Rural-Urban Comparison of Health Risk Behaviors and Health Outcomes Among Chinese Older Adults: A Latent Class Analysis.

This study investigated health risk behavior patterns among older adults in rural and urban China and their association with health outcomes, addressing the limited evidence on rural–urban differences in health behaviors among Chinese older adults. We used cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey. Latent class analysis identified latent classes of health behaviors (e.g., smoking, drinking, unhealthy diet), and regression models examined their associations with health outcomes, including indicators of physical health, perceived health, functional health, and mental health. Among 8,651 participants aged 65 and above (mean age = 82.9 years, SD = 11.2), distinct patterns of risky health behaviors were identified in both rural (n = 3,579) and urban (n = 5,072) samples, with combined unhealthy diet and substance use being most prevalent. Age and gender significantly predicted class membership. Rural participants engaging in smoking and drinking were more likely to experience chronic diseases, obesity, and functional limitations, while urban participants who consumed alcohol had greater risks of depression and anxiety. Distinct urban–rural differences in health behavior patterns were observed among older adults, and these patterns were differentially associated with health outcomes. These findings highlight the need for tailored interventions targeting different risk behaviors in rural and urban older adults in China, which may help reduce health inequalities and improve overall health.