Abstract

Objectives

Understanding longitudinal patterns of rural–urban mental health disparities is vital for effective intervention and policy development in China. However, few studies have estimated separate effects of birth-cohort and ageing and examined the role of community resources on health inequalities.

Methods

Drawing data from the China Health and Retirement Longitudinal Study (2011–2018), this study employed multilevel modelling to identify the mental health trajectories of rural, peri-urban, urban older adults by cohort and the community effects.

Results

The changes in the mental health gap between rural, peri-urban and urban older adults over time varied by birth cohorts. Among younger cohorts aged under 65, the mental health disparities between rural, peri-urban and urban residents increased as they got older. Underdeveloped community infrastructure greatly explained the rural health disadvantage.

Conclusion

The study indicates increasing rural–urban health disparities at the onset of later life. Improving community infrastructure in rural and peri-urban areas is vital to minimise rural–urban health gaps.