yunnan Province as well as in the country as a whole. Between 2021 and 2023, 1,176 families with 2,947 family members were tested for H. pylori in six cities in Yunnan Province with different geographic locations and economic status, to assess the status of H. pylori infection, and to clarify the related factors and modes of transmission by means of a questionnaire survey. In Yunnan Province, the H. pylori infection rate was 31.46

Leading global causes of death are noncommunicable diseases (NCDs), which affect mostly low- and middle-income countries. Over 90

This study examines how the prevalence of depression and anxiety symptoms differ by socioeconomic status and explores their associations with diabetes in rural southwest China. Data were collected from a cross-sectional health interview and examination survey of 5,005 adults aged ≥ 35 years in rural southwest China. Height, weight, waist circumference, and fasting blood glucose measurement were taken. Depression and anxiety symptoms were assessed using Zung’s Self-rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS), respectively. An individual socioeconomic position (SEP) index was constructed using principal component analysis. The overall prevalence of depression, anxiety, comorbid depression and anxiety symptoms, and diabetes was 5.4

INTRODUCTION This study examined the prevalence of tobacco exposure and drinking and ascertained the relationships between tobacco exposure, alcohol drinking, concurrent smoking and drinking, and hypertension in rural southwestern China. METHODS Data were collected from a cross-sectional health interview and examination survey, which included 7572 adults aged >= 35 years, in rural China. Participant demographic characteristics, smoking habits, exposure to secondhand smoke (SHS), and alcohol drinking habits were obtained using a standard questionnaire. Blood pressure (BP), height, weight, and waist circumference were measured for each participant. RESULTS The overall prevalence of smoking, SHS exposure, drinking, concurrent smoking and drinking, concurrent exposure to SHS and drinking, and hypertension was 37.7%, 27.4%, 16.2%, 12.6%, 1.6%, and 41.3%, respectively. Males had a significantly higher prevalence of smoking (74.1% vs 2.2%, p<0.01), drinking (31.1% vs 1.7%, p<0.01), and concurrent smoking and drinking than females (25.3% vs 0.3%, p<0.01). However, females had a higher prevalence of SHS exposure than males (30.2% vs 20.6%, p<0.01). Ethnic minorities had a higher prevalence of SHS exposure, drinking, and concurrent smoking and drinking, than Han participants (p<0.01). Participants with a higher education level had a higher prevalence of smoking, drinking, and concurrent smoking and drinking than their counterparts (p<0.01). In contrast, participants with a lower education level had a higher prevalence of SHS exposure than their counterparts (p<0.01). Multivariate logistic regression analysis found that smokers (AOR=1.31; 95% CI: 1.13-1.51), individuals exposed to SHS (AOR=1.24; 95% CI: 1.11- 1.43), drinkers (AOR=1.31; 95%: CI: 1.15-1.50), and concurrent smokers and drinkers (AOR=1.45; 95% CI: 1.25-1.67) all had a higher probability of having hypertension (p<0.01). Additionally, concurrent smoking and drinking had the strongest association with the prevalence of hypertension (AOR=1.45; 95% CI: 1.25-1.67; p<0.01). CONCLUSIONS Socioeconomic factors play an important role in influencing the prevalence of smoking, exposure to SHS, and drinking in rural southwest China. Interventions to prevent and reduce hypertension should, in particular, focus on smokers, individuals exposed to SHS, drinkers, and, in particular, concurrent smokers and drinkers.

Objectives This study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest China.Design Data were collected from a cross-sectional health interview and examination survey among individuals aged ≥35 years in rural southwest China. Fasting blood glucose, blood pressure, height, weight and waist circumference (WC) were measured for each participant. SEM was employed to assess the relationships between demographic characteristics (sex, age and ethnicity), socioeconomic position (SEP; annual household income, education level and access to medical services), lifestyle factors (obesity status (body mass index and WC) and physical inactivity), hypertension, hyperlipidaemia and family history of diabetes.Setting This study was conducted in rural Yunnan Province of China.Participants 7536 individuals aged ≥35 years consented to participate in the study.Results The overall prevalence of diabetes in the present study was 8.3%. Prevalence did not differ by gender (prevalence for both men and women was 8.3% (p>0.05)). The results of SEM indicated that SEP, age, ethnicity, obesity status and physical inactivity had both significant direct and indirect effects on diabetes, with total effect size of 0.091, 0.149, –0.094, 0.212 and 0.089, respectively (p<0.01). Family history of diabetes (0.128, p<0.01), hypertension (0.135, p<0.01) and hyperlipidaemia (0.137, p<0.01) were directly associated with diabetes.Conclusions Socioeconomic and lifestyle factors have both direct and indirect effects on prevalence of diabetes in rural southwest China. Future efforts to implement comprehensive interventions to promote the prevention and control of diabetes should in particular focus on obese individuals.

