Community-Based Cognitive Social Capital and Self-Rated Health among Older Chinese Adults: The Moderating Effects of Education

The effects of neighborhood socioeconomic status on ADL/IADL among Chinese older adults-neighborhood environments as mediators

Background

There have been few consistencies in the effects and pathways of neighborhood socioeconomic status (SES) on functional limitations. This study aimed to investigate whether neighborhood socioeconomic status influences ADL/IADL in older residents in China through the neighborhood built environment and social environment.

Methods

Activities of daily living/IADL were assessed in a sample of 5,887 Chinese individuals aged 60 or older, utilizing data obtained from the 2011 China Health and Retirement Longitudinal Study (CHARLS 2011). Neighborhood SES was measured by the neighborhood per-capita net income. Neighborhood built environment was measured by the security resources, motion resources, living resources, service resources for older adults, and medical resources of neighborhood. Neighborhood social environment was measured by the organizations, unemployment subsidies, minimum living allowance, subsidies to persons older than 65, and pensions to persons older than 80 of the neighborhood. The two-level logistical regression model and multilevel structural equation model (MSEM) were used.

Results

The rate of ADL/IADL loss among Chinese older adults aged 60 and above in 2011 were 32.17 and 36.87%, respectively. Neighborhood SES was significantly associated with ADL/IADL in older adults. Compared with the respondents living in communities with lower SES, those living in communities with higher SES possessed better ADL (β = -0.33, p < 0.05) and IADL (β = -0.36, p < 0.05) status. The path of neighborhood socioeconomic status on ADL was completely mediated by the neighborhood built environment (β = -0.110, p < 0.05) and neighborhood social environment (β = -0.091, p < 0.05). Additionally, the effect of neighborhood socioeconomic status on IADL was fully mediated by the neighborhood built environment (β = -0.082, p < 0.05) and neighborhood social environment (β = -0.077, p < 0.05).

Conclusion

Neighborhood SES was significantly correlated with ADL/IADL through the neighborhood environment. Improving the ADL/IADL status of older adults residing in low socioeconomic neighborhoods requires enhancing the built and social environment by provisioning additional neighborhood resources.

Complex association of self-rated health, depression, functional ability with loneliness in rural community-dwelling older people

BACKGROUND

This study aimed to explore whether and how self-rated health, depression and functional ability interactively associated with loneliness using a sample group of older adults residing in China rural communities.

METHODS

Data on socio-demographic information, self-rated health, depressive symptoms, functional ability and loneliness (quantified via a single question) were collected from 1009 participants. Cross-tabulations with chi-square test, bivariate correlations, and Classification and Regression Tree (CART) models were employed for analysis.

RESULTS

We found that 45.1% of the participants were classified as lonely. Our results gain insight into the hierarchical order of predictors for the presence of loneliness, suggesting that there was a significant interaction between functional ability and depressive symptoms while self-rated health was not a significant factor. The probability of loneliness increased with the combination of limited functional ability and depression, and varied with different interaction of functional ability, depressive symptoms, and marital status, respectively. Notably, while there were some differences, similar associations were observed among older male and female respondents.

CONCLUSION

To delay or reduce loneliness, early detection which focuses on older people who report limitations in functional ability, depression, and being female, offers opportunities to start early interventions. Our findings might be helpful not only in designing and implementing loneliness prevention programs but also in improving healthcare for older rural community-dwelling people.

Does Neighborhood Social Capital Longitudinally Affect the Nutritional Status of School-Aged Children? Evidence from China

Previous research linking social capital to child nutritional status primarily constitutes cross-sectional studies. To investigate whether a longitudinal relationship exists, by conducting fixed-effects analyses with 16,977 repeatedly measured observations of 6193 children from the 2012, 2014, 2016, and 2018 China Family Panel Studies, this study explored the longitudinal effects of neighborhood participation, bonding trust, and bridging trust on the BMI-for-age z-score (BAZ) and BMI categories of school-aged children, differentiating between urban and rural residence. We found an increasing average BAZ, a decreasing prevalence of underweight, an increasing prevalence of overweight/obesity, and a reducing urban/rural gap in nutritional status. The levels of social capital components descended faster in the urban area. Bonding trust was predictive of a lower BAZ, a higher likelihood of being underweight, and a lower likelihood of being overweight/obese. Bridging trust was predictive of a higher BAZ. The longitudinal effects of bonding trust were significant among only the rural children. Our findings indicate that neighborhood social capital may impose causal impacts on the nutritional status of children. To effectively improve child nutritional status, a more empathetic governmental approach that promotes a more supportive distal social environment is needed.

Factors Associated with Medication Adherence among Community-Dwelling Older People with Frailty and Pre-Frailty in China

BACKGROUND

Frail and pre-frail older people often need to take medications. However, factors related to medication adherence among this population remain unclear, warranting further research. This study aims to identify correlates of medication adherence among frail and pre-frail older adults.

