| With the improvement of medical and health conditions,and the continuous extension of human life expectancy,the global population aging is accelerating.Although China is a developing country,its population aging is almost equal to that of developed countries.In2000,China has entered an aging society,with the accelerating aging process in recent years,how to enable more and more older adults to achieve both "longevity" and "health",that is,to achieve "healthy aging" has become the top priority of the Chinese government's work in new era.In fact,the pressure of China's population aging comes not only from the rapid expansion of the older adults aged 65 and over,but also from the substantial increase in the proportion of the oldest-old.As a vulnerable group among the older adults,the oldest-old are more vulnerable in physical and mental health,economic independence,and social communication.They are more urgent for the care and comfort of life and spirit,their living conditions and satisfaction should attract extreme attention from the society,especially as the contradiction between the people's ever-growing needs for a better life and unbalanced and inadequate development has become the main contradiction in China,improving the quality of life for the oldest-old has become one of the important tasks in people's livelihood field.Therefore,a comprehensive analysis of the quality of life for the oldest-old is not only the fundamental guarantee for the realization of "healthy aging",but also the due meaning of the comprehensive construction of a well-off and a harmonious society.This research based on demographic transition theory,hierarchy of needs theory,social stratification theory,quality of life theory,and man-land relationship theory,combined the research progress on quality of life for the oldest-old at home and abroad systematically,integrated the national census data,statistical yearbook,geographical monitoring data,environmental data,and quality of life questionnaire survey,first construct an index system from a macro scale,with the help of Arc GIS,ENVI,Geo Da and other software platforms,comprehensively assessed the quantity and quality of China's oldest-old.Secondly,take Nanjing city as a case study,use SPSS statistical analysis to construct a theoretical framework for the quality of life of centenarians(a special group of the oldest-old in Nanjing city),and comprehensively evaluated the multi-dimensional and multi-attribute characteristics of their quality of life from a micro scale.Finally,this research used geographic detectors and structural equation modeling technologies to explore the macro and micro factors associated with the quality of life for the oldest-old,and to investigate the causes of quality of life for the oldest-old at macro and micro perspectives comprehensively.This research contains four parts: The first part includes the first and second chapters,which is the basic theoretical section,introducing the research background,significance,goal,method,concept,and research progress at home and abroad.The second part is the empirical analysis,including the third,fourth,fifth and sixth chapters,comprehensively analyzes the quality of life for the oldest-old in China from the macro and micro multiscale perspectives.The third chapter outlines the demographic transition,speed,development level and regional differences of the oldest-old in China;The fourth chapter evaluates the environmental,health,economic,social,and cultural quality of life for the oldest-old from a macro scale;The fifth chapter evaluates the different dimensions and attributes of the quality of life for centenarians in Nanjing city;The sixth chapter analyzes the macro and micro factors influencing the quality of life for the oldest-old.The third part is the seventh chapter contains countermeasures and suggestions,which specifically illustrates the problems and improvement measures of the quality of life for the oldest-old.The fourth part is the eighth chapter,explains the main conclusions,innovations,shortcomings and prospects of this research.The conclusions are as follows:(1)There are more women oldest-old than men in China,and more oldest-old are living in rural areas rather than town areas.The growth rate of the oldest-old is accelerating,and could be divided into four stages: rapid growth period,steady growth period,rapid development period,and stagnation period.The development speed of the oldest-old become increasingly prominent,from the "one" pattern to a "point-to-surface" pattern,and the development speed is inconsistent with economic development.The development degree of the oldest-old continued to deepen,manifests in the expansion from the coast to the inland,southeast to northwest,and maintained relative consistency with the "Hu-Line".Affected by socio-economic development,urbanization,and the inertial shift of the age structure of the population,the overall spatial differences in oldest-old is shrinking,and the intra-regional differences are the main reason for the reduction of the overall differences.(2)The quality of life for the oldest-old in China generally presents an "Eastern,Central and Western Gradient Zones" pattern,forming a gradual decline in the spatial layout of the eastern Beijing-Tianjin-Hebei,Yangtze River Delta,and Pearl River Delta to the central and western regions.Spatial hotspots present the "group cluster" and "ribbon extension" patterns.Although the five quality of life elements of environment,health,economy,society,and culture that constitute the comprehensive quality of life have different spatial layouts,they generally conform a decreasing distribution pattern from east to west.Among them,the five provinces in the first echelon of quality of life are Beijing,Shanghai,Guangdong,Jiangsu and Zhejiang.In addition,the different elements evaluation results show that the overall economic and social life quality is low,and cultural life quality has the highest evaluation score among the five elements.(3)The quality of life for centenarians in Nanjing city is at an intermediate level.The quality of life in centenarians is composed of four dimensions: physical health,psychological support,socioeconomic status,and sensory ability.Centenarians' psychological support is at a moderately high level,and socioeconomic status,physical health and sensory abilities are at a moderately low level.There are significant differences in the quality of life for centenarians of different gender,age,household registration type,and marital status.The results show that centenarians who are male,over 105 years old,have urban household registration,and being married have higher quality of life.(4)On a macro perspective,the factors associated with quality of life for the oldestold are selected from four parts: population structure,family size,economic development level,and social security,and 10 hypotheses are proposed.Among them five hypotheses are verified and will have an impact on the quality of life of the oldest-old,they are "social assistance expenditure per capita","social welfare expenditure as proportion of GDP","per capita GDP","urbanization level",and "average household size".And the superimposition of various factors on the regional differences in the quality of life for the oldest-old is manifested as double-factor enhancement or nonlinear enhancement.(5)On a micro perspective,the factors influencing centenarians' quality of life are verified and analyzed from the four dimensions based on the results of exploratory factor analysis: psychological support,socioeconomic status,physical health,and sensory ability.The results show that socioeconomic status and physical health are significantly associated with the quality of life in centenarians,while psychological support is not associated with centenarians' quality of life.(6)The quality of life in the oldest-old has three problems: uneven regional development,the quality of social and economic life needs to be improved,and the physical health and socio-economic status need to be strengthened.In the future,the country and the government should provide policy guarantees for the improvement of the quality of life for the oldest-old at the macro perspective such as coordinate regional development,establish a medical security system covering urban and rural areas,and gradually promote a national overall plan for the basic old-age security system.The community should strengthen service functions,establish a diversified community older adults care service system,promote the construction of an intelligent older adult's care service system,and create a community environment that respects and assists the oldest-old.In addition,the oldest-old themselves should strive to receive re-education through various channels,actively participate in leisure activities,and improve their quality of life in all aspects individually. |
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