The effect of Internet access on body weight: Evidence from China

The effect of internet use on the health of middle-aged and older adults: evidences from China general social survey

BACKGROUND

According to the United Nations classification of aging societies, China is rapidly transitioning into a moderately aging society, facing significant challenges related to population aging. Concurrently, China is actively implementing the Internet Power Strategy and the Internet Plus action plan, which are profoundly transforming the daily lives of individuals, including their health status. However, research on the impact of internet use on the health of middle-aged and older adults has not reached a consensus. This study aims to investigate the effects of internet use on the health of middle-aged and older adults, as well as the mechanisms and heterogeneity of these effects.

METHODS

This study utilized data from the China General Social Survey conducted in 2018, which includes a sample of 6470 individuals. Self-rated health, mental health, and objective health were used as key health indicators, with internet use identified as the primary independent variable. The study aims to analyze the impact of internet use on the health status of middle-aged and older adults through the application of an ordered probit model and instrumental variable methods.

RESULTS

The results indicate that internet use has a significant positive impact on the health of middle-aged and older adults, with significance at the 1% level. This finding has passed a series of robustness tests. Mechanism analysis reveals that information acquisition is a crucial mediating mechanism between internet use and the health of middle-aged and older adults. This suggests that increased internet use enhances information access, thereby improving health outcomes. Furthermore, heterogeneity analysis shows that the impact of internet use on health is more pronounced among individuals living in rural areas, western regions, low-income groups, and those aged under 60, compared to their counterparts in urban areas, eastern regions, higher-income brackets, and those aged 60 and above.

CONCLUSION

Internet use can improve the health of middle-aged and older adults. Therefore, government departments, senior universities, communities, and families should collaborate to actively conduct digital skills training for older adults. Additionally, efforts should be accelerated to adapt electronic products to be more elder-friendly, helping older adults overcome the digital divide and thereby reducing health inequalities among middle-aged and older groups.

The fattening speed: Understanding the impact of internet speed on obesity, and the mediating role of sedentary behaviour

We examine the impact of access to high-speed internet on obesity. Using 14 waves of longitudinal data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and a newly constructed dataset on the rollout and adoption rate of the National Broadband Network (NBN) across Australian postcodes, we find that access to high-speed internet has a positive effect on obesity. Specifically, our preferred instrumental variable estimates, which predict the variation in timing and location of internet access upgrades, suggest that a 1 % increase in the proportion of a postcode that has access to NBN is associated with a 1.573 increase in Body Mass Index and a 6.6 percentage point increase in the probability of being obese. These results are robust to several checks and alternative specifications. We also find that sedentary behaviour and inactivity are mechanisms through which access to high-speed internet transmits to obesity.

Mediating Effects of Information Access on Internet Use and Multidimensional Health Among Middle-Aged and Older Adults: Nationwide Cross-Sectional Study

BACKGROUND

With the exacerbation of population aging, the health issues of middle-aged and older adults have increasingly become a focus of attention. The widespread use of the internet has created conditions for promoting the health of this demographic. However, little is known about the effects of information access in promoting the relationship between internet use and the health of middle-aged and older adults.

OBJECTIVE

This study aims to examine the relationship between internet use and multidimensional health in middle-aged and older adults, as well as the mediating effect of information access. Moreover, this study will explore the relationship between other dimensions of internet use (purposes and frequency) and health.

METHODS

Data were sourced from the China General Social Survey conducted in 2018. Health outcomes, including self-rated, physical, and mental health, were assessed using the 5-level self-rated health scale, the 5-level basic activities of daily living scale, and the 5-level depression scale, respectively. The ordinal logistic regression model was used to examine the relationship between internet use and health among middle-aged and older adults. Additionally, the Karlson-Holm-Breen decomposition method was used to examine the mediation effect of information access. To address endogeneity issues, the two-stage least squares approach was applied.

RESULTS

In our sample, nearly half (n=3036, 46.3%) of the respondents use the internet. Regression analyses revealed that internet use was positively associated with self-rated health (odds ratio [OR] 1.55, 95% CI 1.39-1.74; P<.001), physical health (OR 1.39, 95% CI 1.25-1.56; P<.001), and mental health (OR 1.33, 95% CI 1.19-1.49; P<.001) of middle-aged and older adults. Various dimensions of internet use positively contribute to health. In addition, information access significantly mediated the relationship between internet use and self-rated health (β=.28, 95% CI 0.23-0.32), physical health (β=.40, 95% CI 0.35-0.45), and mental health (β=.16, 95% CI 0.11-0.20). Furthermore, there were significant differences in the relationship between internet use and health among advantaged and disadvantaged groups.

