Impacts of Social Participation on Self-Rated Health of Aging Women in China: With a Mediating Role of Caring for Grandchildren

Revisiting the association between grandparenting and mental health in China: New evidence from the harmonized CHARLS

BACKGROUND

In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena.

METHODS

The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting.

RESULTS

The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = -0.172, T = 0.65, p = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves.

CONCLUSIONS

In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies.

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.

Does intergenerational support affect older People's social participation? An Empirical study of an older Chinese population

As a means of social support, intergenerational support plays an essential role in encouraging older people to participate in society. Data on 3142 older adults were collected from the China Survey of Elderly Health Influencing Factors (CLHLS), and logistic regression models were used to determine the effects of several types of intergenerational support on social participation and whether self-rated health and life satisfaction mediated the associations between intergenerational support and social participation. Among all the three types of intergenerational support, the results showed that financial support and emotional support were positively associated with the social participation of the older Chinese in our sample. We observed rural-urban differences in the effects of financial support and emotional support on social participation, which were significant in the urban groups. Gender differences also exist in these relationships. The effects of emotional support on social participation were significant in both groups and the impact of financial support was obvious only in the female group. Regarding the mediating effect, financial support was found to improve the participants' self-rated health, which enhanced their social participation. Emotional support increased the participants' life satisfaction, which led to higher levels of social participation. Based on the findings of this study, policymakers should advocate to strengthen financial and emotional support from adult children in the community.

The relationship between oral health status, loneliness, and sleep quality among the migrant elderly following children in Weifang, Shandong Province, China: A comparative analysis on different migration types

Background

The migrant elderly following children (MEFC) are a vulnerable group that emerged during fast urbanization in China. The MEFC faced physical and psychological discomfort upon their arrival in the inflow city, particularly those who came from rural areas.

Objective

This study aimed to explore the relationship between oral health status, loneliness, and sleep quality among the MEFC in China and to clarify the disparities in the above mentioned relationship by migration type.

Methods

In 2021, a cross-sectional survey was conducted in Weifang, Shandong Province, using multistage cluster random sampling to collect data from the MEFC aged 60 years and over. In total, 613 respondents [525 rural-to-urban (RTU) and 88 urban-to-urban (UTU)] were included in the final database. The chi-square test, t-test, and structural equation modeling (SEM) were used to investigate the relationship between oral health status, loneliness, and sleep quality among the RTU and UTU MEFC.

Results

Total scores [mean ± standard deviation (SD)] for oral health status, loneliness, and sleep quality were 54.95 ± 6.47, 8.58 ± 3.03, and 4.47 ± 3.60, respectively. SEM revealed that, among the RTU and UTU MEFC, oral health status was positively and significantly related to sleep quality; however, the correlation was slightly stronger in the UTU MEFC. In both groups, there was a significant negative correlation between oral health status and loneliness, which was stronger in the UTU MEFC. In the RTU MEFC, a significant negative correlation between loneliness and sleep quality was observed, and in the UTU MEFC, no significant association between loneliness and sleep quality was observed.

Conclusion

The sleep quality among the MEFC in this study was higher compared to previous studies. Oral health status was negatively correlated with loneliness and positively associated with sleep quality, whereas loneliness was negatively correlated with sleep quality. These three associations differed significantly between the UTU and RTU MEFC. The government, society, and families should take measures to improve oral health and reduce loneliness among the MEFC to improve their sleep quality.

Evaluating the Risk of Social Isolation in Older People: AHP-Fuzzy Comprehensive Evaluation

Background

Social isolation is a serious and pervasive health issue among older people, and it is difficult to identify and assess effectively. Based on a thorough and scientific evaluation index system, AHP-Fuzzy comprehensive evaluation could be a valuable technique.

Objective

It is crucial to establish interventions that focus on risk factors for the prevention of social isolation in order to give a strong scientific foundation for enhancing older people's health habits. This can be achieved by using a fuzzy comprehensive evaluation method to assess the risk of social isolation in older people.

Methods

A hundred community members over 60 from Nanjing were selected as the evaluation subjects in China. After the element layer was split into three categories of "social risk, economic risk, and cultural risk" using the analytic hierarchy process approach, a total of 22 assessment indicators were picked to develop a risk evaluation index system.

Results

The risk level of social isolation belonging to the "low risk, relatively low risk, medium risk, relatively high risk, high risk" of membership degree are respectively "0.3392, 0.2632, 0.2257, 0.1069, 0.0650". Fuzzy comprehensive evaluation analysis showed that social relations (0.4934), monthly income (0.4654), health status (0.5960) were significant factors of social isolation risk in older people. The results showed that factors related to social risk had the most significant impact on social isolation.

Conclusion

It is scientific and feasible to construct the risk evaluation index model of social isolation risk for the elderly by using AHP-Fuzzy comprehensive evaluation method. In preventing social isolation of older people in the future, we should pay attention to the impact of social and cultural factors on them, and provide practical intervention programs and references from the government, community, family.

