To explore the influencing factors of health poverty among the elderly in China and provide a basis for improving the health poverty situation of the elderly.

Based on the health ecology theory, this study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) in 2020, selecting the elderly aged 60 and above as the research subjects.The occurrence of health poverty among the elderly was taken as the dependent variable, and independent variables were included from five dimensions: personal traits, behavioral characteristics, interpersonal networks, family living environment, and policy systems. Chi-square tests and stratified Logistic regression analyses were conducted for statistical processing.

Age (70-79 years old, OR=1.416, 95% CI: 1.248-1.606; 80 years old and above, OR=1.583, 95% CI: 1.263-1.983), having three or more chronic diseases (OR=1.464, 95% CI: 1.300-1.649), self-rated health (fair, OR=0.449, 95% CI: 0.366-0.550; good, OR=0.335, 95% CI: 0.256-0.438; very good, OR=0.314, 95% CI: 0.238-0.415), drinking alcohol (OR=0.833, 95% CI: 0.735-0.944), marital status (married, OR=2.655, 95% CI: 2.062-3.419), family size (2 people, OR=0.567, 95% CI: 0.425-0.756; 3 people or more, OR=0.218, 95% CI: 0.163-0.292), per capita high income of the family (OR=0.782, 95% CI: 0.672-0.911), medical insurance type (urban and rural residents’ medical insurance, urban residents’ medical insurance, new rural medical insurance, OR=1.296, 95% CI: 1.052-1.596), and central region (OR=0.755, 95% CI: 0.643-0.887) were all important factors influencing the incidence of health poverty among the elderly.

The incidence of health poverty among the elderly in China is relatively high, and factors at different levels have significant impacts on the occurrence of health poverty among the elderly, with interactions among these factors. Therefore, it is necessary to take a multi-dimensional approach and comprehensively consider individual, family, social, and policy factors to effectively improve the health poverty situation of the elderly.