CONCLUSIONS

The study showed that different dimensions of internet use are associated with better self-rated health, better physical health, and better mental health in middle-aged and older adults. Information access mediates the relationship between internet use and health. This result emphasizes the significance of promoting internet access as a means to enhance the health of middle-aged and older adults in China.

Impact of mobile Internet use on health-seeking behaviors: evidence from China

Introduction

Although health-seeking behaviors are crucial to China's healthcare delivery system, the influence of mobile Internet use in this context remains under-explored. This study aimed to comprehensively explore the influence of mobile Internet use on health-seeking behaviors, and meticulously examined the heterogeneity in health outcomes associated with the intersection between mobile Internet use and health-seeking behaviors.

Methods

We used nationally representative data derived from the China Family Panel Studies. Given that individuals typically make the decision to use mobile Internet autonomously, an instrumental variable regression methodology was adopted to mitigate potential selection biases.

Results

Our findings revealed that mobile Internet use significantly promoted self-medication and adversely affected the use of primary care facilities among Chinese adults. Furthermore, our findings highlighted the heterogeneous effects of mobile Internet use across diverse health demographic groups.

Conclusion

These findings underscore the importance of strategic planning and utilizing mobile Internet resources to steer individuals toward more appropriate healthcare-seeking behaviors.

The hidden cost of sophistication: economic complexity and obesity

Obesity has become a global health crisis, affecting people of all ages, regions, and socio-economic backgrounds. While individual behaviour and genetic factors contribute to obesity, the role of economic complexity in the evolution of obesity rates has not yet been empirically studied. Using a large panel of 110 countries over the period 1976-2015, this article estimates the linear and non-linear links between obesity and economic complexity. According to baseline results, an improvement in economic complexity will lead to an increase in obesity up to a certain threshold. Beyond this turning point, any further increase in economic complexity will significantly contribute to obesity reduction. The issue of simultaneity is tackled using the two-stage instrumental variable method. Our findings support the Obesity Kuznets Curve (OKC) pattern, which suggests that economic progress and obesity have an inverted U-shaped relationship. Our results suggest that greater embeddedness of knowledge in the products produced and exported by a country increases the likelihood of obesity in society, at least up to a threshold. From these results, some important policy implications are discussed.

Effects of mobile Internet use on the health of middle-aged and older adults: evidences from China health and retirement longitudinal study

The rapid development of digital technology has radically changed people's lives. Simultaneously, as the population is rapidly aging, academic research is focusing on the use of Internet technology to improve middle-aged and older people's health, particularly owing to the popularity of mobile networks, which has further increased the population's accessibility to the Internet. However, related studies have not yet reached a consensus. Herein, empirical analysis of the influence of mobile Internet use on the subjective health and chronic disease status of individuals in their Middle Ages and above was conducted utilizing ordered logit, propensity score matching (PSM), and ordered probit models with data from the 2020 China Health and Retirement Longitudinal Study. The study aimed to provide a theoretical basis and reference for exploring technological advances to empower the development of a healthy Chinese population and to advance the process of healthy aging. The health of middle-aged and older adults mobile Internet users was greatly improved, according to our findings. Further, the use of mobile Internet by these persons resulted in improvements to both their self-assessed health and the state of their chronic diseases. As per the findings of the heterogeneity analysis, the impact of mobile Internet use was shown to be more pronounced on the well-being of middle-aged persons aged 45-60 years compared to those aged ≥ 60 years. Further, the endogeneity test revealed that the PSM model could better eliminate bias in sample selection. The results suggest that the estimates are more robust after eliminating endogeneity, and that failure to disentangle sample selectivity bias would overestimate not only the facilitating effect of mobile Internet use on the self-assessed health impacts of middle-aged and older adults, but also the ameliorating effect of mobile Internet use on the chronic diseases of middle-aged and older adults. The results of the mechanistic analysis suggest that social engagement is an important mediating mechanism between mobile Internet use and the health of middle-aged and older adults. This implies that mobile Internet use increases opportunities for social participation among middle-aged and older adults, thereby improving their health.

Improving health and reducing health inequality: An innovation of digitalization?

RATIONALE

The association between digitalization and individual health has attracted increasing attention from both scholars and policymakers. Existing research, however, has not agreed on whether digitization can improve health or reduce health inequality.

OBJECTIVE

The purpose of this study is to clarify whether and how the development of digitalization may be related to health and health disparities.

METHODS

We rely on China Family Panel Studies (CFPS) surveys from 2012 to 2018 to obtain a sample of 82,471 observations to explore the impact of digitalization on self-rated health and health inequality and its transmission mechanisms. The hypotheses are tested by Ordinary Least Squares Modeling.

RESULTS

As expected, digitalization is significantly and positively correlated with self-rated health. Furthermore, the development of digitalization has led to a notable decrease in health inequality. The influencing mechanisms of digitalization include income, healthcare consumption and health behaviors. Both dimensions of digitalization-internet development and digital finance-generate significant effects and the effects of internet development are greater.

