| BackgroundChina is experiencing rapid aging.By 2030,China will become the most aging country in the world.The prevalence of chronic diseases in the elderly is 4.2 times higher than that of the whole population,which is a high incidence of chronic diseases.The health problems of the elderly will bring heavy economic burden to the family and the whole society.Healthy behavior can affect health.At the same time,smoking and drinking have become a worldwide public health problem.In order to deal with the aging of the population actively,reduce the incidence of chronic diseases,and improve health-related behaviors,the CPC Central Committee and the State Council issued formal social systems such as "the outline of the 203u Plan for healthy China"to guide people.s healthy behavior.As an informal system,social capital plays an important role in promoting health.ObjectiveThe purpose of this paper was to analyze the smoking of the elderly aged 60 years and over through theoretical research and empirical analysis using the longitudinal data of the China Health and Retirement Longitudinal Study in 2011 and 2015.Different levels(individual/community)social capital factors are used to analyze the effects of smoking and drinking behaviors.Improving the health of the elderly provides scientific evidence and policy recommendations.MethodsThe study collected the required variables using Chinese health and old-age tracking questionnaire.According to the research needs,the 2011 national baseline survey data and 2015 national tracking survey data were selected for analysis.The subjects were over 60 years of age,including socio-demographic information,socio-economic status,health status,community/individual social capital information and smoking and drinking information.Through the process of extracting,sorting,culling,merging and so on,the number of valid samples is 7686.In this study,description analysis,Chi-square test and other methods were used to analyze the smoking and drinking behaviors of the elderly and the influencing factors,the data analysis was mainly completed by statistical software Stata14.0.A two-level logistic regression model was used to analyze the smoking and drinking behavior of the elderly over 60 years old.The data was fitted to the two-level model using the multi-level analysis software MLwiN2.30.Results(1)Among the individual-level social capital,47.32%of the elderly have lower social trust;most of the elderly have emotional support and financial support;94.89%of the elderly don’,t have reciprocal behavior;there are 3,909 elderly without any social participation activities accounted for 50.86%.(2)The proportion of non-smokers(51.18%)was slightly higher than that of smokers(48.82%);among the elderly who smoked,the proportions of mild,moderate and heavy smoking were 16.19.%,17.67%and 14.96%.The proportion of non-drinkers(55.90%)was slightly higher than that of drinkers(44.10%);the proportion of moderate drinking and excessive drinking were 37.48%and 6.62%,respectively.(3)The results of single factor analysis showed that the difference of sex,age,place of residence,living way,marital status,education level,type of medical insurance,self-rated health status,the condition of chronic disease and BMI were of statistical significance in the factors of influencing the smoking behavior of the elderly(P<0.05).There were significant differences in individual-level social capital,social trust,economic support,reciprocity and social participation(P<0.05).Multivariate analysis showed that social participation at the individual level(OR=1.141,P = 0.005)was a risk factor for smoking behavior of the elderly;social trust at the individual level(OR = 0.792,P<0.001)and community social support(OR=0.853,P = 0.001)were protective factors for smoking behavior of the elderly.(4)The social capital variables at the community-level were used to analyze the smoking behavior of the elderly at two levels.The results of multi-factor analysis showed that men over 75 years old,urban communities lived,non-married,middle-high economic level,self-rated health status of general or poor and drinking behavior were a risk factor for smoking behavior;the level of secondary and higher education and basic medical insurance were the protective factors of smoking;In the variables of social capital,higher social trust,higher community-level social support and community-level reciprocal behavior were the protective factors of smoking behavior,while higher individual-level social participation and community-level social participation will increase the risk of smoking in the elderly.(5)The results of single factor analysis showed that the difference of sex,age.place of residence,marital status,education level,type of medical insurance,economic level,self-rated health status,the condition of chronic disease and BMI were of statistical significance in the factors of influencing the smoking behavior of the elderly(P<0,05).There were significant differences in individual-level social capital,social trust,reciprocity and social participation(P<0.05).Multivariate analysis showed that community-level social trust(OR =0.825.P=0.001)was a protective factor for the elderly’s drinking(?)havior.(6)The social capital variables at the community-level were used to analyze the drinking behavior of the elderly at two levels.The results of multi-factor analysis showed that men over 75 years old,urban communities lived.,non-married,non-literate,normal BMI,only living with the spouse and drinking behavior were a risk factor for drinking behavior;the level of secondary and higher education and self-rated health status of general and higher community-level social support were the protective factors of drinking behavior.Conclusions and SuggestionsThis study used the China Health and Retirement Longitudinal Study 2011 and 2015 survey data to find that gender,age,place of residence,marital status,education level,annual per capita consumption level,self-rated health status and BMI were influencing factors of smoking and drinking behaviors.Through the use of two-level model to analyze the relationship between social capital and smoking and drinking,it is found that individual-level social trust and community-level social support were the protective factors of smoking behavior.Individual-level social participation and community-level social participation were the risk factor of smoking behavior.Community-level social trust was a protective factor for drinking behavior.Therefore,in order to improve the health behavior of the elderly and improve the healthy life quality of the elderly,we propose the following policy recommendations:(1)Create a harmonious and loving social environment and improve the level of social trust.The government must create a harmonious social environment actively,ease social conflicts,and promote the establishment of good social relations.(2)The government must constantly improve the social security system,actively speed up the pace of popularizing the old-age insurance,the nursing insurance for the elderly and the medical insurance system,increase the scope of medical care for the social security,and provide multiple security for the elderly.Promote the family,the community,the government three levels of social support system construction.(3)Increase investment in community infrastructure and increase the enthusiasm of all employees for social participation.The government will set up a special fund project to invest in community activities for the elderly.While encouraging the elderly to participate actively in the society,it is necessary to guide the elderly to participate selectively in the social participation activities which are conducive to their healthy development and to promote the establishment of healthy behaviors.(4)The state should continuously strengthen health education so that the common sense of smoking,drinking and other harmful health is deeply rooted in the hearts of the people,and advocates a healthy social interaction environment and culture. |
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