ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1602953
This article is part of the Research TopicHealth Promotion Through The Life Stages: from Newborn to the ElderlyView all articles
Unclosed Wound: Effect of Childhood Access to Healthcare on Cardiovascular Health Trajectories of Chinese Older Adults Based on Entropy Balancing Analysis
Provisionally accepted
- 1School of Social Development and Public Policy, Fudan University, Shanghai, Shanghai Municipality, China
- 2Institute of Population Research, Peking University, Beijing, China
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Background: Cardiovascular Diseases (CVD) remain a leading threat among aging populations globally, with Cardiovascular Health (CVH) trajectories shaped by cumulative exposures across the life course. understanding these life-course connections is urgent to inform equitable geriatric care strategies. Objective: This study aims to examine the long-term trajectories of CVH and the association between Childhood Access to Healthcare (CAH) and CVH trajectories in Chinese older adults. Methods: Data were obtained from Chinese Longitudinal Healthy Longevity Study (CLHLS). A composite CVH score was established based on the American Heart Association's (AHA) guidelines. Group-Based Trajectory Modeling (GBTM) was employed to identify distinct CVH trajectories over time. Multi-logistic regression was used to analyze the association between CAH and CVH trajectories. To minimize potential confounding and selection bias, entropy balancing was applied to balance covariates between the treatment and control groups.Results: Three distinct CVH trajectories were identified: Low-rapid decline (25.2%), Moderatestable (65.7%), and High-stable (9.1%). Compared with high-stable trajectory, individuals with CAH were associated with lower likelihood in moderate-stable trajectory (Adjusted and balanced OR = 0.61, 95% CI: 0.44 -0.85, p < 0.01) and low-rapid decline trajectory (Adjusted and balanced OR = 0.63, 95% CI: 0.44 -0.90, p < 0.05), suggesting that CAH was associated with more favorable longterm CVH outcomes. Subgroup analysis indicated that the association was generally stable across different populations.Conclusions: CAH significantly influences the long-term CVH trajectories of older adults in China.These findings underscore the need for public health interventions that prioritize childhood healthcare access to reduce the burden of CVD in the aging population.These survey data are free and publicly available, and can be downloaded directly from the CLHLS website (https://opendata.pku.edu.cn/dataset.xhtml?persistentId=doi:10.18170/DVN/WBO7LK) by users and researchers worldwide.
Keywords: Childhood Access to Healthcare, Cardiovascular health, Group-based trajectory modeling, entropy balancing, older adults
Received: 04 Apr 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Mao, Fang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Boshu Mao, School of Social Development and Public Policy, Fudan University, Shanghai, 200433, Shanghai Municipality, China
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