Original Article

The Impact of Different Levels of Physical Activity on Health among Middle-Aged and Elderly Chinese Adults


Background: There is a lack of specific study of the impact of physical activities on middle-aged and elderly adults in developing countries. We aimed to investigate the causal impact of different levels of physical activity on self-rated health status for Chinese adults with an average age of 61 yr from years 2011 to 2015.

Methods: China Health and Retirement Longitudinal Study (CHARLS) conducted by the Peking University of China was utilized which was a longitudinal database and thus allowed to control for the effect of unobserved individual heterogeneities. In this study, this control was carried out using fixed effect and propensity score matching methods. In addition, this study further took into consideration of the discrete feature of our response variable, self-rated health status, by applying an ordered logit model.

Results: Participating in moderate-to-vigorous physical activity significantly increased individuals’ self-rated health status (P<.05) whereas lower intensity physical activity did not increase individuals’ self-rated health status.

Conclusion: Moderate-to-vigorous physical activity is an important instrument to improve the health status of middle-aged and elderly population in China. Government should encourage people to involve in more moderate-to-vigorous physical activity as it is an efficient way to improve individuals’ health status. 

1. Warburton DE, Nicol CW, Bredin SS (2006). Health benefits of physical activity: the evidence. CMAJ, 174(6):801-9.
2. NHS (2018). Physical activity guidelines for older adults. https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-older-adults/
3. NHS (2018). Physical activity guidelines for adults https://www.nhs.uk/live-well/exercise/
4. The State Council of the People's Republic of China (2016). National fitness program (2016-2020). http://www.gov.cn/zhengce/content/2016-06/23/content_5084564.htm (in Chinese)
5. Sherwood NE, Jeffery RW (2000). The behavioral determinants of exercise: implications for physical activity interventions. Annu Rev Nutr, 20(1):21-44.
6. Brown WJ, Burton NW, Rowan PJ (2007). Updating the evidence on physical activity and health in women. Am J Prev Med, 33(5):404-11. e25.
7. Tsang HW, Chan EP, Cheung WM (2008). Effects of mindful and non‐mindful exercises on people with depression: a systematic review. Br J Clin Psychol, 47(3):303-22.
8. Janssen I, LeBlanc AG (2010). Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Act, 7(1):40.
9. Faraoni D, Schaefer ST (2016). Randomized controlled trials vs. Observational studies: why not just live together? BMC Anesthesiol, 16(1):102.
10. Schillaci G, Battista F, Pucci G (2013). Are observational studies more informative than randomized controlled trials in hypertension? Hypertension, 62(3):470-6.
11. Humphreys BR, McLeod L, Ruseski JE (2014). Physical activity and health outcomes: evidence from canada. Health Econ, 23(1):33-54.
12. Lechner M (2009). Long-run labour market and health effects of individual sports activities. J Health Econ, 28(4):839-54.
13. Rasciute S, Downward P (2010). Health or happiness? What is the impact of physical activity on the individual? Kyklos, 63(2):256–70.
14. Pawlowski T, Schüttoff U, Downward P, Lechner M (2018). Can sport really help to meet the millennium development goals? Evidence from children in peru. J Sports Econom, (No.4):498-521.
15. Driediger M, Vanderloo LM, Truelove S, Bruijns BA, Tucker P (2018). Encouraging kids to hop, skip, and jump: Emphasizing the need for higher-intensity physical activity in childcare. J Sport Health Sci, 7(3):333-6.
16. Samitz G, Egger M, Zwahlen M (2011). Domains of physical activity and all-cause mortality: Systematic review and dose-response meta-analysis of cohort studies. Int J Epidemiol, 40(5):1382-400.
17. Gu LB, Feng HH, Jin J (2017). Effects of medical insurance on the health status and life satisfaction of the elderly. Iran J Public Health, 46(9):1193-203.
18. Chiao C, Ksobiech K, Wei CY (2014). National health insurance and life satisfaction in late life: Longitudinal findings from a natural experiment in taiwan. J Public Health (Oxf), 36(2):308-16.
19. Tamiya N, Noguchi H, Nishi A, et al (2011). Japan: Universal health care at 50 years 4 population ageing and wellbeing: Lessons from japan's long-term care insurance policy. Lancet, 378(9797):1183-92.
20. O'Donovan G, Blazevich AJ, Boreham C, Cooper AR, et al (2010). The abc of physical activity for health: A consensus statement from the british association of sport and exercise sciences. J Sports Sci, 28(6):573-91.
21. Li X, Zhang W (2013). The impacts of health insurance on health care utilization among the older people in China. Soc Sci Med, 85:59-65.
22. Deng YZ, Paul DR (2018). The relationships between depressive symptoms, functional health status, physical activity, and the availability of recreational facilities: a rural-urban comparison in middle-aged and older chinese adults. Int J Behav Med, 25(3):322-30.
23. Johnson BT, Acabchuk RL (2018). What are the keys to a longer, happier life? Answers from five decades of health psychology research. Soc Sci Med, 196:218-26.
24. Rosenbaum PR, Rubin DB (1983). The central role of the propensity score in observational studies for causal effects. Biometrika, 70(1):41-55.
25. Mensah J, Oppong JR, Schmidt CM (2010). Ghana's national health insurance scheme in the context of the health mdgs: an empirical evaluation using propensity score matching. Health Econ, 19(S1):95-106.
26. Rosenbaum PR, Rubin DB (1985). Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Stat, 39(1):33-8.
27. Baetschmann G, Staub KE, Winkelmann R (2015). Consistent estimation of the fixed effects ordered logit model. J R Stat Soc Ser A Stat Soc, 178(3):685-703.
28. Winkelmann L, Winkelmann R (1998). Why are the unemployed so unhappy?Evidence from panel data. Economica, 65(257):1-15.
29. Chamberlain G (1979). Analysis of Covariance with Qualitative Data. National Bureau of Economic Research Cambridge, Mass, USA.
30. NHS Digital (2017). Statistics on obesity, physical activity and diet. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/613532/obes-phys-acti-diet-eng-2017-rep.pdf
31. Andreff W (2001). The correlation between economic underdevelopment and sport. Eur Sport Manag Q, 1(4):251-79.
32. Li F, Liu Y, Harmer PA (2016). Physical activity, aging, and health in China: Addressing public health needs in the presence of continued economic growth and urbanization. J Sport Health Sci, 5(3):253-4.
33. Zhu W, Chi A, Sun Y (2016). Physical activity among older Chinese adults living in urban and rural areas: a review. J Sport Health Sci, 5(3):281-6.
34. Rognmo Ø, Hetland E, Helgerud J, Hoff J, Slørdahl SA (2004). High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil, 11(3):216-22.
35. Schwarz AJ, Brasel JA, Hintz RL, Mohan S, Cooper DM (1996). Acute effect of brief low- and high-intensity exercise on circulating insulin-like growth factor (IGF) I, II, and IGF-binding protein-3 and its proteolysis in young healthy men. J Clin Endocrinol Metab, 81(10):3492-7.
36. Tong Y, Jun M, Yan JIANG JL, Yunlong Gen YW, Wenjie S (2018). Assessing pain among Chinese elderly-chinese health and retirement longitudinal study. Iran J Public Health, 47(4):553-60.
IssueVol 48 No 11 (2019) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v48i11.3515
Physical activity Self-rated health status Propensity score matching

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How to Cite
GUAN J, WANG G, GENG C. The Impact of Different Levels of Physical Activity on Health among Middle-Aged and Elderly Chinese Adults. Iran J Public Health. 2019;48(11):1971-1978.