The Impact of Multidimensional Poverty on Rural Households' Health: From a Perspective of Social Capital and Family Care

Although absolute poverty has been eliminated in rural China, multidimensional poverty has an unstoppable impact on the self-rated health of rural households through multiple dimensions. This study constructed a moderated mediation model with multidimensional poverty as the independent variable to explore the impact on rural households' self-rated health, social capital as a mediating variable, and family care as a moderating variable. We used the survey data of 382 sample out-of-poverty rural households in Jiangxi, China, in 2020. Our results indicated that multidimensional poverty had a detrimental impact on the self-rated health and social capital of rural households, both of which were significant at the 1% level (β = -0.751, t = -4.775, and β = -0.197, t = -7.08). A test of the mediating effect of social capital using the mediation model found the mediating effect accounting for 84.95% of the entire effect of multidimensional poverty on rural households' self-rated health. Further, the interaction term between family care and multidimensional poverty and its beneficial effect on social capital as well as the interaction term between family care and social capital and its negative effect on rural household' self-rated health are both statistically significant at the 1% level (β = 0.558, t = -5.221 and β = -2.100, t = -3.304). It is revealed that multidimensional poverty affects rural households' self-rated health through social capital and that family care moderates the mediating pathway. Family care exacerbates the negative effect of multidimensional poverty on rural households' self-rated health and weakens the beneficial effect of social capital on rural households' self-rated health. The lower (higher) the level of family care, the more significant the positive (negative) effect of social capital on rural households' health. Therefore, rural households should prioritize building social capital and shifting the responsibility for family care. First, through enhancing housing infrastructure and establishing cultural and educational initiatives, households can improve their viability. Second, increasing engagement in group activities will enhance social networks and boost interpersonal connections. Finally, to lessen the stress on family caregivers, building socialized care services can cover the gap in family care.

Factors related to the social network of core members of elderly care service social organizations: a cross-sectional study

Background

The social network of the core members of elderly care service social organizations could affect the performance of the organization, while studies concerning its related factors are limited. We aimed to explore factors that are associated with the social network of core members from elderly care service social organizations and provide references and suggestions for improving elderly care services.

Methods

This cross-sectional study employed a multi-stage stratified sampling method, and collected data concerning social network, demographic information and occupation. Univariate analysis and binary logistic regression were used to analyze factors that could affect the social network of the core members.

Results

Our results demonstrated that there is low social network of core members of elderly care social organizations. Out of the total membership, men (AOR = 1.708; 95%CI: 1.034–2.823), those with senior high school education (AOR = 1.923; 95%CI: 1.053–3.511), those with a college degree and above (AOR = 3.010; 95%CI: 1.591–5.692) and those that receive awards related to elderly care services (AOR = 2.260; 95%CI: 1.285–3.976) were associated with higher social network scores.

Conclusions

Our data successfully characterized the social status of core members of elderly care organizations. Therefore, health care professionals and policy makers in social organizations should use this knowledge in the care and service provision to the elderly; and implement actions that would promote networking in social organizations.

The Protective Effect of Caring for Grandchildren on the Mental Health of the Elderly: A Structural Equation Modeling Analysis

Population aging has become a common problem all over the world, and the process of China’s population aging is developing rapidly. China has made active aging a national development strategy, giving full attention to the physical and mental health of the elderly. Bloodline and family continuity make the Chinese elderly attach great importance to the responsibility of caring for grandchildren. This study takes the elderly as the research center, and aims to investigate the relationship between caring for grandchildren and the mental health of the elderly in China, and whether participation in social activities mediates such an association. Adopting the data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a Chi-squared test and multiple regression results showed that caring for grandchildren significantly improved the mental health level of the elderly in China, and the results were still valid after the use of the Propensity Score Matching (PSM) to solve the endogenous problems. Analysis of the mediating effects using the Structural Equation Model (SEM) showed that caring for grandchildren indirectly contributed to the reduction of depression by increasing the diversity and frequency of participation in social activities. The constant adjustment of China’s fertility policy increases the possibility of the elderly caring for multiple grandchildren, and prolongs their time of caring for grandchildren. The elderly caring for grandchildren is a proactive choice, which continuously relieves the child-rearing stress, and highlights the family value and social value of the elderly. At the same time, raising and accompanying grandchildren makes the elderly’s lives more fulfilling and positive, which in turn promotes participation in social activities, and the mental health of the elderly.

Agricultural Water Use Efficiency and Rebound Effect: A Study for China

Agricultural water use accounts for the largest proportion of water withdrawal, so improving agricultural water use efficiency is an important way to alleviate water shortage. However, the expected water saving by the improved agricultural water use efficiency may be offset by the rebound effect, which means the goal of water saving by improving agricultural water use efficiency is not achieved. Based on the definition of the rebound effect of agricultural water use, this paper first uses a fixed model to measure the causal effect of agricultural water use efficiency on agricultural water use to analyze the agricultural water rebound effect, then analyses the heterogeneity and mechanism of the effect of agricultural water use efficiency on agricultural water use with the panel data from 30 provinces or cities in China from 2000 to 2017. The results show that, firstly, the agricultural water use efficiency has a significant negative effect on agricultural water use, but the average agricultural water rebound effect is 88.81%. Secondly, the effect of agricultural water use efficiency on agricultural water use is heterogeneous, in which the improvement of agricultural water use efficiency in humid or major grain-producing areas will have a lower agricultural water rebound effect. Finally, agricultural water use efficiency can affect agricultural water use through planting area and planting structure. An increase in agricultural water use efficiency will expand the planting area to increase water use. However, this will change the planting structure to decrease water use. The implication for agricultural water management is that the irrigation agricultural scale has to be controlled under the condition of available water resource, while improving agricultural water use efficiency.