How Urban Life Exposure Shapes Risk Factors of Non-Communicable Diseases (NCDs): An Analysis of Older Rural-to-Urban Migrants in China.

There has been a long-lasting debate about whether urban settings are beneficial to the health of rural-to-urban migrants. Research in some low- and middle-income countries (LMICs) has documented that exposure to urban life negatively impacts their health, especially in terms of non-communicable diseases (NCDs), and attributed the association to health-related behaviors. However, it is unclear if such patterns exist in China, the biggest LMIC and home to 19% of the world population. Meanwhile, given the severe population aging trend, previous research lacks focus on rural-to-urban migrants of older age groups. In addition, different extents of urban life exposure among migrants are either ignored or indirectly measured, and the mediating effects of health behavioral factors have not been quantified. Using data from 2011 China Health and Retirement Longitudinal Study (CHARLS), this study examined three major NCD risk factors, hypertension, general obesity, and abdominal obesity, among older adults (45 +) with different residential types (N = 11,126). Employing logistic regression models and mediation analysis, I find that rural-to-urban migrants have significantly higher odds of having all three NCD risk factors than rural dwellers, and have similar risk profiles as urban residents. Among rural-to-urban migrants, years lived in cities significantly and cumulatively predict hypertension. However, health-related behaviors, including tobacco use, alcohol consumption, and physical activity, only account for a small proportion of the differences between rural-to-urban migrants and rural dwellers, implying other pathways through which urban settings shape older rural-to-urban migrants' health outcomes. [ABSTRACT FROM AUTHOR]