A new study published in the International Journal of Aging and Human Development estimated that in China 14.3 percent of the population has physical disabilities considered instrumental to daily life—but ethnic minority Chinese in rural China were 44% more likely to have one or more physical disabilities compared to Han Chinese, who form the majority country-wide.

“Ethnic health disparity is still an under-research topic in China, which is surprising given that China is a multiethnic country with 56 ethnic groups,” says the lead author, Shen (Lamson) Lin, a Ph.D. candidate and researcher from University of Toronto’s Factor-Inwentash Faculty of Social Work.

Han Chinese make up 92% of China’s total population. The remaining 55 ethnic groups are officially classified as Chinese ethnic minorities.

The study analyzed data from 16,589 respondents age 45 and older from the 2018 China Family Panel Studies (CFPS), a nationally representative survey conducted by Peking University. The standardized Instrumental Activities of Daily Living (IADL) scale was used to assess older individuals’ ability to perform important self-care activities and independent living skills, such as preparing and eating meals, managing housekeeping, doing laundry, planning transportation, and walking 300 meters without assistance.

In rural areas, 7.6% of those who identified as an ethnic minority reported 3 or more physical disabilities, compared to 4.7% of Han Chinese. No such pattern was observed in the urban population.

Lin’s research also discovered that certain ethnic minority groups in rural China were more susceptible to physical disabilities. Mongolians, Tibetans, and the Yi ethnic minority had more than triple the odds of having three or more physical disabilities relative to Han Chinese. There were no significant differences in physical disabilities for the Miao ethnic minority, Buyi ethnic minority, and Manchu ethnic minority when compared to the Han Chinese.

“Mongolians, Tibetans, and Yi ethnic groups mainly reside in high-altitude mountainous areas in China, such as the Yunnan–Guizhou Plateau, and they have adapted their livelihoods to the unique highland environment, which includes diminished atmospheric pressure, highland climate, and exposure to sun radiation,” said Lin. “The greater risks of physical disabilities among these three groups suggests that the highland habitat, which includes low oxygen and restricted environmental resources, could accelerate the human aging process.”

Lin’s study also demonstrated that cumulative social vulnerabilities—including belonging to an ethnic minority and having lower income and lower levels of education—increased the possibility of having physical disabilities among rural respondents. In rural China, ethnic minority populations from the poorest socioeconomic strata had more than 5 times the odds of having three or more physical disabilities relative to their Han Chinese peers with moderate to high socioeconomic standings, after controlling for other confounding sociodemographic variables.

“My findings have important implications for the Healthy China 2030 policy agenda and the implementation of United Nation’s sustainable development goals in remote rural areas,” said Lin. “A number of promising anti-poverty initiatives have been put in place in China to tackle upstream social inequities that could fundamentally improve older adults’ physical health and well-being; however more social resources need to be redirected to high-altitude mountainous areas in China to improve the living conditions for ethnic minorities—especially those who are socioeconomically disadvantaged.”