Background Chronic diseases have become a major public health problem affecting the health of the population, and the number of patients with chronic diseases in China continues to increase, as well as the increasing number of deaths due to chronic disease by year, and the increasing burden of disease on patients gradually. Understanding the changes in the burden of chronic diseases is of great importance for the prevention and control of chronic diseases. However, there is a lack of research on the changes in the burden of common chronic diseases in rural Yunnan Province. Objective To examine the changes in the disease burden of five common chronic diseases [hypertension, coronary heart disease (CHD), stroke, asthma, and chronic obstructive pulmonary disease (COPD) ] among rural residents in Yunnan Province in 2011 and 2021. Methods A repeated cross-sectional design was used to select 8 400 and 7 700 rural residents aged≥35 years in Yunnan Province using multistage stratified random sampling method in 2011 and 2021 as the research subjects, respectively. Data were collected from on-site questionnaires and physical examinations of study participants, as well as data on the causes of death of five common chronic diseases. Principal component analysis was used to construct a socioeconomic position (SEP) indicator by selecting three variables including education level, annual household income per capita and accessibility to medical services, the coefficients of the variables were used to calculate the SEP composite score, and the SEP was classified into four grades of low, medium-low, medium-high and high based on the quartiles of the SEP composite score. Disability-adjusted life year (DALY) was used to measure the magnitude of the disease burden for five chronic diseases. Results Compared with 2011, the overall prevalence of hypertension (25.14% vs. 41.57%), stroke (1.03% vs. 2.52%), and COPD (9.23% vs. 12.60%) in rural Yunnan Province in 2021 increased (P<0.05), as well as the prevalence for males, females, and participants with all SEP grades (P<0.05) ; the overall prevalence of CHD (2.02% vs. 2.30%) and asthma (1.36% vs. 1.61%) did not change significantly (P>0.05), while an increase was found in the prevalence of CHD among males and those with high SEP grade, and in the prevalence of asthma among males and those with medium-high SEP grade (P<0.05). In 2021, the prevalence of all 5 chronic diseases was higher in males than in females (P<0.05), and there was a decreasing trend in the prevalence of COPD by different grades of SEP in 2021 (χ2trend=6.801, P<0.001). In addition, an increase was found in DALY per 1 000 population of CHD (10.45 vs. 18.18), stroke (12.80 vs. 23.20), asthma (4.54 vs. 9.10), and COPD (35.99 vs. 49.07), while a decrease was found in DALY per 1 000 population of hypertension (1.38 vs. 1.26). COPD presents higher DALY per 1 000 population and years of life disability (YLD) per 1 000 population, while stroke presents higher years of life lost (YLL) per 1 000 population among the five chronic diseases. Conclusion The prevalence and disease burden of five common chronic diseases among rural residents in Yunnan Province in 2021 were mainly higher than 2011, and the disease burden of COPD was the heaviest in 2021, with males and those with low SEP grade being the key populations for future prevention and control of chronic diseases. Targeted prevention and control strategies should be adopted to reduce its harm to the health of population.

Background This study aimed to uncover the changing prevalence of obesity and its association with hypertension across socioeconomic gradients in rural southwest China. Methods Data were collected from two cross-sectional health interviews and surveys from 2011 to 2021 among individuals aged ≥ 35 years in rural China. Each participant’s height, weight, waist circumference, and blood pressure were measured. The overall prevalence of obesity, central obesity, and hypertension was directly standardized by age based on the total population of the two surveys. Multivariate logistic regression was used to analyze the association between obesity and prevalence of hypertension and an individual socioeconomic position (SEP) index was constructed using principal component analysis. Results From 2011 to 2021, the prevalence of obesity, central obesity, and hypertension increased substantially, from 5.9%, 50.2%, and 26.1–12.1%, 58.0%, and 40.4% ( P < 0.01), respectively. These increasing rates existed in all subcategories, including sex, age, ethnicity, education, annual household income, access to medical services, and SEP ( P < 0.05). In both 2011 and 2021, lower education level and poor access to medical services correlated with higher prevalence of central obesity, while higher SEP correlated with higher prevalence of obesity and central obesity ( P < 0.01). Prevalence of obesity was higher in the Han ethnicity participants and individuals with poor access to medical services than in their counterparts ( P < 0.01). Whereas the prevalence of central obesity was lower in Han participants than in ethnic minority participants in 2011 ( P < 0.01), this trend reversed in 2021 ( P < 0.01). A positive relationship between annual household income and prevalence of obesity and central obesity was only found in 2021 ( P < 0.01). Obese and centrally obese participants were more likely to be hypertensive in both survey years ( P < 0.01). Conclusions Future interventions to prevent and manage obesity in rural China should give increased attention to high income, less educated, poor access to medical services, and high SEP individuals. The implementation of these obesity interventions would also help reduce the prevalence of hypertension.

