Does the Community You Live in Make A Difference? Multilevel Analysis of Ageing-in-place Preference in China

Abstract

Promoting aging in place (AIP) has been challenging for policymakers, as there has been growing concern about the quality and appropriateness of neighborhood environments. This study aims to examine the associations between aging-in-place preference with neighborhood-level characteristics in China. The study used a city-level data from 2015 the Chinese Urban and Rural Elderly Living Conditions study and linked community-level data from the city-level administration information system. The sample included 553 community-dwelling residents aged over 60 years old and 26 communities where the sample resides. The majority of the sample (88%) preferred to age in place when their physical and mental health deteriorate to a point where they could no longer live independently without assistance. By employing multilevel logistic regression analysis, the study found that (1) low educational attainment (odds ratio [OR] = 3.44) increased the odds of AIP preference; elders with more children (OR = 1.46) were more likely to prefer AIP when they could no longer live independently; living alone (OR = 0.40) decreased the odds of AIP preference; (2) after controlling the individual-level variables, older adults living in an urban community (OR = 0.44) or a community with a high percentage of older population (OR = 0.98) were less likely to stay in the communities. This study demonstrated that the significant relationships between community-level factors and AIP preference under Chinese context. In the light of Lawton’s ecological theory, the findings can inform the policy decisions about community resource allocation and the development of AIP policy.