Impact of Internet Use on Mental Health among Elderly Individuals: A Difference-in-Differences Study Based on 2016-2018 CFPS Data

Internet access during COVID-19 and depressive symptoms in middle-aged and older adults: Evidence from a quasi-experimental study in China

BACKGROUND

Amid the COVID-19 pandemic, the mental health of middle-aged and older adults has become an increasing concern, and the role of the internet in addressing this public health crisis has drawn the attention of researchers. This study evaluated the impact of internet access during COVID-19 on depressive symptoms among middle-aged and older adults.

METHODS

Data were derived from China Health and Retirement Longitudinal Study (CHARLS) 2018 and 2020. Difference-in-differences analysis was performed to compare changes in depressive symptoms between the internet users during COVID-19 and those who didn't have access to the internet before and during the pandemic.

RESULTS

We found that internet access during COVID-19 pandemic significantly reduced middle-aged and older adults' depressive symptoms. Further investigation identified the underlying mechanisms through which internet access helps in alleviating depressive symptoms by reducing the likelihood of experiencing negative emotions about COVID-19. Heterogeneity analyses showed that rural residents and middle-aged individuals benefited more from internet access during the pandemic.

CONCLUSIONS

Since internet access can alleviate middle-aged and older adults' depressive symptoms amidst public health crisis, policy makers should focus on enhancing their access to the internet.

Association between internet exclusion and depressive symptoms among older adults: panel data analysis of five longitudinal cohort studies

Background

Internet exclusion and depressive symptoms are prevalent phenomena among older adults; however, the association between internet exclusion and depressive symptoms remains limited. This study aims to investigate the association between internet exclusion and depressive symptoms among older adults from high-income countries (HICs) and low- and middle-income countries (LMICs).

Methods

We conducted a comprehensive longitudinal, cross-cultural analysis, and the participants were adults aged 60 years and older from 32 countries participating in five nationally representative longitudinal cohort studies: the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Mexican Health and Ageing Study (MHAS). Internet exclusion was defined as the self-reported absence from internet use. Depressive symptoms were evaluated using the Centre for Epidemiologic Studies of Depression scale (CES-D) or the Euro-Depression scale (Euro-D). These five cohorts, being heterogeneous, were respectively conducted with panel data analysis. Logistic regression, implemented within the generalized estimating equations framework, was used to examine the association between internet exclusion and the likelihood of experiencing depressive symptoms, adjusting for the causal-directed-acyclic-graph (DAG) minimal sufficient adjustment set (MSAS), including gender, age, education, labour force status, household wealth level, marital status, co-residence with children, residence status, cognitive impairment, and functional ability.

Findings

Our study included a total of 129,847 older adults during the period from 2010 to 2020, with a median follow-up of 5 (2, 7) years. The pooled proportion of internet exclusion was 46.0% in HRS, 32.6% in ELSA, 54.8% in SHARE, 92.3% in CHARLS, and 65.3% in MHAS. Internet exclusion was significantly associated with depressive symptoms across all cohort studies: HRS (OR = 1.13, 95% CI 1.07-1.20), ELSA (OR = 1.22, 95% CI 1.11-1.34), SHARE (OR = 1.55, 95% CI 1.47-1.62), CHARLS (OR = 1.49, 95% CI 1.26-1.77), and MHAS (OR = 1.48, 95% CI 1.39-1.58). Moreover, internet exclusion was found to be associated with all dimensions of depression in the SHARE, MHAS, and ELSA cohorts (except for sleep and felt sad) cohorts.

Interpretation

A considerable proportion of older adults experienced internet exclusion, particularly those in LMICs. Internet exclusion among older adults, irrespective of their geographic location in HICs or LMICs, was associated with a higher likelihood of experiencing depressive symptoms, which demonstrated the importance of addressing barriers to internet access and promoting active participation in the internet society among older adults.