Objectives Cardiovascular disease (CVD) is the leading cause of death in China. To provide evidence for preventing and controlling the development of CVD among older adults in ethnic minority communities by understanding the ethnic disparities and lifestyle determinants of CVD. This study aimed to compare ethnic disparities and lifestyle determinants in the prevalence of CVD (hypertension, CHD, and stroke) among older adults between Han majority and Ha Ni ethnic minority in rural southwest China. Methods A cross-sectional questionnaire and physical examination were conducted among Han majority and Ha Ni ethnic minority groups aged ≥ 60 years in rural Southwest China. Height, weight, waist circumference and blood pressure values of each participant were recorded. The relationship between ethnic and lifestyle factors and CVD was analyzed using multivariate logistic regression. Results A total of 1413 Han majority and 1402 Ha Ni ethnic minority elderly individuals participated in this study. Han majority older adults had a higher prevalence of CHD and stroke than in Ha Ni ethnic minority counterparts (P < 0.01). Compared with the Han majority elderly, Ha Ni ethnic minority older adults had a higher risk of hypertension (OR = 1.168, 95%CI: 1.070–1.274), and a lower risk of CHD (OR = 0.818, 95%CI: 0.680–0.985) and stroke (OR = 0.736, 95%CI: 0.605–0.895). Participants with obesity were more likely to have hypertension (OR = 2.092, 95%CI: 1.344–3.255) and CHD (OR = 2.259, 95%CI: 1.341–3.808). Additionally, those who with central obesity and physically inactivity were more likely to have hypertension (OR = 2.349, 95%CI: 1.930–2.858 and OR = 1.303, 95%CI: 1.105–1.537) and stroke (OR = 2.205, 95%CI: 1.384–2.962 and OR = 2.024, 95%CI: 1.405–2.916). Current drinking increased the risk of hypertension (OR = 1.311, 95%CI: 1.077–1.596), but decreased the risk of stroke (OR = 0.428, 95%CI: 0.243–0.754). Conclusion CHD and stroke are more prevalent among the Han majority older adults in rural Southwest China, and there is a significant influence of lifestyle factors on CVD.

Objectives: This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. Methods: A cross-sectional survey of 5,642 was conducted among the rural southwest population aged >= 60 years, consisting of a structured interview and measurement of fasting blood glucose, height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results: The overall prevalence of diabetes and sleep disorder was 10.2% and 40.1%, respectively. Bai participants had the highest prevalence of diabetes (15.9%) and obesity (9.9%)(P < 0.01), while Ha Ni participants had the lowest prevalence of diabetes (5.1%) and obesity (3.4%)(P < 0.01). The highest prevalence of sleep disorder (48.4%) was recorded in Bai participants, while Dai participants had the lowest prevalence of sleep disorder (25.6%)(P < 0.01). In all four studied ethnicities, females had a higher prevalence of sleep disorder than males (P < 0.01), and the prevalence of sleep disorder increased with age (P < 0.01). The results of multivariate logistic regression analysis indicated older adults with sleep disorder had a risk of developing diabetes (P < 0.05). Moreover, the higher educational level, family history of diabetes, and obesity were the main risk factors for diabetes in participants (P < 0.01). Conclusion: There are stark ethnic disparities in the prevalence of diabetes and sleep disorders in southwest China. Future diabetes prevention and control strategies should be tailored to address ethnicity, and improving sleep quality may reduce the prevalence of diabetes.

