Family members' education differentially shapes later-life health trajectories, with these processes being sensitive to health measures and gender.
Key Findings
Results
Among men, mental health disparities linked to spousal and children's education widened with age, while those by own education remained stable.
Study used hierarchical linear regression models on China Health and Retirement Longitudinal Study (CHARLS) data from 2011–2020
Sample included N = 15,304 individuals aged 45–85, contributing N = 62,836 person-years
Mental health disparities by own education were stable across age for men, but spousal and children's education showed diverging (widening) trajectories
Findings suggest that for men's mental health, the educational resources of family members become increasingly important with advancing age
Results
Among men, physical health disparities by own education were stable with age, while those related to children's education diminished with age.
Physical health trajectories for men showed that own education-based disparities did not significantly change with age
Children's education-based disparities in physical health narrowed (diminished) as men aged
This contrasts with the pattern seen for mental health, indicating health-measure sensitivity in these processes
Data span was 2011–2020 across four waves of CHARLS
Results
Among women, mental health disparities tied to both own education and family members' education widened with age.
Unlike men, women showed widening mental health disparities associated with their own education as they aged
Disparities linked to parental, spousal, and children's education also widened for women's mental health trajectories
This pattern suggests cumulative disadvantage processes are more pervasive across education sources for women's mental health
Sample was drawn from individuals aged 45–85 across China
Results
Among women, physical health disparities driven by own and children's education increased with age, while those associated with spousal education remained stable.
Women's physical health showed diverging trajectories for own education and children's education over the aging period
Spousal education-based physical health disparities for women remained stable rather than widening or narrowing
This gender difference highlights that women's physical health trajectories are more sensitive to intergenerational educational resources than men's
Findings demonstrate that health measure (mental vs. physical) and gender jointly moderate the role of family education
Results
The effects of family members' education on later-life health trajectories varied by both health measure (mental vs. physical) and gender.
The study explicitly examined four education sources: own, parental, spousal, and children's education
No single uniform pattern emerged; each combination of education source, health measure, and gender produced distinct trajectory patterns
For example, children's education widened men's mental health disparities but diminished men's physical health disparities with age
The authors describe these processes as 'sensitive to health measures and gender'
Methods
The study used hierarchical linear regression models applied to four waves of CHARLS data spanning 2011–2020.
Total analytical sample: N = 15,304 individuals aged 45–85 at baseline
Total person-years: N = 62,836
China Health and Retirement Longitudinal Study (CHARLS) was the data source
The longitudinal design allowed examination of health trajectories (change over time) rather than cross-sectional status
Both mental and physical health were included as outcome measures
Conclusions
The authors recommend policies that enhance women's education and support disadvantaged families to reduce health inequalities among aging populations.
Policy implications were specifically directed at women's education given the broader and more pervasive widening disparities observed for women
Support for disadvantaged families was highlighted as a complementary strategy
The Chinese context was noted as important, given cultural norms around family interdependence and gender roles
Findings were framed as relevant to aging population health inequality reduction
What This Means
This research suggests that not only a person's own level of education, but also the education levels of their parents, spouse, and children, can shape how their health changes as they age. Using nearly a decade of data from over 15,000 middle-aged and older adults in China, the researchers tracked both mental and physical health over time and found that these 'family education effects' play out differently depending on whether you are looking at mental or physical health, and whether the person is a man or a woman.
For men, gaps in mental health between those with more- versus less-educated spouses and children grew larger as they got older, while gaps related to their own education stayed constant. For physical health in men, children's education-related gaps actually shrank with age. Women showed a broader pattern of widening health gaps: both their own education and the education of family members were associated with growing mental health disparities over time, and own education and children's education also drove growing physical health gaps. Only spousal education's link to women's physical health stayed stable rather than widening.
This research suggests that in the Chinese context, where family ties are central to elder care and social support, the educational attainment of the broader family unit — not just the individual — has meaningful consequences for health in later life. The findings point to the importance of policies that improve educational opportunities for women and provide extra support to families with lower educational resources, as a way to reduce growing health inequalities among older adults.
Ge T, Han Q. (2026). Whose education matters for later-life health trajectories? A three-generation comparison in China.. International journal of public health. https://doi.org/10.3389/ijph.2026.1609298