METHODS

From November 2020 to December 2020; a total of 4218 community-dwelling residents aged ≥ 60 years were interviewed by a cross-sectional survey in China. Data on subjects' general information; medication adherence; and frailty status was obtained via the face-to-face structured questionnaire. Logistic regression models were fitted; separately; to examine these factors linked to medication adherence.

RESULTS

We found that 36.2% (n = 1527) and 18.8% (n = 792) of respondents were classified as pre-frail and frail. According to the Morisky scale scores, 66.74% (n = 2815) were found to have adequate medication adherence, and 33.26% (n = 1403) were found to have inadequate medication adherence. Among the pre-frail respondents, age (adjusted odds ratio (AOR) = 1.64; 95% confidence interval (CI): 1.18-2.29, P = 0.003), marital status (AOR = 1.52; 95% CI: 1.04-2.21, P = 0.030), smoking status (AOR = 0.61; 95% CI: 0.37-0.99, P = 0.044), and functional ability (AOR = 0.72; 95% CI: 0.58-0.91, P = 0.006) were significantly related to medication adherence. Among them, advanced age and single were risk factors, which were positively related to the medication adherence of subjects in pre-frailty, while quitting smoking and limited functional ability contributed to improving their medication adherence. In contrast, only age (AOR = 1.77; 95% CI: 1.16-2.69, P = 0.008) was significantly associated with medication adherence among frail subjects.

CONCLUSION

Influencing factors to medication adherence of old people in pre-frailty and frailty have been enriched, which provides a certain reference for promoting medication adherence in this population. Future adherence intervention methods should be designed based on these factors.

Association between social capital and self-rated health among community-dwelling older adults

Background

It is less known about whether the association of social capital with self-rated health (SRH) varies by the presence of health conditions and how social capital, together with other variables, is linked to self-rated health in later life.

Objectives

This article aimed to explore the association of social capital with self-rated health and to examine whether the association varies among older people with and without health conditions, with a special focus on how social capital and relevant factors have an effect on self-rated health among community-dwelling older adults.

Methods

Cross-sectional data were obtained from a survey that commenced from July to September 2017 in Anhui Province. Data on socio-demographic information, social capital (six dimensions), and self-rated health were analyzed. Binary logistic regression and classification and regression tree (CART) models were used to estimate the association.

Results

Based on the findings, we found that social capital regarding less social support (adjusted odds ratio (AOR) = 1.57, 95% CI: 1.21-2.04), and less reciprocity (AOR = 1.73, 95% CI: 1.29-2.31) were associated with self-rated health among general older adults. Social capital as measured by less social participation (AOR = 1.55, 95% CI: 1.06-2.27), less cohesion (AOR = 0.63, 95% CI: 0.42-0.94), and less reciprocity (AOR =1.77, 95% CI: 1.17-2.68) were linked to self-rated health among older people with health conditions. While social capital regarding less social support (AOR = 2.15, 95% CI: 1.39-3.33) was related to self-rated health among older people without health conditions. We observed the interacting effect of social capital in the CART model, an implication that much focus should be geared toward vulnerable subgroups, especially depressed and lonely older people, as they have low reciprocity and little cohesion.

Conclusion

This work demonstrates that social capital may be relevant in devising programs and measures to improve self-rated health among community-dwelling older adults with comorbidity.

Association between changes in social capital and mental well-being among older people in China

Background

The mental well-being of older people has become social concern under aging times in China. Social capital has been linked to mental well-being. Our aims were to explore how social capital and the state of mental well-being of older people were changing and what the relationship between them was.

Methods

Data were from six waves of the China Family Panel Studies that were conducted between 2010 and 2020, and a total of 1,055 participants aged 60 and over were included in the analysis. The Generalized Estimated Equation model (GEE) was used to clarify the long-term relationship, and to use GEE we first defined how time points were related, in other words, an appropriate working correlation structure was supposed to choose. Therefore, correlation coefficient between measurements at two time points was calculated to choose the exchange structure. All the analyses were performed in the statistical software Stata 15.0.

Results

The mental well-being of older people has deteriorated over time, especially we found that between 2014 and 2016, the mental well-being of older people plummeted. In addition, cognitive social capital was positively correlated with mental well-being, while structural social capital was inverse.

Conclusions

Policymakers are supposed to take into account the long-term impact of cognitive and structural social capital on the mental well-being of older people and to provide them with projects aimed at increasing cognitive social capital and turning the pressure of structural social capital into a source of happiness in life.