Funding

National Key R&D Program of China (grant number 2022ZD0160704), the Scientific Research and Innovation Team of The First Affiliated Hospital of Zhengzhou University (grant number ZYCXTD2023005), the Collaborative Innovation Major Project of Zhengzhou (grant number 20XTZX08017), the Joint Project of Medical Science and Technology of Henan Province (grant number LHGJ20220428), and National Natural Science Foundation of China (grant number 82373341).

Socioeconomic inequalities in the relationship between internet usage patterns and depressive symptoms: Evidence from a Chinese longitudinal study

Background

The increasing prevalence of depressive symptoms has emerged as a critical public health issue globally, highlighting the need for analyses of the factors contributing to depressive symptoms within the Chinese population and the development of targeted recommendations for improving mental well-being. We aimed to explore the correlation between internet use and depressive symptoms and the role of socioeconomic inequalities in this association.

Methods

We included data on 8019 residents aged 18 years and above, which we retrieved from the 2018 and 2020 waves of the China Family Panel Studies. We used latent profile analysis to categorise individuals' internet usage patterns and multiple linear regression to determine their association with depressive symptoms.

Results

Higher socioeconomic status (SES) was associated with fewer depressive symptoms (τ = -0.08; 95% confidence interval (CI) = -0.36, -0.18). Individuals in the high-dependence group presented a greater likelihood of developing depressive symptoms (τ = 0.04; 95% CI = 0.007, 0.66). We observed no significant difference in the interaction effect between individual-level SES and the four patterns of internet usage. However, compared with urban-dwelling respondents, those in rural areas had a stronger association between internet usage patterns and depressive symptoms, especially those in the high-dependence group (τ = -0.07; 95% CI = -1.47, -0.20).

Conclusions

Our findings indicate a significant association between depressive symptoms and internet usage patterns, indicating a need for interventions related to internet use, especially those targeted at reducing the risk of depressive symptoms in individuals of lower SES.

The impact of digital economy development on public health: evidence from Chinese cities

Introduction

The swift advancement of the digital economy not only plays a crucial role in stimulating a country's economic growth but also exerts a significant influence on national health and well-being.

Methods

Adopts the data of 285 prefecture-level cities in China from 2010 to 2022, and employs the panel data fixed-effects model, spatial Durbin model, and mediated effects model to study the impact of digital economic development on the level of urban public health.

Results

It is found that digital economic development significantly improves the level of urban public health, and the effect has a spatial spillover effect. The impact of digital economic development on urban public health is mainly concentrated in cities with higher levels of economic development, higher levels of digital economic development, and lower levels of urban public health. Among them, technological innovation and information dissemination are the main dissemination channels through which digital economic development affects the level of urban public health.

Discussion

The advancement of the digital economy significantly impacts urban public health. It is advisable to bolster policies guiding digital economy development, enhance cross-sector collaboration between the digital economy and public health, reinforce public health education and awareness campaigns, improve the digital health literacy of the population, continue to enhance the fairness and accessibility of basic medical services, and address and bridge the "digital divide" between regions, as well as urban and rural areas.

Internet use and loneliness among older Chinese adults

OBJECTIVES

This study examined the association between Internet use and loneliness among Chinese older adults (aged 60+) over a two-year period using nationally representative survey data from China.

METHODS

Using data from the 2016 and 2018 waves of the China Longitudinal Ageing Social Survey (N = 8,059), we estimated difference-in-differences regression models to assess the association between Internet use and levels of loneliness over time.

RESULTS

Compared to Internet non-users, Chinese older adults who were new Internet users, as well as those who were continuous Internet users, reported lower levels of loneliness over time (B = -0.21, p < 0.001 and B = -0.16, p < 0.001, respectively). Conversely, those Chinese older adults who used the Internet in wave 1 but then disengaged from using the Internet in wave 2 demonstrated an upward trend in loneliness over time, similar to Internet non-users (the estimate of difference-in-differences was non-significant for the comparison between disengaged-users and non-users: B = -0.03, p = 0.42).

CONCLUSION

This study provided new evidence to support the potential benefits of Internet use for reducing the risk of loneliness among Chinese older adults. The findings suggested that supporting current Internet users to remain digitally engaged is as important as encouraging Internet non-users to cross the digital divide.

