Association between residential greenness and general health among older adults in rural and urban areas in China

While it is widely recognized that exposure to residential greenness is beneficial to older adults’ health and wellbeing, surprisingly few studies have examined whether the health-promoting effect of residential greenness varies between urban and rural populations in China, a rapidly urbanizing country. In addition, most previous studies on residential greenness-health associations in China have used data collected in a particular city instead of the entire country, resulting in insufficient statistical power and inadequate generalizability. This study assessed the relationship between the amount of surrounding greenness at the township-level and self-rated general health at the individual-level among older adults across the entire country of China, using the geo-referenced micro-data sample of the 2010 China population census and multilevel logistic models. Results indicated that Normalized Difference Vegetation Index (NDVI) was positively associated with self-rated health among all older people, and that the NDVI-health association was stronger in high-density urban areas relative to low-density urban areas and rural areas. Furthermore, the association was stronger for participants who were younger, higher-educated, and non-agricultural hukou holders. Our findings provide evidence in support of China’s recent endeavour to promote an eco-friendly and greener development strategy.