Understanding the longitudinal dynamics of rural-urban mental health disparities in later life in China

Objectives: Understanding longitudinal patterns of rural–urban mental health disparities is vital for effective intervention and policy development in China. However, few studies have estimated separate effects of birth-cohort and ageing and examined the role of community resources on health inequalities. Methods: Drawing data from the China Health and Retirement Longitudinal Study (2011–2018), this study employed multilevel modelling to identify the mental health trajectories of rural, peri-urban, urban older adults by cohort and the community effects. Results: The changes in the mental health gap between rural, peri-urban and urban older adults over time varied by birth cohorts. Among younger cohorts aged under 65, the mental health disparities between rural, peri-urban and urban residents increased as they got older. Underdeveloped community infrastructure greatly explained the rural health disadvantage. Conclusion: The study indicates increasing rural–urban health disparities at the onset of later life. Improving community infrastructure in rural and peri-urban areas is vital to minimise rural–urban health gaps.