Does digital technology make people healthier: the impact of digital use on the lifestyle of Chinese older adults

BACKGROUND

With the arrival of the era of large-scale production, sharing and application of data, digital use has gradually changed people's daily entertainment, consumption, social interaction, learning and other behaviors in its efficient form. This paper mainly discusses whether this fast and convenient behavior leads Chinese older adults to adopt healthier lifestyles.

METHODS

Using the most recent information from the Chinese Family Panel Studies (CFPS) in 2020, this paper conducted a descriptive statistical analysis on the basic situation of digital use and lifestyles among Chinese older adults and used a structural equation model to analyse the influence of frequency and types of digital use in a variety of different aspects of the real life of Chinese older adults.

RESULTS

Research revealed that the quality of life of Chinese older adults improved significantly as a result of their use of digital technology. The frequency of digital use (FDU) significantly improved Chinese older adults' diet, sleep, exercise, smoking and drinking, and relieved their depression. The types of digital use (TDU) had a significant positive correlation with the lifestyle of Chinese older adults, especially in the influence of digital entertainment (DE), digital consumption (DC) and digital social interaction (DI) on the lifestyle of Chinese older adults.

CONCLUSIONS

Digital use can improve the health of Chinese older adults by promoting a healthy lifestyle through various means. The findings of this study have a substantial positive impact on bridging the digital divide that Chinese older adults face, as well as fostering the integration of digital use into their healthy lifestyles.

Social networks and the mental health among Chinese older adults: the mediating role of loneliness and moderating role of Internet use

Background

Although a large body of research suggests that social networks from family and friends are important factors in protecting the mental health of older adults, we know little about the mediating and moderating mechanisms behind this relationship. Using China as an example, this study aims to investigate a comprehensive model that includes social networks, loneliness, Internet use, and mental health outcomes in the older population.

Methods

We analyzed data from 7,648 Chinese older people over 60 using the 2018 CLASS survey. We studied how various social networks affect their mental health. Using SPSS's PROCESS macro, we first employed descriptive statistics to examine the characteristics of the participants and calculate the correlations of core variables. Then, we assessed whether loneliness mediated this relationship and tested the moderated mediation effect of Internet use. Our findings shed light on these complex dynamics.

Results

The statistics indicate a positive correlation between social networks and mental health. Furthermore, mediation models revealed that loneliness moderates the relationship between social networks and mental health. In addition, moderated mediation models revealed that Internet use played a distinct function in the family networks model compared to the friend networks model. Internet use moderates explicitly the effects of family networks on loneliness and friend networks on mental health.

Conclusion

The findings emphasize the importance of differentiating the types of social networks to understand their impact on older adults well-being, encouraging policymakers, medical professionals, and families to adopt more targeted approaches when devising policy interventions and medical strategies, especially for older individuals with insufficient social support. Additionally, we urge governments to recognize the varying types of social networks among older populations and harness the protective effects of Internet technology on their well-being within a digital society.

Effect of extracurricular tutoring on adolescent students cognitive ability: A propensity score matching analysis

In recent years, there has been a substantial increase in the number of adolescent students attending extracurricular tutoring. However, extracurricular tutoring, being a distinct form of education, may have varying effects on cognitive capabilities compared to conventional education. Accordingly, the purpose of this paper is to conduct a thorough examination of the effects of extracurricular tutoring on cognitive abilities among adolescent students. The study utilized national data from the China Family Panel Study 2018 to explore the relationship between involvement in extracurricular tutoring among students and cognitive abilities. The study included 2567 valid respondents. A binary logistic regression model was built to determine the factors associated with tutoring involvement while controlling for 19 individual, family, and school factors. Furthermore, a propensity score-matched analysis was conducted in order to mitigate potential bias by using confounding variables identified in the previous step. The study results show that participation in extracurricular tutoring can significantly increase the level of cognitive ability of adolescent students, with adjustments made for age, gender, ethnicity, number of family members, net family income per capita, education and training expenditure in the past years, change of residence for enrollment, change of domicile address for enrollment, locality of the current school, class size, hold a position as a class cadre, average daily study time on weekdays, average study time per day during weekends. The findings imply that the government should provide tutorial subsidies to disadvantaged groups of adolescent students, allocate educational resources equitably, and invest more in education resources in less developed regions to foster fair and healthy development of education and improve the cognitive abilities of young students in the long-term.

