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Journal of Peking University (Health Sciences) ›› 2025, Vol. 57 ›› Issue (6): 1136-1144. doi: 10.19723/j.issn.1671-167X.2025.06.018

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Association between socioeconomic status and vision impairment among Chinese elderly

Yuehui WEI, Weiyan JIAN*()   

  1. Department of Health Policy and Management, Peking University School of Public Health, Beijing 100191, China
  • Received:2025-02-09 Online:2025-12-18 Published:2025-09-24
  • Contact: Weiyan JIAN
  • Supported by:
    the National Social Science Fund of China (Major Project)(22&ZD143)

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Abstract:

Objective: To assess the association between socioeconomic status and vision impairment (Ⅵ) among Chinese elderly aged 65 years and above, and explore its comparison and contrast from 2008 to 2018. Methods: Using the 2008 and 2018 waves of cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), which included 12970 and 9702 participants, respectively. Logistic regression models with a stepwise forward approach were employed to assess the association between the household income, educated level, job before retirement and Ⅵ. Results: In 2008, the prevalence of Ⅵ among the elderly aged 65 years and above in China was 16.92% (95%CI: 15.91%-17.98%), which increased to 18.45% (95%CI: 17.41%-19.53%) in 2018. In terms of household income, the highest and upper middle income groups had lower odds of Ⅵ compared with the lowest one in 2008. By 2018, only the upper middle had lower odds (OR=0.761, 95%CI: 0.603-0.961), with its disparity narrowing compared with 2008. For educated level, in 2008, individuals with primary school education, and those with junior high school education or above had lower odds of Ⅵ compared with illiterate individuals. By 2018, the disparity in Ⅵ between the illiterate individuals and those with primary school education widened, while the gap between the illiterate ones and those with junior high school education or above decreased. In addition, after controlling for other factors, the odds of Ⅵ for the individuals educated by junior high school and above was higher than for those educated by primary school (OR=0.691, 95%CI: 0.533-0.896; OR=0.592, 95%CI: 0.494-0.708). Regarding job before retirement, in 2008, compared with the professional, technical or managerial personnel, those engaged in agriculture or domestic work had higher odds of Ⅵ. In 2018, this disparity persisted (OR=1.707, 95%CI: 1.319-2.210; OR=1.925, 95%CI: 1.310-2.829), with the gaps widening compared with the reference group. Conclusion: The prevalence of Ⅵ among Chinese elderly increased from 2008 to 2018, with socioeconomic status, specifically household income, educated level, and job before retirement, demonstrating associations with Ⅵ. To be specific, the gap in the odds of Ⅵ across household income strata decreased from 2008 to 2018; disparities among different educated levels generally diminished, while the gap between illiterate individuals and ones educated by primary school widened; and job-before-retirement groups exhibited expanding disparities over time.

Key words: Vision disorders, Socioeconomic status, Aged, Correlational research

CLC Number: 

  • R197.1

Table 1

Characteristics of participants"

Variables Year 2008 (n=12 970), n (%) Year 2018 (n=9 702), n (%)
Age/years
  65-74 2 485 (19.16) 2 392 (24.65)
  75-84 2 576 (19.86) 2 401 (24.75)
  85 and above 7 909 (60.98) 4 909 (50.60)
Gender
  Female 7 340 (56.59) 5 350 (55.14)
  Male 5 630 (43.41) 4 352 (44.86)
Marital status
  Others 8 255 (63.65) 5 167 (53.26)
  Currently married 4 715 (36.35) 4 535 (46.74)
Household income quintile
  Lowest 2 857 (22.03) 1 970 (20.31)
  Lower middle 2 926 (22.56) 1 973 (20.34)
  Middle 2 442 (18.83) 1 861 (19.18)
  Upper middle 2 472 (19.06) 2 000 (20.61)
  Highest 2 273 (17.53) 1 898 (19.56)
Educated level
  Illiterate 8 024 (61.87) 4 678 (48.22)
  Primary school 3 653 (28.16) 3 140 (32.36)
  Junior high school and above 1 293 (9.97) 1 884 (19.42)
Job before retirement
  Professional, technical or managerial personnel 956 (7.37) 1 084 (11.17)
  Commercial, service or industrial worker 1 734 (13.37) 1 403 (14.46)
  Self-employed 249 (1.92) 181 (1.87)
  Agriculture 8 592 (66.25) 5 980 (61.64)
  Houseworker 1 075 (8.29) 655 (6.75)
  Military personnel 85 (0.66) 90 (0.93)
  Never worked 86 (0.66) 143 (1.47)
  Others 193 (1.49) 166 (1.71)
Residence
  Rural 7 771 (59.92) 4 173 (43.01)
  Urban 5 199 (40.08) 5 529 (56.99)
Location
  East 5 202 (40.11) 4 554 (46.94)
  Middle 3 200 (24.67) 2 166 (22.33)
  West 3 510 (27.06) 2 514 (25.91)
  North-east 1 058 (8.16) 468 (4.82)
Smoking
  Never 8 610 (66.38) 6 688 (68.93)
  Past or current 4 360 (33.62) 3 014 (31.07)
Drinking
  Never 8 953 (69.03) 7 080 (72.97)
  Past or current 4 017 (30.97) 2 622 (27.03)
Regular exercising
  Never 7 812 (60.23) 5 919 (61.01)
  Past or current 5 158 (39.77) 3 783 (38.99)
Fruit
  Not often 7 704 (59.40) 5 222 (53.82)
  Often 5 266 (40.60) 4 480 (46.18)

Table 2

Prevalence of vision impairment among Chinese elderly grouped by socioeconomic status, residence, and location from 2008 to 2018"

Variables Year 2008, n (%)a Year 2018, n (%)a
Household income quintile
  Lowest 1 237 (19.87) 774 (20.59)
  Lower middle 1 218 (17.87) 807 (20.73)
  Middle 981 (16.37) 654 (17.45)
  Upper middle 881 (14.73) 728 (15.73)
  Highest 802 (15.70) 611 (17.75)
F=2.924b, P=0.020 F=3.218b, P=0.012
Educated level
  Illiterate 3 855 (22.99) 2 388 (28.49)
  Primary school 1 029 (14.24) 816 (14.82)
  Junior high school and above 235 (9.53) 370 (13.47)
F=46.582b, P < 0.001 F=69.762b, P < 0.001
Job before retirement
  Professional, technical or managerial personnel 215 (11.69) 245 (12.37)
  Commercial, service or industrial worker 499 (13.70) 414 (15.33)
  Self-employed 88 (12.46) 60 (17.14)
  Agriculture 3 574 (18.61) 2 380 (19.94)
  Houseworker 606 (26.24) 321 (23.44)
  Military personnel 23 (13.62) 25 (17.51)
  Never worked 45 (21.32) 78 (22.85)
  Others 69 (13.84) 51 (18.23)
F=5.804b, P < 0.001 F=4.356b, P < 0.001
Residence
  Rural 3 142 (17.30) 1 631 (19.63)
  Urban 1 977 (16.50) 1 943 (17.29)
F=0.556b, P=0.456 F=4.789b, P=0.029
Location
  East 2 048 (17.02) 1 639 (17.24)
  Middle 1 291 (17.83) 830 (18.77)
  West 1 394 (16.97) 972 (20.76)
  North-east 386 (14.10) 133 (16.61)
F=1.086b, P=0.353 F=2.531b, P=0.055

Table 3

Logistic regression analyses on vision impairment among Chinese elderly in 2018 (n=12 970)"

Table 4

Logistic regression analyses on vision impairment among Chinese elderly in 2018 (n =9 702)"
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