Does Participation in Local Non-agricultural Employment Improve the Mental Health of Elderly Adults in Rural Areas? Evidence From China

Work status among middle-aged and older individuals in China: the effects on physical and mental health

Objective

China's middle-aged and older population is a rich source of human capital. Therefore, considering the health of this group is important when creating and using human resources.

Methods

Using data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) 2018 baseline survey of 19,000 adults ages 45 years and older, this study was an objective investigation of the effects of work on the physical and mental health of middle-aged and older adults. We conducted several types of analyses using details of participants' lifestyles and demographic characteristics (living environment, education, financial level, and access to medical services) with work (i.e., employment or volunteer work) as a primary input component of health production to examine their effects on the health status of middle-aged and older individuals.

Results

Six primary outcomes were identified: (1) Employment positively affects both the physical and mental health of middle-aged and older people; (2) Employment can influence the physical and mental health of middle-aged and older people through income, cognitive level, and social support networks; (3) Compared to non-self-employment, self-employment dramatically worsens physical health but has no apparent detrimental effects on mental health. Compared to non-agricultural employment, agricultural labor affects both physical and mental health. (4) Employment has more positive physical and mental health effects in Individuals with higher rather than lower levels of education. (5) Employment opportunities in the eastern region are more likely to promote better physical health than those in the central and western regions of China, although the effects on mental health are negative. (6) When considering groups at different ages of the lifespan, the 60-65-year-old group, who are just entering retirement probably benefit more from continuing work.

Conclusion

We provide some recommendations to encourage middle-aged and older people to work and utilize their experience, which will enhance their physical and mental well-being and help them in realize their own value and social integration.

Associations between employment and mental health of older workers with disparate conditions: Evidence from China

PURPOSE

This study aimed to examine associations between the employment of older people and mental health across demographic characteristics, socioeconomic conditions, and health status, with a focus on pensions.

METHODS

This study included 4,512 participants aged 60-69 from the CLASS in 2014. A multiple linear regression was conducted to investigate the association between employment and mental health. A causal forest model was applied to estimate the heterogeneous treatment effects.

RESULTS

Employed individuals (n = 1,295) reported better mental health than their non-employed counterparts. This association displayed significant heterogeneity, primarily attributed to pensions. Those with lower pensions may be compelled to work due to financial reasons, thus offsetting the health-promotion effect of employment.

CONCLUSION

Employment may benefit the mental health of older adults, which has a more significant marginal effect on those who are men, older, urban residents, without a spouse, below primary education, receiving more pensions, and less family and friend support.

The impact of self-employment on mental health of the younger elderly in China

BACKGROUND

With the prolongation of the life expectancy of the Chinese population and the intensification of the aging process of the population, the mental health problems of the elderly have become increasingly prominent. This study aims to explore whether self-employment can promote and how to promote the mental health of the elderly.

METHOD

Based on the 2018 China Longitudinal Aging Social Survey (CLASS) data, this paper uses OLS model and KHB method to verify the impact of self-employment on the mental health of the younger elderly and its mechanism.

RESULTS

The results indicate that self-employment can significantly reduce the depression tendency of the younger elderly and promote their mental health. Heterogeneity analysis shows that self-employment has a more significant positive impact on the mental health of the younger elderly who are self-rated healthy, free of chronic diseases and low-level medical service utilization. The mechanism shows that self-employment can indirectly improve the mental health of the younger elderly through income growth effect and self-worth realization effect, in which the self-worth realization effect is greater than the economic effect. It illustrates that with the development of China's economy, the elderly are pursuing more intrinsic values brought by self-employment than economic benefits.

CONCLUSION

In view of the above research results, it is suggested to encourage the elderly to actively participate in social activities, provide policy support for the younger elderly to engage in self-employment, increase government support as well as health guarantee level, and improve the subjective initiative of the elderly to participate in self-employment, so that the society can truly realize the healthy aging of "being useful and productive for the elderly".

Effect and mechanism of reading habits on physical and mental health among the elderly: Evidence from China

Responding to an aging society worldwide and ensuring the physical and mental health of the elderly are important problems that need to be addressed. Thus, this study aimed to improve the quality of providing the spiritual and cultural needs of the elderly and study the internal transmission of reading habits and its effect on the physical and mental health of the elderly. Using the data from China's comprehensive social survey in 2018, this study applied the Probit model and ordinary least squares method to comprehensively estimate the influence of reading habits of the elderly on their physical and mental health. Stepwise regression and bootstrap method were combined to explore the influencing mechanism, and an instrumental variable method was used to solve endogeneity problems. Results indicate that the reading habits of the elderly have a significantly positive effect on their own physical and mental health. Social activity is the positive conduction path, whereas social justice perception and learning willingness are the negative conduction path. Among low-income families, agricultural workers, and the elderly whose household registration is in rural areas, the benefits of reading to the body and mind are more significant. After dealing with endogeneity problems and a series of robustness tests, the conclusion of this paper still holds. Finally, reference policy suggestions are proposed for the follow-up active aging policy, such as promoting reading for all, organizing various social activities, formulating active pension policies for the elderly, and allocating more public resources for vulnerable elderly groups.

Can community health centers improve the self-rated health of migrants? Evidence from China

Background

Due to the "epidemiological paradox," migrants face the risk of health attrition during their migration. Meanwhile, institutional constraints cause a health gap between migrants and non-migrants. To narrow this gap and maintain equity, scholars have studied the role and impact mechanism of medical insurance participation in improving the health of migrants. However, due to the provision of China's basic medical insurance system, the proportion of migrants participating in employee medical insurance is still relatively low, while the community health center (CHC) is a more accessible medical resource for this group. Therefore, this study attempts to explore the impact of CHCs on the self-rated health (SRH) of migrants and identify the factors and mechanisms associated with such an impact. This study addresses the hypotheses whether (a) CHCs can significantly improve the SRH of migrants in China and (b) CHCs improve the SRH of migrants by promoting both their health knowledge and health behavior.

Methods

Data was obtained from the 2017 China Migrants Dynamic Survey (CMDS). From the survey, 127,687 migrants were identified, and a series of logit regressions were conducted to explore the correlation between CHCs and the SRH of migrants. Propensity score matching (PSM) logit was also used for the robustness tests.

Results

Logit estimations revealed that CHC is positively related to the SRH of migrants (OR = 1.095, p < 0.001). Compared to others, males (OR = 1.156, p < 0.001), younger people with higher education (OR = 1.027, p < 0.001), more stable employment (OR = 1.544, p < 0.001), and people with a lower proportion of elderly (> 65 years) household family members (OR = 0.842, p < 0.001) tended to have better SRH. The results also showed that the impact of CHCs on migrants' SRH varied by gender, age, and income (p < 0.001). A possible mechanism is that CHCs can improve migrants' SRH by promoting both their health knowledge and health behaviors.

Conclusion

Programs that strengthen health knowledge and policies to enhance access to healthcare could be prioritized to improve the SRH of migrants in China.