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How educational inequality among rural residents relates to healthy lifestyle behaviors in later life

Evidence from the Northern China lifestyle medicine cohort baseline

Datos Bibliográficos

ID17832196
AutoresYudong Miao (0000-0002-2231-3214, Zhengzhou University), Jinxin Cui (0000-0001-5769-155X, Zhengzhou University), Lei Yin (0009-0008-6821-9208, Zhengzhou People's Hospital), Zhanlei Shen (0000-0002-7654-7243, Zhengzhou University), Dongfang Zhu (0009-0008-6923-2789, Zhengzhou University), Jingbao Zhang (0009-0009-1516-0852, Zhengzhou University), Jiajia Zhang (0000-0002-2916-0636, Zhengzhou University), Mingyue Zhen (Zhengzhou University), Xinran Li (0000-0002-5678-6829, Zhengzhou University), Lingxiao Mou (Zhengzhou University), Yixi Wang (0000-0002-7499-3450, Zhengzhou University), Jiaxin Han (0000-0002-8010-6715, Zhengzhou University), Jingwei Qin (0009-0002-8958-1413, Zhengzhou University), Jingming Wei (Peking University), Clifford Silver Tarimo (0000-0002-0672-9471, Dar es Salaam Institute of Technology), Qiuping Zhao (0009-0005-3654-1735, Zhengzhou Central Hospital), Rongmei Liu (0000-0002-0454-1854, Zhengzhou Central Hospital), Nengguang Dai (Health Commission of Anhui Province), Qingyong Lu (Zhengzhou University, autor de correspondencia)
Año2026
Fecha de publicación2026-03-31
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHumanities and Social Sciences Communications (JOURNAL)
Identificadores de la revistaISSN: 2662-9992 • E-ISSN: 2662-9992
EditorialPalgrave Macmillan (PUBLISHER • GB)
DOI10.1057/s41599-026-06907-8
OpenAlexW7147643241
IdiomaEN
Referencias citadas63

Educational inequality affects health, but its link to healthy lifestyles among older adults in low-resource rural settings remains unclear. This study utilized baseline data from the Northern China Lifestyle Medicine Cohort (July 2023–January 2024). Adults aged 65 and older with hypertension or diabetes in the National Basic Public Health Service program were included. A composite Healthy Lifestyle Score (HLS, range 0–7) was constructed from seven behavioral indicators. We employed linear/logistic regression and propensity score matching (PSM) to analyze associations between educational attainment and lifestyle outcomes. Among 10,459 adults (57.2% female), 34.0% were illiterate. The mean HLS was 4.69 (SD = 1.24). Each educational attainment increase added 0.17 points to HLS (95% CI: 0.14–0.20). Higher education was positively linked to a healthy diet (OR = 1.15, 95% CI: 1.10–1.21), adequate sleep (OR = 1.17, 95% CI: 1.11–1.23), physical activity (OR = 1.18, 95% CI: 1.11–1.24), and leisure activity (OR = 1.34, 95% CI: 1.27–1.41), but negatively with non-drinking (OR = 0.82, 95% CI: 0.77–0.88). After PSM adjustment, illiterate participants had a significantly lower HLS (4.59, 95% CI: 4.55–4.63) than non-illiterate counterparts (4.89, 95% CI: 4.84–4.93), a net difference of 0.30 points. These findings highlight that higher educational attainment is consistently associated with healthier lifestyle choices among older adults in resource-limited rural areas. Strengthening rural education and integrating health literacy into public health strategies could be pivotal for promoting healthy aging

Cohort · Cohort study · Educational attainment · Inequality · Literacy · Public health · Rural area · Sedentary lifestyle · Aging and Gerontology Research · Health disparities and outcomes · Technology Use by Older Adults

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