Wellbeing in England and China James Banks, Xiaoyan Lei, Albert Park, Andrew Steptoe, Yafeng Wang, Winnie Yip, Paola Zaninotto, Yaohui Zhao

Motivation Healthy aging is priority in aging societies Understanding determinants of wellbeing and health is key for public policy Cross-country comparisons can be invaluable for identifying which factors are universal and which depend on local contextualizing factors Two harmonized data sets (ELSA and CHARLS) enable a comparison between the UK and China

Background China has experienced rapid economic development Today’s elderly have had very different economic status in their life time – Tremendous wealth accumulation in recent decades, some due to random factors, especially in the housing market – Uneven distribution of luck Legacies of the past events may have long-term impacts on wellbeing – Collectivization, the Great Famine, the Cultural Revolution, and rapid economic development

CHARLS Baseline Survey Nationally representative sample of people aged 45 and older – About 18,000 individuals in 10,000 households distributed across 450 communities, 150 counties in 28 provinces – Fielded Strict quality control in sampling and survey stages Harmonized with the HRS-ELSA family of surveys Compare with ELSA wave 4

Measures of Well-being Poor self-reported health One or more limitations with ADLs/IADLs One or more mobility impairment Memory (immediate word recall) Elevated depression symptoms (3 or more) High Life satisfaction

Harmonizing Well-being Measures Example: ADLs/IADLs and Mobility ELSANo 0 Yes 1 CHARLSNo, I don’t have any difficulty 1 I have difficulty but can still do it 2 Yes, I have difficulty and need help 3 I can not do it 4 Do have any difficulty…..

Outcome measures % by country * * * * *

SES Variables Non-pension wealth per capita quintiles Educational attainment (4 groups) Controls: – Age groups (5-year cohorts) – Gender – Marital status

Methodology for Comparative Analysis For each country, regress each outcome on the full set of explanatory Report coefficients for each explanatory variable (controlling for other factors) Denote with “*” if the coefficients for the two countries are statistically different

Key Findings: Wealth For physical health measures (self-reported health, ADLs/IADLs, mobility), wealth has stronger relationship in England than in China, with the poorest especially disadvantaged But opposite is true for psychological health measures (life satisfaction, depression) Result on memory is mixe

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Explaining Wealth Findings Wealth less correlated with physical health in China than in England – Current wealth less correlated with lifetime wealth? Wealth more correlated with psychological wellbeing in China – People in China are more dependent on their current wealth for their livelihood; social security is less important in China

Key Findings: Education Education gradients greater in China for some measures (ADLs/IADLs, life satisfaction, memory)

Explaining Education Gradients Education measures lifetime wealth better than current wealth

Conclusions Health and wellbeing seem to be more related to lifetime socioeconomic status (e.g. education) in China than in the UK Perhaps due to rapid development and random factors in reshuffling wealth distribution, association between current wealth and lifetime living standards is less in China than in UK Current wealth is associated with psychological wellbeing – Psychological wellbeing easier to alter than physical health