CONCLUSIONS

This study is the first to systematically investigate the impact of digitalization development on health and health inequality. Our findings provide evidence for the health promotion theory by clarifying the benefits of digitalization in improving residents' health and reducing health inequality. Therefore, utilizing the tools of digitalization efficiently could be a focus of policymakers aiming to accomplish the SDGs' health targets.

The effect of Internet use on nutritional intake and health outcomes: new evidence from rural China

Introduction

Internet use is changing nutritional intake and health outcomes, but the results are mixed, and less attention is given to the rural developing regions. Based on the China Health and Nutrition Survey (CHNS) data from 2004 to 2015, this study seeks to better understand the effect of Internet use on nutritional intake and health outcomes.

Methods

An instrumental variable estimation is used to address endogeneity problem.

Results

The results show that Internet use improves the dietary knowledge of rural residents, and thus has a positive impact on dietary quality, such as healthy eating index (HEI) and dietary diversity score (DDS). The higher the dietary quality, the better the nutritional health status. However, results also show that Internet use increases the risk of overweight, and obesity among rural Chinese residents. Because Internet use has significantly reduced the physical activity of rural residents in China. Interestingly, we also find that the Internet increases the risk of chronic diseases such as diabetes and high blood pressure, but there is a positive causal relationship between Internet use and the self-assessment score of health.

Discussion

Our findings suggest that there may be a serious lack of awareness of the health risks of chronic diseases among Chinese rural residents. Therefore, policymakers are suggested to consider the possible negative effects when promoting digital development.

Online health information seeking behavior, healthcare access, and health status during exceptional times

Online health information seeking behavior (e-HISB) is becoming increasingly common and the trend has accelerated as a result of the COVID-19 pandemic when individuals strongly relied upon the Internet to stay informed by becoming exposed to a wider array of health information. Despite e-HISB having become a global trend, very few empirical investigations have analyzed its potential influence on healthcare access and individuals' health status. In this paper, we try to fill this gap. We use data from the second SHARE Corona Survey, supplemented with data from the previous 8th wave of SHARE, and estimate a recursive model of e-HISB, healthcare access, and individuals' health status that accounts for individuals' unobserved heterogeneity. Our findings suggest that e-HISB can empower individuals to better understand health concerns, facilitating improved health condition management. However, e-HISB can also trigger a chain reaction, as navigating vast amonts of online health information can heighten fear and anxiety. This increased anxiety may lead to higher utilization of medical services, adversely affecting individuals' perceptions of their health.

Does digital infrastructure improve public Health? A quasi-natural experiment based on China's Broadband policy

This study proposed a scheme for improving people's health from the perspective of digital infrastructure construction. We used the China Family Panel Studies conducted between 2010 and 2020 and the digital infrastructure construction marked by the Broadband China policy between 2014 and 2016 as a quasi-natural experiment. We adopted the multi-time difference-in-differences method to identify the causal relationship between digital infrastructure and people's health. We found that digital infrastructure construction significantly improved people's health, and the effect was more prominent among young and middle-aged residents and those with less than a university education. Moreover, digital infrastructure construction improved the utilization of medical services, helped residents develop healthy lifestyles, and increased people's health investments. Additionally, digital infrastructure reduced health inequality among people and promoted health equity. The findings could guide future policies to improve people's health and well-being.

Does digital technology promote carbon emission reduction in the service industry: Economic logic and empirical evidence from China

Digital technology enables the service industry to develop rapidly, which also brings about the increase of carbon emissions in the service industry (CESI). How to better integrate the service industry into China's carbon emission reduction model has become an important content that the Chinese government needs to pay attention to. This paper uses the industry-level panel data of the service in 30 provinces of China from 2008 to 2019 to examine the relationship between the degree of digital technology and CESI through theoretical and empirical methods. The results reveal that there is an inverted U-shaped relationship between digital technology and CESI, and the effect of digital technology on curbing CESI is limited. Furthermore, the pilot policy of carbon market reduces CESI by 173.17 Mt and CESI per 10,000 people by 0.0065 Mt. Resource differences, regional differences and industrial structure differences bring about heterogeneous impacts. The Chinese government in particular, and the government established by the carbon emission reduction model should pay attention to promoting the digital transformation of the service industry to achieve the carbon emission reduction target, but the digital transformation of the service industry should be carried out in a hierarchical and orderly manner under the coordination of the government.

