Journal Article

Assessing the impact of COVID-19 on middle-aged and older females in China: a comparative study of urban-rural disparities

Gao, Jie, Jiang, Xiaoxu

2025

Overview

Background The impact of COVID-19 has been long-lasting and severe. Middle-aged and older females, as a vulnerable group, need special attention. China is a typical urban-rural dualistic society, and the impact of the urban-rural gap on middle-aged and older females is unknown. The purpose of this study was to explore the influence of COVID-19 on middle-aged and older females in Chinese urban and rural areas. Methods This study used CHARLS (China Health and Retirement Longitudinal Study) database. A total of 10,063 participants were included in this study (3,680 in urban and 6,383 in rural). The chi-square test and t-test were used to analyze differences between urban and rural participants, and binary logistic regression (forward: conditional) was used to analyze differences in the factors influencing the two groups in terms of mask wearing. Results During the epidemic, there were significant differences between urban and rural middle-aged and older females in terms of demographic characteristics, prevention knowledge, attitude, identification, isolation, personal activities, mental health, containment measures in residential areas and individual preventive behavior. Rural middle-aged and older females had poorer preventive behavior. Age, marital status, preventive knowledge, calling and messaging, internet contact, containment measures in residential areas were the common influencing factors affecting mask wearing behavior of the participants. The mask-wearing behavior of urban participants was also influenced by the attitude towards government’s measures, COVID-19 test and fear. Conclusions Middle-aged and older females in Chinese urban and rural areas faced different situations during the epidemic and required targeted measures.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / At risk populations / Attitudes / Biostatistics / CHARLS / Chi-square test / China - epidemiology / Comparative analysis / Comparative studies / Containment / Coronaviruses / COVID-19 / COVID-19 - epidemiology / COVID-19 - prevention & control / Disease prevention / Disease transmission / Environmental Health / Epidemics / Epidemiology / Female / Females / Gender / Health aspects / Health services utilization / Health Status Disparities / Humans / Knowledge / Longitudinal Studies / Marital status / Masks - statistics & numerical data / Medicine / Medicine & Public Health / Mental health / Middle age / Middle Aged / Middle aged persons / Middle-aged and older females / Nonresidents / Pandemics / Public Health / Quarantine / Residential areas / Rural areas / Rural health / Rural Population - statistics & numerical data / SARS-CoV-2 / Urban areas / Urban health / Urban Population - statistics & numerical data / Urban studies / Urban-rural / Vaccine / Women / Womens health