Objectives This study aimed to analyse trends in the prevalence and economic burden of hypertension and its socioeconomic disparities in rural southwestern China.Design Two repeated cross-sectional studies were conducted to collect interview and health examination data among individuals aged ≥35 years in rural Yunnan Province, China.Setting Three rural areas of Yunnan, China.Participants We invited 8187 consenting participants in 2010–2011 and 7572 consenting participants in 2020–2021 to undergo interviews and health examinations.Results The standardised prevalence of hypertension significantly increased from 26.1% in 2011 to 40.4% in 2021 (p<0.01), and the per capita direct, indirect and disease economic burdens increased from US$1323, US$46 and US$1369 to US$2196, US$49 and US$2244, respectively. In addition to the indirect economic burden, the direct and disease economic burdens increased significantly. The prevalence of hypertension was higher in illiterate population, among participants with low annual household income per capita, and participants with good access to medical services than in their counterparts who had good education, high annual household income per capita and poor access to medical services (all p<0.05). Moreover, the prevalence of hypertension showed a downward trend with improvement in socioeconomic position (SEP) (p<0.05). The per capita direct and disease economic burdens increased most in participants with low SEP, but the per capita indirect economic burden increased most in participants with upper-middle SEP.Conclusions The prevalence and economic burden of hypertension have visibly accelerated in rural Yunnan Province over the 10 years studied, and socioeconomic disparities have been found in the prevalence and economic burden of hypertension. These findings highlight that socioeconomic differentials should be tailored to address the timing of effective interventions for hypertension prevention and control and reduce the economic burden of hypertension in rural southwestern China.

Abstract Background Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity, and imposes a substantial financial burden on society. However, few studies have examined the role of individual socioeconomic status (SES) in temporal trends of COPD prevalence and economic cost. This study aimed to uncover the changing prevalence and economic burden of COPD across socioeconomic gradients in rural southwest China. Methods Data were collected from two cross-sectional health interviews and examination surveys administered 10 years apart among individuals aged ≥ 35 years in rural China. A prevalence-based cost-of-illness method was used to estimate the cost of COPD. The individual socioeconomic position (SEP) index was constructed using principal component analysis. Post-bronchodilator spirometry tests were performed for each participant. Results From 2011 to 2021, the prevalence of COPD increased from 8.7% to 12.8% (P < 0.01), while the economic cost of COPD increased 1.9-fold. Unit hospital costs and outpatient costs increased 1.57–fold and 1.47–fold, while unit medication costs fell by 10.6%. Increasing prevalence was also observed when the data were stratified by sex, age, ethnicity, level of education, level of income, and SEP (P < 0.05). Men, ethnic minorities, and those with a lower educational level, lower income, or lower SEP had a higher prevalence of COPD than their counterparts both in 2011 and 2021 (P < 0.05). Unit outpatient costs and medication costs increased with patients’ SEP in both survey years (P < 0.05). Conclusions The prevalence and economic costs of COPD increased substantially across all socioeconomic gradients in rural southwest China in the decade from 2011 and 2021. Future COPD prevention and management interventions as well as efforts to improve access to affordable COPD medication and treatment should focus in particular on ethnic minority and low SEP populations.

Background As the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest Chinese older adults. Methods A cross-sectional survey was conducted in rural southwest population aged ≥ 60 years consisting of 5,642 consenting participants of Han and three ethnic minority groups (Dai, Ha Ni, and Bai). Information about participants’ demographic characteristics and lifestyle behaviors was obtained using a standard questionnaire. Anthropometric measurements including height, weight, and waist circumference, fasting blood sugar and blood pressure measurement, as well as post-bronchodilator spirometry test were recorded for each participant. Results The age-standardized prevalence of five common chronic NCDs– hypertension, diabetes, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD) – and its multimorbidity was 72.8%, 15.9%, 4.0%, 10.0%, 9.8%, and 27.6%, respectively. Bai participants had both the highest overall and sex-specific prevalence rates of hypertension, diabetes, stroke, and COPD, whereas Han participants had the highest rates of CHD ( P < 0.01). The results of multivariate logistic regression analysis indicated that female and older participants had a higher probability of chronic NCDs multimorbidity than their counterparts ( P < 0.01). Bai ethnic minority participants were more likely to have NCDs multimorbidity while Ha Ni and Dai ethnic minority participants were less likely to have NCD multimorbidity relative to the Han participants ( P < 0.05). Older adults with a higher level of education and family history of chronic NCDs, and who were also current smokers, current drinkers, obese, centrally obese, and physically inactive had a greater probability of developing chronic NCDs multimorbidity ( P < 0.01). Conclusions Ethnicity and individual demographic and lifestyle factors significantly impact prevalence of chronic NCDs multimorbidity. Future chronic NCDs prevention and control strategies must be tailored to address ethnicity, and culturally tailored lifestyle interventions may reduce the prevalence of chronic NCDs multimorbidity in rural southwest China.