The Effects of Adopting Mobile Health and Fitness Apps on Hospital Visits: Quasi-Experimental Study

BACKGROUND

Overcrowding in public hospitals, a common issue in many countries, leads to a range of negative outcomes, such as insufficient access to medical services and patient dissatisfaction. Prior literature regarding solutions to reducing hospital overcrowding primarily focuses on organizational-level operational efficiency. However, few studies have investigated the strategies from the individual patient perspective. Specifically, we considered using mobile health and fitness apps to promote users' health behaviors and produce health benefits, thereby reducing hospital visits.

OBJECTIVE

This study estimated the causal effect of health and fitness app adoption on hospital visits by exploiting the staggered timing of adoption. We also investigated how the effect varied with users' socioeconomic status and digital literacy. This study provides causal evidence for the effects of health apps, extends the digital health literature, and sheds light on mobile health policies.

METHODS

This study used a data set containing health and fitness app use and hospital-related geolocation data of 267,651 Chinese mobile phone users from January to December 2019. We used the difference-in-differences and difference-in-difference-in-differences designs to estimate the causal effect. We performed a sensitivity analysis to establish the robustness of the findings. We also conducted heterogeneity analyses based on the interactions of postadoption indicators with users' consumption levels, city tiers, and digital literacy.

RESULTS

The preferred model (difference-in-difference-in-differences) showed a significant decrease in hospital visits after the adoption of health and fitness apps. App adoption led to a 5.8% (P<.001), 13.1% (P<.001), and 18.4% reduction (P<.001) in hospital visits 1, 2, and 3 months after adoption, respectively. In addition, the moderation analysis shows that the effect is greater for users with high consumption levels, in high-tier cities, or with high digital literacy.

CONCLUSIONS

This study estimated the causal effect of health and fitness app adoption on hospital visits. The results and sensitivity analysis showed that app adoption can reduce users' hospital visits. The effect varies with users' consumption levels, city tiers, and digital literacy. These findings provide useful insights for multiple stakeholders in the Chinese health care context.

The impacts of low-carbon city pilot policies on natural population growth: empirical evidence from China's prefecture-level cities

Introduction

The carbon emissions that cities contribute drive the development of low-carbon cities (LCCs) and low-carbon city pilot (LCCP) policies. However, the lack of comprehensive understanding regarding the impacts of LCCP policies on natural population growth hampers effective policy design and implementation, thus constraining sustainable development at the city level.

Methodology

Extending the existing papers which focus on the relations between low-carbon pilot policies and industry transformation or economic growth, this research applies several experimental methods [e.g., Propensity Score Matching-Difference in Differences (PSM-DID)] to investigate the impacts of low-carbon pilot policies on natural population growth by applying the data from 287 prefecture-level cities in China from 2003 to 2019.

Results and Discussion

This research found that low-carbon pilot policies would positively influence the low-carbon cities' natural population growth by influencing (a) economic factors, (b) political factors, (c) technological factors, and (d) the living environment. This research establishes a framework for understanding the impact mechanisms of LCCP on natural population growth. This paper investigates how industrial structure optimization, policy design and implementation in different regions, technological innovations, and urban green space theoretically affect natural population growth. This paper also proposed characteristics of LCCP which should be theoretically concerned by the government. From a practical perspective, this research suggests several policy recommendations. Central and local governments are encouraged to prioritize industrial structure optimization and assess populations' dependence on cultivated land. Providing additional policy support to underdeveloped areas is crucial to promote the balance between economic and environmental development. Furthermore, establishing online public health platforms and urban green spaces is proposed to enhance the population's health and complement the implementation of LCCP policies. This offers both theoretical and practical insights into the impacts of LCCP policies on natural population growth. Its findings contribute to designing and implementing LCCP policies in China and other developing countries at a similar development stage.

How does digital infrastructure affect residents' healthcare expenditures? Evidence from Chinese microdata

Healthcare expenditure is only one of the heavy burdens that families face in developing countries. Current research mainly focuses on analyzing the effects of financial policy. There is a lack of studies that examine the understanding and assessment of the impact of digital infrastructure on this issue. In this study, we used the Broadband China policy as a quasi-natural experiment to explore the impact of digital infrastructure on residents' healthcare expenditures in China. Using the differences-in-differences (DID) model and micro-survey data, we found that digital infrastructure has a positive impact on reducing the burden of healthcare expenditure in China. Our findings indicate that residents in cities can save up to 18.8% on healthcare expenses following large-scale digital infrastructure construction. Through mechanism analysis, we found that digital infrastructure reduces residents' healthcare expenditures by improving both commercial insurance availability and the healthcare efficiency of residents. In addition, the effects of digital infrastructure on reducing healthcare expenditure are more pronounced among middle-aged individuals, those with low levels of education, and those with low incomes, which indicates this digital construction wave helps bridge the social gap between the poor and the rich. This study provides compelling evidence of the positive impact of digital society construction on social health and wellbeing.