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This study explores the disparities in older adults' self-rated health within the urban landscape of China. Drawing on the 1% national population survey of China in 2015, it highlights how variations in city development contribute to geographical health disparities among older residents. In the era of the decentralized fiscal system, a crucial mechanism identified is the role of cities' local fiscal revenue in connecting their socioeconomic development and the health status among older adults. Despite efforts by cities in lower socioeconomic positions to increase fiscal expenditure and address deficits through central transfer payments, they prove inadequate in effectively mitigating population health disparities. The prioritization of economic growth and neglect of public service provision responsibilities are fundamental causes within this fiscal framework. The findings underscore the urgent need for increased central transfer payments in public services to address the growing disparities in older adults' health. • Revealing health disparity among urban older adults amidst fiscal decentralization. • Local fiscal revenue connecting cities' development and individual health. • Ineffectiveness of local fiscal expenditure and deficit in alleviating disparities. • Urgency for leveraging public transfer payments toward public health services. [ABSTRACT FROM AUTHOR]

Objective: Self-rated health represents a reliable and important health measure related to general health and quality of life. This study aimed to identify the differences of health states of rural residents in a lower middle income setting in China and its associated factors. Methods: A descriptive study of a stratified random sample of 3870 individuals was conducted in rural Anhui during 2015. We investigated the influence of five independent variables: individual demographic characteristics, family factors, social capital traits, physical health conditions and healthy lifestyle habits of participants who self-related their health as good. A chi-square test and ordinal logistic regression analyses were used to identify the relationship of these variables and self-rated health. Results: The study found that respondents who negatively rated their health often were female, elderly, poor, lived alone, had low levels of education, inadequate social support, poor physical health, used healthcare services and lived in the lower economic regions. We found no significant correlations between self-rated health and employment, marital status, medical insurance, or exercise frequency. Surprisingly, smoking and drinking also seemed to be unrelated to poor self-reported health. Conclusion: Health differences based on region were apparent in rural China. We highlighted the possible impacts of income, age, physical health, education, advanced age, and social support on health. The results from this study could inform the delivery of appropriate health and social healthcare interventions to promote rural residents' health and quality of life. [ABSTRACT FROM AUTHOR]