Living arrangements and associations with well-being among older adults in China: a national population-based study

The patterns of living arrangements among older adults have changed dramatically in China from multigeneration households to more diverse forms, including a growing number of empty-nest households. However, few studies have evaluated the role of living arrangements in the health status of older adults in China. This study aims to explore the associations between living arrangements and well-being among older adults in China, with a focus on gender differences. This study used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which is a nationally representative survey of older people, contributing to research on the health, retirement, and intergenerational support of the older population in China. A total of 6,535 participants aged 60 years or older were selected for this study. We analysed the association of living arrangements with three dimensions of health: physical health, mental health, and self-rated health among Chinese older adults using chi-square, one-way ANOVA, logistic regression, and bivariate and multivariate linear regression tests. The average age of the participants was 68.35 ± 6.24 years, and 49.78% were female. The most popular living arrangement among older adults in China was living only with spouse (51.9%). Older men’s living arrangements significantly differed from older women’s (χ2 = 143.128, p < 0.001). Further, older men living alone had significantly better self-rated health than those living with their spouse and children (ß=0.273, p = 0.024). Among older women, those who lived alone (ß=1.557, p < 0.001) or only with their children (ß=1.177, p = 0.005) had significantly higher depression scores compared to those who lived with both their spouse and children. The findings of this study showed that living arrangements were significantly associated with health outcomes among older women but not older men. Older adults who did not live with spouses were more likely to have mental issues, suggesting that older adults’ well-being could be improved through health promotion programs that consider their social and living conditions.