Association between social capital and oral health among adults aged 50 years and over in China: a cross-sectional study

Background

Social capital has a potential effect in protecting oral health among population. However, no study has explored the association between social capital and oral health in the Chinese context. Due to the unique culture, political, social context in China, it is important to understand their association in the Chinese context. The study aims to investigate the association between cognitive and structural dimensions of social capital with edentulism among adults aged 50 years and over in China.

Method

The study used data from the WHO SAGE (Study on Global AGEing and Adult Health) wave 1 China component. Structural social capital was operationalized as social participation. Cognitive social capital was operationalized as perceived community trust and perceived community safety. Community-level social capital was measured by aggregating individual-level social capital into community level. Oral health was measured using a final marker of oral health status, self-reported edentulism. A 2-level multilevel logistic regression was used to evaluate the association between different dimensions of social capital and oral health.

Results

In total, 12,856 individuals were included in the study, the overall prevalence of edentulism was 9.1% (95% CI 8.3–10.0). Multilevel logistic analysis revealed that individual-level social capital and community-level social capital are independently associated with edentulism. Individuals with low structural social capital and living in areas with low structural social capital have, respectively, 1.54 (95% CI 1.18–2.01) and 2.14 (95% CI 1.47–3.12) times higher odds for edentulism, after adjustment for potential confounders (age, sex, marital status, residence locality, wealth, education level, chronic conditions) and a potential mediator(smoking).

Conclusions

Living in a community with lower structural social capital and individual with low structural social capital is associated with higher risk for edentulism among adults aged 50 years and over in China.

Offspring Education and Parents' Health Inequality in China: Evidence from Spillovers of Education Reform

In the context of a rapidly aging population, improving the parents’ health outcomes, especially in parents with poorer health, is essential for narrowing elderly health inequality. Using data from the China Health and Retirement Longitudinal Study, we took the university enrollment expansion policy as the instrumental variable and employed the two-stage least square (2SLS) and instrumental variable quantile regression (IVQR) approaches to explore the spillovers of offspring education on the elderly parents’ frailty index. The results show that one additional year of offspring educational attainment was associated with a 0.017 or 4.66% decline in the parents’ frailty index. These spillovers are stronger where parents are cohabiting with their children than when separating (more than 2 times higher). Moreover, there is substantial heterogeneity that is determined by the gender of parents. The spillover on mothers is greater than that on fathers. Further analysis of a cohort of parents with different frailty indexes reveals that the upward spillovers of offspring education on parents’ health are non-linear and non-averaged. The spillovers may diminish as parents own health improves. These spillovers suppress the “Matthew Effect”, which can lead to the further widening of health inequality.

The Influence of Perception of Social Equality and Social Trust on Subjective Well-Being Among Rural Chinese People: The Moderator Role of Education

The present study explored the moderation effect of education on the relationship between the perception of social equality and social trust and individuals’ subjective well-being (SWB) in rural China. Data were derived from the nationally representative cross-sectional Chinese General Social Survey (CGSS). After handling missingness, 5,911 eligible participants (age 18 years or older) from the 2015 wave were included in the model. We used logistic regression to test the hypotheses. We first tested the effect of the perception of social equality and social trust on SWB. Then we added an interaction term to test the moderation effect of education in this relationship. The results show that education had a significant moderating effect on the association between general social trust and SWB. While had no significant effect on the association between the perception of social equality, special social trust and SWB. The perception of social equality had significant effects in both groups. The relationship between special social trust and SWB in both groups was not significant. For the more educated group, general social trust had a significant and positive effect on SWB.

Examination of the Moderating Role of Household Income in the Association Between Cognitive Social Capital and Subjective Well-Being Among Rural Older Adults in Northeast China

The present study explored the moderating effects of household income on the relationship between cognitive social capital and subjective well-being in rural community-dwelling older adults in China. The data were derived from a rural community survey conducted in Liaoyuan City in China's Jilin Province in 2019. The analytic model featured 458 respondents who completed the survey. We used multiple group analyses to test the hypotheses. A latent construct of cognitive social capital was built using social trust and reciprocity indicators. The results showed that household income had a significant moderating effect on the association between cognitive social capital and life satisfaction, but not on the relationship between cognitive social capital and depressive symptoms. Thus, household income and cognitive social capital should be used to assess subjective well-being in older populations. Older adults with low household income deserve particular attention in the design of future social capital policies and programs.

Community Social Capital, Family Social Capital, and Self-Rated Health among Older Rural Chinese Adults: Empirical Evidence from Rural Northeastern China

This study investigated the relationships among community social capital, family social capital, and self-rated health of older adults in rural China. Data came from a community survey in Jilin Province, China, in 2019. Using a quota sampling method, 458 respondents aged 60 years or older were recruited. Two-step structural equation modeling was adopted to examine the proposed hypotheses. The relationships between community-based structural social capital, family social capital and self-rated health were statistically significant, whereas the relationship between community-based cognitive social capital and self-rated health was statistically nonsignificant. In order to enhance healthy aging, social capital policies and interventions should be developed to promote not only family social capital indicators (e.g., quality of family relationship and support) but also older adults' structural social capital indicators (e.g., social participation and volunteering) in rural Chinese contexts.

