Abstract: Against the backdrop of accelerated global population ageing, achieving “healthy ageing” has become a critical global policy objective. China faces severe challenges due to its large and rapidly growing older population, compounded by the distinctive national condition of “getting old before getting rich”—ageing at a relatively early stage of economic development. While existing research acknowledges these challenges, empirically grounded, comprehensive measurement frameworks tailored to the Chinese context remain scarce. This study addresses this gap by constructing a multidimensional index and conducting a systematic spatiotemporal analysis of China's healthy ageing levels from 2018 to 2023.

This research addresses three core questions: (1) How can a comprehensive measurement system for healthy ageing be constructed for China, considering China's unique socioeconomic conditions? (2) What are the temporal trends, structural characteristics, and regional disparities in China's healthy ageing levels? (3) Based on empirical findings, what targeted pathways can be proposed for optimization? To answer these questions, we developed a six-dimensional index encompassing physical health, mental health, social participation, living environment, economic security, and health behaviors and knowledge. The analysis integrates nationally representative microdata from the China Longitudinal Aging Social Survey (CLASS) with macro-level statistics from the China Statistical Yearbook. Entropy method is employed for objective weighting to synthesize a composite Healthy Ageing Index (HAI), and kernel density estimation is utilized to analyze distribution dynamics and regional evolution.

The key findings reveal a steady improvement in China's national HAI, rising from 0.1653 in 2018 to 0.2339 in 2023. However, progress is highly uneven across dimensions and regions. Significant gains were observed in the dimensions of physical health, living environment, and health behaviors and knowledge, which emerged as the primary drivers of overall improvement. In contrast, mental health, social participation, and economic security showed minimal improvement, constituting critical and persistent bottlenecks. Furthermore, healthy ageing among China's older population exhibits significant regional disparities and dimensional imbalances.

Based on these empirical findings, this study proposes five interconnected optimization pathways: (1) strengthening the economic security system to solidify the foundation for healthy ageing; (2) constructing community-based psychosocial support networks to address gaps in mental well-being and social inclusion; (3) promoting life-cycle health management to sustain gains in physical health and behavioral improvements; (4) leveraging smart technologies for inclusive, age-friendly environmental upgrades while bridging the digital divide; and (5) cultivating an interdisciplinary talent pool to support the sustainable operation of service systems.

The contributions of our study are threefold. Firstly, it advances the theoretical framework by integrating the World Health Organization's “functional ability” concept with China's specific contextual factors into a coherent, multi-dimensional measurement system. Secondly, it provides a robust longitudinal and spatial analysis of healthy ageing trends in China using recent nationwide data and objective weighting techniques, offering novel empirical evidence on evolving regional patterns and dimensional bottlenecks. Thirdly, in terms of policy relevance, the findings and proposed pathways offer a data-driven, localized roadmap for policymakers to design targeted interventions, contributing to the strategic goals of “Healthy China 2030” and an effective response to population ageing.

Keywords: Population Ageing, Healthy Ageing, Healthy Ageing Index

摘要： 在全球人口加速老龄化的背景下，健康老龄化已成为积极应对人口老龄化的关键策略。本文针对中国老年人口的特点，构建了涵盖生理健康、心理健康、社会参与、生活环境、经济保障、健康知识与行为6个维度的健康老龄化综合测度指标体系。基于中国老年社会追踪调查(CLASS)等多源数据，运用熵值法与核密度估计法，对2018~2023年中国老年人口的健康老龄化水平进行系统测度与时空分析。研究结果显示，中国老年人口的健康老龄化指数由2018年的0.1653提升至2023年的0.2339；生理健康、生活环境、健康知识与行为3个维度的指数明显提升，而心理健康、社会参与和经济保障3个维度的指数提升缓慢。此外，中国老年人口健康老龄化存在显著的区域发展不均衡状况与维度差异。基于此，本文从经济保障、心理—社会支持网络、全周期健康管理、智慧技术赋能及人才培养5个方面提出实现健康老龄化的优化路径。

关键词: 人口老龄化, 健康老龄化, 健康老龄化指数