Abstract This study aimed to explore the early-life discrimination in parenting on the physical and mental well-being of middle-aged and older adults, while also exploring the potential mediating role of early-life health. By combined data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018 and related life history survey in 2014, 8204 females and 7305 males aged 45-84 were analyzed in this study. Logistic regression was employed to analyze the association between early-life discrimination in parenting and the incidence of chronic diseases as well as depression in middle-aged and older individuals. The KHB method was used to assess the mediating effect of early-life health in these connections. Regarding gender-based discrimination in parenting, parental preference for sons during early life was found escalated the probability of chronic diseases by 18% (OR=1.18, 95%CI: 1.01-1.38) and increased depression risk by 16% (OR=1.16, 95%CI: 1.03-1.31) among middle-aged and older females. In terms of sibling-related discrimination, parental inclination towards specific siblings heightened the likelihood of depression during middle and older years among females (OR=1.17, 95%CI: 1.03-1.34). However, these effects were not significant in males. The study further identified that early-life health partially mediated the influence of gender-based parental preferences on the mental well-being of middle-aged and older females, accounting for 8.603% of the overall effect. These findings underscored the potential for early-life discrimination within parenting to impact both the physical and mental health of middle-aged and older females by shaping their early-life health status, consequently resonating throughout their mental well-being in later life.

OBJECTIVES:This study aimed to determine the changing prevalence of clustering of cardiovascular disease (CVD) risk factors across socioeconomic spectra in rural southwest China.DESIGN:Data were collected from two waves of cross-sectional health interviews and examinations among individuals aged ≥35 years in rural China. Anthropometric measurements, blood pressure and fasting blood sugar levels were recorded for each participant.SETTING:This study was conducted in rural Yunnan Province of China.PARTICIPANTS:8187 individuals in 2011 and 7572 in 2021 consented to participate in this study.RESULTS:From 2011 to 2021, prevalence increased of hypertension (26.1% vs 41.6%), diabetes mellitus (5.9% vs 9.8%), obesity (5.9% vs 12.0%) and central obesity (50.0% vs 58.3%) (p<0.01), while prevalence decreased of current smoking (35.2% vs 29.6%), secondhand smoke exposure (42.6% vs 27.4%) and current drinking (26.6% vs 29.6%) (p<0.01). This decade also saw an increase in the prevalence of participants with clustering of ≥2 (61.8% vs 63.0%) and ≥3 CVD risk factors (28.4% vs 32.2%) (p<0.05). These increasing rates were also observed among subgroups categorised by sex, ethnicity, education level, income level and those ≥45 years of age (p<0.05). In both 2011 and 2021, male participants and participants with a lower education level had higher prevalence of clustering of ≥2 and ≥3 CVD risk factors than their counterparts (p<0.01). Ethnic minority participants and participants with higher annual income had higher prevalence of clustering of CVD risk factors in 2011 but presented opposite associations in 2021 (p<0.01).CONCLUSION:The prevalence of clustering of CVD risk factors increased substantially across all socioeconomic spectra in rural southwest China from 2011 to 2021. Future efforts to implement comprehensive lifestyle interventions to promote the prevention and control of CVD should in particular focus on men, those of Han ethnicity and those with low socioeconomic status.

Abstract There has been an increasingly important trend that more and more older people take part in activities of digital technology nowadays in China. In this study, the research question associated to determinants of older people’s digital engagement was addressed, which has been quantitatively analyzed by statistical models in a sample of older people 60 to 98 years of age from China Longitudinal Aging Social Survey (N=11207). For dependent variable, digital participation of older people has been measured by the access to the Internet with mobile phones and various digital devices, whereas for independent variables, individual, situational, environmental, and social policy factors which were based on a conceptual model of productive aging framework have been constructed to present academic explanations on dependent variable. Results of Probit and Ordered-Probit regression showed that the older people’s participation in digital technology was closely related to individual and situational factors, whereas the effects of environmental factors and social policies were not statistically significant. Older adults who were much younger and physically healthier had higher probability of participation in digital technology. Meanwhile, those who lived in urban area, had higher levels on income, literacy and social support were more likely to be involved in digital activities. Conclusions shed light on the significance of academic research to improve productive ageing and successful ageing which takes a more active role on exploring and grappling with issues related to application of digital technology especially technological difficulties that older people have confronted with in an ageing society.