Internet use and self-rated health among Chinese older adults: The mediating role of social capital

AIM

This study aimed to examine the relationship between Internet use and self-rated health among older adults in China, with a particular focus on the mediating role of social capital.

METHODS

The data used in this study was obtained from the 2018 wave of China Family Panel Studies, including 7193 older adults aged between 60 and 95 years in urban and rural areas. Furthermore, a binary logit regression model was used to explore the association between Internet use and self-rated health among older adults. Moreover, we investigated the mediating effect of social capital on the relationship between Internet use and self-rated health among older adults.

RESULTS

The overall regression results show that Internet use was significantly associated with a higher possibility of being healthy for older adults. In addition, social capital plays a mediating role in the relationship between Internet use and self-rated health among the older adults.

CONCLUSIONS

This study shows that Internet use was positively related to self-rated health for the older adults. In addition, this study finds that social capital mediates the relationship between Internet use and self-rated health among the older adults. Geriatr Gerontol Int 2021; 21: 34-38.

Does Education Moderate the Relationship between Social Capital and Cognitive Function among Older Adults? Evidence from Suzhou City, China

While social capital is recognized as an important protective determinant of cognitive function in later life, there is a lack of research examining the potential moderators and mediators in the mechanisms linking social capital to cognitive function. This study investigated the moderating role of education on the relationship between social capital and cognitive function among older adults in urban Chinese communities. Data were derived from a community survey conducted in Suzhou, Jiangsu Province, China, in late 2015. A quota sampling method was applied to recruit respondents aged 60 years or older from 16 communities in the Gusu district. The final analytic sample size was 446. Multiple group analysis was applied to test the proposed model. The results show that cognitive social capital was significantly associated with cognitive function in the high education group only. Structural social capital was not significantly associated with cognitive function. The findings highlight the important role of social capital in influencing cognitive function in later life. Social capital interventions could be particularly useful as a preventive approach to help older adults sustain their cognitive function levels. Policy and intervention implications are discussed.

The Relationship Between Social Capital and Depressive Symptoms Among the Elderly in China: The Mediating Role of Life Satisfaction

Background and Aim

Depression has become a serious health and social issue in recent years in China. This study aims to explore the relationship between social capital and depressive symptoms among the elderly in China, with a particular focus on the mediating role of life satisfaction.

Methods

The data of this study were sourced from the 2016 wave of China Family Panel Studies (CFPS), involving 1243 older adults aged 60 and above. A multiple linear regression model was used to explore the impact of social capital on depressive symptoms. Moreover, the add-on PROCESS macro for SPSS was employed to measure the mediating effect of life satisfaction on the relationship between social capital and depressive symptoms.

Results

The regression results suggest that CES-D score was associated with trust (coefficient = −0.1013, p < 0.01). In addition, the protective role of trust was significantly stronger for older adults aged 70–79, women, the poorest 1/3, and the elderly who live in rural areas. Moreover, the mediation analysis results suggest that the effect of trust on depressive symptoms was fully mediated by life satisfaction.

Conclusion

This study reveals that social capital has a positive effect on depressive symptoms among the elderly, and the positive health effect shows significant age, gender, income, and location inequalities. Furthermore, this study also provides new evidence indicating that life satisfaction fully mediates the relationship between social capital and depressive symptoms. Improving social capital could be a promising way for China to promote healthy aging in the future.

Exploring Determinants of Population Ageing in Northeast China: From a Socio-Economic Perspective

The paper aims to examine the population ageing process in northeast China, typically perceived as a region experiencing dramatic demographic change and socio-economic slowdown that is much deeper and more significant compared to other regions. Using the 2000 and 2010 census data at the sub-regional level, the SEM (spatial error model) estimation suggests that at least seven socio-economic factors are associated with the evolution of the ageing pattern in northeast China, including birth rate, mortality, education, healthcare conditions, the level of economic development, urbanization, and population mobility. However, these associations vary according to time and space, which are further confirmed by the geographical weighted regression (GWR). These findings imply that there are complicated and diversified factors which may be associated with the deteriorating population ageing at the local level in northeast China. Therefore, the sustainable development of the northeast region may not be delivered by dichotomous policy interventions, such as the control of birth rate or mortality rate, as many of the previous studies have focused on; instead, the implementation of ageing policy shall be consistent and complementary with the principles of social benefits, for example, providing incentives for improving regional economic structures, or by policies aimed at building up an adequate “tolerant culture” for slowing down population outflows.