The importance of social cohesion and healthy behaviors for healthy ageing in China

Populations are aging, and unhealthy lifestyles and chronic diseases are becoming more prevalent. The global population will include an estimated 1 billion people (about 12.5% of the total population) aged > 65 years by 2030, and older people are predicted to outnumber children aged < 5 years for the first known time in human history. Keeping older people healthy and active in the context of the major achievement of increased life expectancy poses a challenge.

Population ageing is even more pronounced in less developed countries. Given the increased life expectancies globally, investigation of whether additional years of life are likely to be spent in good or poor health is important. In low-and middle-income countries there is a significant health decline as people age. In addition, there is a wide distribution of preventable risk factors, such as tobacco use, insufficient physical activity, obesity, and hypertension.

Healthy lifestyle promotion

The demand for health care has risen as such unhealthy lifestyles have rapidly increased the prevalence of chronic illness, constraining the organisation and delivery of care. This trend can be reversed through the encouragement of healthy ageing by healthy lifestyle promotion. China ranks the list of population ageing as well as unhealthy lifestyles such as smoking. Healthy behaviours can slow age-related declines in health down and may increase the likelihood that older individuals will remain in good health.

Policies and programmes promoting a healthy lifestyle may thus be a good investment, as the combined effects of healthy habits may increase the likelihood of active and healthy ageing. Measures to prevent (increasingly prevalent) chronic diseases and improve health behaviours in older populations are thus considered priorities in the fields of public health, geriatric research, and clinical practice. Such research is currently lacking in low- and middle-income countries.

First research investigating the role of social cohesion on health behaviours

The proposed research will be among the first longitudinal studies to investigate amendable health behaviours and health outcomes in China using a nationally representative sample. Furthermore, this will be the first research investigating the role of social cohesion on health behaviours and outcomes in China using longitudinal data.

With the proposed research we will identify if variations in social cohesion explain variations in population health among groups/regions. These results are expected to contribute to meeting societal, economic, and policy-related challenges associated with China’s ageing population and promote active and healthy ageing.

Important modifiable risk factors

Healthy behaviours have been identified as important modifiable risk factors contributing to chronic illnesses and poor health. Changing social and behavioural patterns affect non-communicable disease risks, which in turn incur high health and economic costs, disproportionately in low- and middle-income countries, especially China.

This research will lead to an increased understanding of the interplay among social cohesion, health behaviours, and health outcomes over time. Theories and empirical evidence on these relationships over time are lacking, especially in China. The scientific advancements of this research will also be disseminated to a broader audience of policy makers and stakeholders (e.g. through publications, presentations, organisation of [mini-]symposia) and are thus likely to have substantial societal, economic, and political impacts.


Increase our understanding of the (longitudinal) relationships between social cohesion, health behaviors and health and quality of life outcomes among older people in China.


PhD thesis (5 papers)

Involved Researchers & Departments

  • Zeyun Feng (PhD candidate), Dr. Jane Cramm & Prof.dr Anna Petra Nieboer - Socio-Medical sciences, ESHPM

Countries Involved



CSC scholarship

Contact info

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Zeyun Feng, PhD candidate

Zeyun Feng, PhD candidate

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