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Part I. Trends of healthy aging in china -- Chapter 1. Twenty years' follow-up surveys on elder people's health and quality of life -- Chapter 2. Changes in Socioeconomic Status as Determinants of Health with Increase in Ages: Convergence or Divergence? -- Chapter 3. The Age, Gender, Urban-Rural and Regional Differences in Dynamic Changes of Activity of Daily Living among the Chinese Oldest-old -- Chapter 4. Trends of Dynamic Changes in Activities of Daily Living, Physical Performance, Cognitive Function and Mortality Rates among the Oldest-old in China -- Chapter 5. The Trends of Family Support for the Chinese Oldest-old -- Chapter 6. Analysis of Trends of Future Home-based Care Needs and Costs for the Older Adults in China -- Part II. Determinants of Healthy Aging -- Chapter 7. The Impact of Empty-nested Living on Physical and Psychological Health among Chinese Elder -- Chapter 8. Residential Proximity to Major Roadways and Cognitive Function among Chinese Adults 65 Years and Older -- Chapter 9. Self-Assessment of Health and Life Satisfaction and the Determinants among the Older Adults -- Chapter 10. Analyses of Gender Difference in Self-rated Health among the Older adults in China -- Chapter 11. A Study on the Intensity of Care Needs among the Chinese Older Adults -- Chapter 12. The Impacts of Universal Medical Insurance Coverage on Health Care Utilization, Financial Burden and Health Status among the Older adults -- Chapter 13. How Does the New Rural Pension Scheme Remold the Elder-care Pattern in Rural China? -- Chapter 14. Effects of the New Rural Social Endowment Insurance Program on Intergenerational Transfer -- Chapter 15. Impacts of Changes in Living Arrangements on Mortality Risk of the Older Adults.

This book studies healthy aging in China based on analyses of the datasets of eight waves of longitudinal survey in 1998-2018 with worldwide largest sample of oldest-old. It consists of four parts. The first part reports the 6th, 7th, and 8th surveys of "Chinese Longitudinal Healthy Longevity Survey" (CLHLS), with the largest sample of oldest-old aged 80+ in the world and comparable sample of young-old aged 6579, trends and characteristics of physical health and mental health of older adults in China based on analyses of the CLHLS datasets. The second part focuses on analyses and discussions of the influencing factors of healthy aging from perspectives of families, socioeconomics and community environments. The third part reports studies on the gender and age differences in main chronic diseases prevalence rates, inflammation, anti-oxidation, trace elements, effects of the nutritional dietary structure and the environmental selenium on health among the older adults. The fourth part focuses on the analyses and discussions of policy recommendations to face the serious challenges of the population aging in China and the database of the eight waves of CLHLS from 1998 to 2018, which are available free of charge to scholars, practitioners and general public for scientific research and socioeconomic planning. This book is easy to read and to understand by researchers and the general public, and no special professional background is required.

The relationship between the ever-increasing cancer mortality and water pollution is an important public concern in China. This study aimed to explore the association between serious water pollution and increasing digestive cancer mortality in the Huai River Basin (HRB) in China. A series of frequency of serious pollution (FSP) indices including water quality grade (FSPWQG), biochemical oxygen demand (FSPBOD), chemical oxygen demand (FSPCOD), and ammonia nitrogen (FSPAN) were used to characterize the surface water quality between 1997 and 2006. Data on the county-level changing mortality (CM) due to digestive tract cancers between 1975 and 2006 were collected for 14 counties in the study area. Most of investigated counties (eight) with high FSPWQG (>50%) distributed in the northern region of the HRB and had larger CMs of digestive tract cancers. In addition to their similar spatial distribution, significant correlations between FSP indices and CMs were observed by controlling for drinking water safety (DWS), gross domestic product (GDP), and population (POP). Furthermore, the above-mentioned partial correlations were clearly increased when only controlling for GDP and POP. Our study indicated that county-level variations of digestive cancer mortality are remarkably associated with water pollution, and suggested that continuous measures for improving surface water quality and DWS and hygienic interventions should be effectively implemented by local governments.

On July 15, 2019, the State Council of China issued new guidelines for the implementation of the country's Healthy China Initiative (2019–2030) and for the promotion of population health across the nation. This article interprets Healthy Environment Promotion Campaign (HEPC) in the Healthy China Initiative from four main aspects—background, major indices, strategies, and features. Two outcome indices and four advocacy indices are proposed by the HEPC, and the strategies are mainly embodied at three levels: individual/family, society and government. The strategies have the following features: 1) the strategies are developed on the basis of scientific evidence; 2) the strategies advocate that citizens must be responsible for their own health; 3) the administrative impetus provided by the Chinese government to integrate health into all policies is an important driver for developing and implementing the HEPC; and 4) HEPC is not an isolated campaign, so it is necessary to coordinate all 15 campaigns in order to proactively and properly implement HEPC.

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM(2.5)) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM(2.5) exposure with a threshold concentration of 33 μg/m(3), and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM(2.5) concentrations; compared to 33 μg/m(3), the hazard ratio ranged from 1.03 (1.00-1.06) at 40 μg/m(3) to 2.25 (1.54-3.29) at 110 μg/m(3). The risk magnitude was not significantly changed below this threshold. Each 10 μg/m(3) increase in PM(2.5) exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051-1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM(2.5) exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m(3), and supported that reduction to current World Health Organization interim target-1value (35 μg/m(3)) and Chinese national ambient air quality standards (35 μg/m(3)) or lower may be associated with lower risk of disability in ADL.

Abstract
China is one of the largest producers and consumers of coal in the world. The National Action Plan on Air Pollution Prevention and Control in China (2013–2017) particularly aimed to reduce emissions from coal combustion. Here, we show whether the acute health effects of PM2.5 changed from 2013 to 2018 and factors that might account for any observed changes in the Beijing–Tianjin–Hebei (BTH) and the surrounding areas where there were major reductions in PM2.5 concentrations. We used a two-stage analysis strategy, with a quasi-Poisson regression model and a random effects meta-analysis, to assess the effects of PM2.5 on mortality in the 47 counties of BTH. We found that the mean daily PM2.5 levels and the SO42− component ratio dramatically decreased in the study period, which was likely related to the control of coal emissions. Subsequently, the acute effects of PM2.5 were significantly decreased for total and circulatory mortality. A 10 μg/m3 increase in PM2.5 concentrations was associated with a 0.16% (95% CI: 0.08, 0.24%) and 0.02% (95% CI: −0.09, 0.13%) increase in mortality from 2013 to 2015 and from 2016 to 2018, respectively. The changes in air pollution sources or PM2.5 components appeared to have played a core role in reducing the health effects. The air pollution control measures implemented recently targeting coal emissions taken in China may have resulted in significant health benefits.