Objective: This study compared urban and rural factors associated with life satisfaction among older adults in mainland China. Method: Study data were extracted at random from 10% of the Sample Survey on Aged Population in urban/rural China in 2006 for 1980 participants aged 60 and older, including 997 from urban cities and 983 from rural villages. Results: In this study, 54.6% of urban older adults and 44.1% of rural older adults reported satisfaction with their lives. Binary logistic regression analysis showed that financial strain, depressive symptoms, filial piety, and accessibility of health services were significantly associated with life satisfaction for both urban and rural participants, but age and financial exchange with children were only associated with life satisfaction among urban older adults. Conclusion: Findings are consistent with some previous studies that indicated the importance of financial strain, depressive symptoms, filial piety, and accessibility of health services to life satisfaction among the older adults in both urban and rural areas. This study also demonstrated the importance of age and family financial exchange to the life satisfaction of urban older adults.

Birth defects, which are the major cause of infant mortality and a leading cause of disability, refer to "Any anomaly, functional or structural, that presents in infancy or later in life and is caused by events preceding birth, whether inherited, or acquired (ICBDMS)". However, the risk factors associated with heredity and/or environment are very difficult to filter out accurately. This study selected an area with the highest ratio of neural-tube birth defect (NTBD) occurrences worldwide to identify the scale of environmental risk factors for birth defects using exploratory spatial data analysis methods. By birth defect registers based on hospital records and investigation in villages, the number of birth defects cases within a four-year period was acquired and classified by organ system. The neural-tube birth defect ratio was calculated according to the number of births planned for each village in the study area, as the family planning policy is strictly adhered to in China. The Bayesian modeling method was used to estimate the ratio in order to remove the dependence of variance caused by different populations in each village. A recently developed statistical spatial method for detecting hotspots, Getis's [ 7 ], was used to detect the high-risk regions for neural-tube birth defects in the study area. After the Bayesian modeling method was used to calculate the ratio of neural-tube birth defects occurrences, Getis's statistics method was used in different distance scales. Two typical clustering phenomena were present in the study area. One was related to socioeconomic activities, and the other was related to soil type distributions. The fact that there were two typical hotspot clustering phenomena provides evidence that the risk for neural-tube birth defect exists on two different scales (a socioeconomic scale at 6.84 km and a soil type scale at 22.8 km) for the area studied. Although our study has limited spatial exploratory data for the analysis of the neural-tube birth defect occurrence ratio and for finding clues to risk factors, this result provides effective clues for further physical, chemical and even more molecular laboratory testing according to these two spatial scales.

Visual impairment has become a global challenge, especially for developing countries. This study aims to estimate the prevalence, causes and social factors of visual impairment among Chinese adults. Data were from a nationally representative population-based cross-sectional study. The study population were 1,909,199 non-institutionalized adults aged 18 years and older in mainland China. In the survey, low vision and blindness were checked by ophthalmologists according to the WHO best-corrected visual acuity (BCVA) criteria. Population weighted numbers and prevalence of low vision and blindness with 95% confidence intervals (CIs) were estimated where appropriate. Multivariable logistic regression analysis was used to identify the social factors of visual impairment. The weighted prevalence of visual impairment was 17.17 (95% CI, 16.84–17.50) per 1000 Chinese adults aged 18 years and older. Cataract (57.35%), disorders of choroid and retina (9.80%), and disorders of cornea (6.49%) contributed more than 70 percent to the visual impairment in Chinese adults. Older age groups, young or middle-aged male adults, female elders, illiterate, rural dwellers, non-eastern residents, singles, unemployment, and from family with lower income were associated with visual impairment. More efforts are warranted to enhance treatment and rehabilitation among people with eye disorders to prevent visual impairment.

Background: Considerable socioeconomic and health inequalities have been reported in China. However, because of a lack of appropriate data, limited research has been conducted on variations in disability-free life expectancy (DFLE) among older adults. This study aimed to use the most up-to-date disability survey data to explore geographical variations in DFLE at age 60 in China and to identify the socioeconomic and health care factors that partially account for these variations.Methods: This study used 2006 mortality data extrapolated from the 1990 and 2000 Census and disability data from a national disability survey conducted in 2006. Disability was performance based and was diagnosed by trained physicians. DFLE was calculated by region using the Sullivan method. Multiple linear regression models by gender were conducted to explore correlates of DFLE.Results: DFLE at age 60 varied widely by region, from 11.2 to 20.8 years in 2006. Per capita gross domestic product, proportion of urban residents, and access to health care were the primary factors associated with geographical variations in DFLE.Conclusion: The pattern of differences in DFLE by region mirrors the pattern of regional economic development in China. Countermeasures to decrease regional differences in DFLE include accelerating regional economic development and improving health care distribution.

Despite efforts to tackle folate deficiency and Neural Tube Defects (NTDs) through folic acid fortification, its implementation is still lacking where it is needed most, highlighting the need for studies that evaluate the effectiveness of folic acid fortified wheat flour in a poor, rural, high-risk, NTD region of China. One of the most affected regions, Shanxi Province, was selected as a case study. A community intervention was carried out in which 16,648 women of child-bearing age received fortified flour (eight villages) and a control group received ordinary flour (three villages). NTD birth prevalence and biological indicators were measured two years after program initiation at endline only. The effect on the NTD burden was calculated using the disability-adjusted life years (DALYs) method. In the intervention group, serum folate level was higher than in the control group. NTDs in the intervention group were 68.2% lower than in the control group (OR = 0.313, 95% CI = 0.207–0473, p < 0.001). In terms of DALYs, burden in intervention group was approximately 58.5% lower than in the control group. Flour fortification was associated with lower birth prevalence and burden of NTDs in economically developing regions with a high risk of NTDs. The positive findings confirm the potential of fortification when selecting an appropriate food vehicle and target region. As such, this study provides support for decision makers aiming for the implementation of (mandatory) folic acid fortification in China.