Does Social Pension Expansion Relieve Depression and Decrease Medical Costs? Evidence From the Rural Elderly in China

Depressive symptoms and receipt of pensions: a cross-sectional analysis of the ELSI-Brazil study

OBJECTIVE

To investigate association between depressive symptoms and receipt of retirement pensions or other pensions in the Brazilian population aged 50 years or older.

METHOD

This was a cross-sectional study with participants from the baseline (2015-2016) of the Longitudinal Study of the Health of Elderly Brazilians. Depressive symptoms were measured by the eight-item Center for Epidemiologic Studies Depression Scale. Prevalence ratios (PR) were obtained by Poisson regression.

RESULTS

Among the total 8,469 participants, 33.9% (95%CI 32.8;34.9) reported depressive symptoms and 52.8% (95%CI 51.8;53.9) of the participants received a retirement or other pension. Prevalence of depressive symptoms was lower among participants receiving a retirement or other pension (PR = 0.79; 95%CI 0.73;0.86). Association remained significant after adjustments for sociodemographic and health indicators (PR = 0.84; 95%CI 0.76;0.92).

CONCLUSION

Participants who receive retirement or other pensions are less likely to report depressive symptoms.

MAIN RESULTS

Prevalence of depressive symptoms was 33.9% in the population studied and, after adjusted analysis, it remained statistically lower among participants who received retirement or other pensions.

IMPLICATIONS FOR SERVICES

Prevalence of depressive symptoms was higher in individuals who do not receive retirement or other pensions, which demands attention from health services in caring for this public in vulnerable situations regarding social security.

PERSPECTIVES

Carrying out longitudinal studies capable of assessing the temporality of association between receiving retirement or other pensions and the mental health of the elderly, thus contributing to better knowledge about the social determinants of mental health.

New rural pension scheme, intergenerational interaction and rural family human capital investments

Introduction

The new rural pension scheme (NRPS) can improve the quality of life for rural older adult individuals; however, can it have a spillover effect on rural household human capital investments through intergenerational interactions?

Methods

Based on data from the China Family Panel Studies (CFPS) in 2010, 2012, 2014, 2016, and 2018 and from the perspective of intergenerational interactions, the spillover effect and influencing mechanism of the new rural insurance policy on rural household human capital investments are empirically tested.

Results

The results show that the participation of families in the new rural insurance policy can significantly promote the human capital investments of rural families, and they are robust. Moreover, the spillover effect of this new policy is significantly different due to the gender, insurance phase, and family income of the insured. Through intergenerational interactions, the new rural insurance policy has an impact on the human capital investments of rural families from the material level of intergenerational economic support, housework and childcare for children and the nonmaterial level of old-age care cognition.

Discussion

Therefore, continuing to promote the coverage of the new rural insurance policy and scientifically improving rural social security through publicity and education to promote benign intergenerational family interactions can improve the accumulation of human capital in rural areas.

Safeguarding the Right to Health of the Elderly in Rural China: A Legal Analysis

Older people in rural China enjoy the right to health under Chinese law. However, the problems of economic difficulties, the unbalanced allocation of medical resources between urban and rural areas and the weakening of the traditional function of the family as a provider of old-age care in reality make the elderly in rural areas face a higher risk of health problems. The law is an important tool to mitigate these problems. Although China has made great efforts to legally guarantee the right to health of the rural elderly, it has not yet fully implemented the requirements of Article 12 of the International Covenant on Economic, Social and Cultural Rights, Article 14 of the Madrid Political Declaration and International Plan of Action on Ageing. China needs to further improve the relevant legislation to provide adequate legal support for the exercise of the right to health of the elderly in rural areas.

The Nonlinear Relationship Between Body Mass Index (BMI) and Perceived Depression in the Chinese Population

Purpose

Existing studies on the association between BMI and depression report conflicting results with some demonstrating a positive relationship, while others a negative link or insignificant correlation. Very limited research on the nonlinear relationship between BMI and depression has yet to clarify the reliability and robustness of the potential nonlinearity and whether a more complex association exists. This paper aims to systematically investigate the nonlinear relationship between the two factors applying rigorous statistical methods, as well as explore the heterogeneity of their association.

Materials and Methods

A large-scale nationally representative dataset, Chinese General Social Survey, is used to empirically analyze the nonlinear relationship between BMI and perceived depression. Various statistical tests are employed to check the robustness of the nonlinearity.

Results

Results indicate that there is a U-shaped relationship between BMI and perceived depression, with the turning point (25.718) very close to while slightly larger than the upper limit of the range of healthy weight (18.500 ≤ BMI < 25.000) defined by World Health Organization. Both very high and low BMIs are associated with increased risk for depressive disorders. Furthermore, perceived depression is higher at almost all BMI levels among individuals who are older, female, lower educated, unmarried, in rural areas, belonging to ethnic minorities, non-Communist Party of China members, as well as those with lower income and uncovered by social security. In addition, these subgroups have smaller inflection points and their self-rated depression is more sensitive to BMI.

Conclusion

This paper confirms a significant U-shaped trend in the association between BMI and depression. Therefore, it is important to account for the variations in this relationship across different BMI categories when using BMI to predict depression risk. Besides, this study clarifies the management goals for achieving an appropriate BMI from a mental health perspective and identifies vulnerable subgroups at higher risk of depression.

Does Elderly Chronic Disease Hinder the Sustainability of Borderline Poor Families’ Wellbeing: An Investigation From Catastrophic Health Expenditure in China

Objectives: Health and health expenditure caused by elderly chronic diseases are a global problem. As China has just lifted itself out of poverty in 2020, the sustainable development of Borderline Poor Families’ Wellbeing faces severe challenges. Therefore, it is of great practical significance to explore the impact of elderly chronic diseases on the catastrophic health expenditure of Borderline Poor Families.

Methods: Based on screening 8086 effective samples from China Health and Retirement Longitudinal Study (CHARLS) database and calculating catastrophic health expenditure, this paper uses two-part model and logit regression to discuss the impact of elderly chronic diseases on the sustainable development of Borderline Poor Families’ Wellbeing.

Results: The results showed that stroke, cancer, and liver disease caused the most catastrophic health expenditures and had the greatest impact on the Borderline Poor Families’ Wellbeing.

Conclusion: Therefore, in order to ensure the sustainable development of Borderline Poor Families’ Wellbeing, the government should strengthen the publicity of pre-prevention and post-healthcare of chronic diseases such as stroke, and combine pre-prevention policy with post-guarantee policy.