Educational differences of healthy life expectancy among the older adults in China: A multidimensional examination using the multistate life table method

Healthy life expectancy (HLE) is an emerging field in aging studies. Nevertheless, understanding of HLE from the perspective of socioeconomic status (SES) is inadequate. To fill this gap, the present study explores differences in HLE by SES based on two nationally representative longitudinal databases in China. The study adopts education as a proxy of SES and employs the multistate life table method to compute HLE. Health is measured by the following four indicators: physical function, cognitive function, depression, and self-rated health. The results show that educational differences are associated with significantly different results in these four health indicators. Active life expectancy, cognitive-impairment-free life expectancy, and self-rated healthy life expectancy differ by existence of educational attainment among the old adults, with the nonilliterate group enjoying both longer cognitive-impairment-free life expectancy and self-rated healthy life expectancy, while unexpectedly, the illiterate group has a higher active life expectancy at most ages. In contrast, depression-free life expectancy is similar between the two educational categories. The positive association between educational attainment and cognitive-impairment-free life expectancy and self-rated healthy life expectancy might be explained by the beneficial effect of education in improving and maintaining cognitive ability and SES, while the negative association between educational attainment and active life expectancy might be interpreted by the higher rate of mortality and the absence of social-security support among less educated Chinese senior citizens. The lack of difference by educational attainment in depression-free life expectancy requires further investigation.