Work-family Trajectories and Later-life Health in China

The academic recognition that work-family roles are relevant determinants of health over the life course requires more empirical evidence from contexts in the Global South, such as China, where rapid social changes and widening health inequalities among the older population coexist. This research aims to explore the associations between combined work-family trajectories and health outcomes among Chinese older adults from life course and gender perspectives. Using data from the China Health and Retirement Longitudinal Study (CHARLS), this study used sequence and cluster analysis on individuals’ work-family trajectories from age 16 to 50 among those born between 1935 and 1964. Multivariate linear regressions were then utilized to assess associations between work-family trajectories and health outcomes (chronic diseases and depressive symptoms). Results show that distinctive life course paths underlie health inequalities at older ages, with varying effects on men and women. Individuals following work-family trajectories characterized by protective roles and transitions—such as employment in non-agricultural occupations and enduring marriages—experience better health outcomes in later life. Conversely, trajectories involving disadvantageous roles, including employment in agricultural occupations, economic inactivity, higher fertility, and unmarried childbearing, are associated with poorer health. Notably, health variations across work-family trajectories are greater for women than men, and women face worse health outcomes than men, though this gender disparity narrows with employment in non-agricultural occupations. • Work-family trajectories show greater health divergence for women than men. • Shifting to non-agricultural jobs lowers depressive risks for both men and women. • Agricultural work paths show no health advantage over economic inactivity. • Lifelong childlessness predicts fewer chronic diseases for both men and women. • Early fertility is linked to worse health conditions especially among women.