Multidimensional Internet Use, Social Participation, and Depression Among Middle-Aged and Elderly Chinese Individuals: Nationwide Cross-Sectional Study

BACKGROUND

There is growing evidence that the internet has beneficial effects on the mental health of middle-aged and older people (≥45 years), but the evidence is inconclusive, and the underlying mechanisms are less known.

OBJECTIVE

This study aims to explore the relationship between multidimensional (devices, frequency, and purpose) internet use and depression in middle-aged and elderly Chinese, as well as the mediating effect of social participation. Moreover, this study will explore the moderating effect of the regional informatization development level (RIDL) on the relationships between individual internet use, social participation, and depression.

METHODS

Data on 17,676 participants aged 45 years or older were obtained from the China Health and Retirement Longitudinal Study (CHARLS) 2018 data set. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to identify the presence of depression. Logistic regression was used to explore the relationship between each dimension of internet use and depression. Multiple linear regression was used to explore the mediating effect of social participation and the moderating effect of the RIDL.

RESULTS

The results showed that 28.33% (5008/17,676) of the total population had depression. In terms of regional subgroups, respondents living in the western region exhibited the highest proportion of depression (2041/5884, 34.69%). Internet use was negatively associated with depression (odds ratio 0.613, 95% CI 0.542-0.692; P<.001). Various dimensions of internet use positively contributed to individual social participation and reduced individual depression (devices: β=-.170, 95% CI -0.209 to -0.127; frequency: β=-.065, 95% CI -0.081 to -0.047; and purpose: β=-.043, 95% CI -0.053 to -0.031). In addition, the RIDL weakened the relationship between individual-level internet use and social participation (internet use: F74.12,9.82=7.55, P<.001; devices: F51.65/9.88=5.23, P=.005; frequency: F66.74/10.08=6.62, P=.001; and purpose: F66.52/9.78=6.80, P=.001), and negatively moderated the relationship between the frequency of internet use and depression (frequency: F662.67/188.79=3.51, P=.03).

CONCLUSIONS

This study found that different dimensions of internet use are associated with lower levels of depression. Social participation partially mediates the association between multidimensional internet use and depression in the eastern, central, and western regions, respectively. Additionally, the RIDL helps individuals further their internet use and social participation, reducing the impact of depression. However, this effect weakens sequentially from the western region to the central region and then to the eastern region.

The longitudinal associations between perceived importance of the internet and depressive symptoms among a sample of Chinese adults

Objective

The aim of this study is to examine the extent to which individuals' cognitive evaluation of the importance of the Internet is associated with depressive symptoms, and in what ways.

Methods

This study utilized a sample of 4,100 participants from the fourth (2016), fifth (2018), and sixth (2020) waves of the China Family Panel Studies. Structural equation modeling was employed for data analysis.

Result

The findings of this study reveal that individuals' cognitive evaluation of the importance of the Internet in 2016 was positively linked with the frequency of Internet use and subjective socioeconomic status in 2018. Furthermore, the frequency of Internet use and subjective socioeconomic status in 2018 were found to be negatively associated with depressive symptoms in 2020. These results indicate that the perceived importance of the Internet has an indirect effect on depressive symptoms through the identified pathway.

Conclusion

The present findings contribute to the existing literature by highlighting the importance of individuals' perceived importance of the internet as a significant factor that influences depressive symptoms. The results suggest that policy makers should take actions to increase public awareness of the importance of the Internet in the digital era, and to ensure equitable access to the internet, thus facilitating convenient internet use and helping individuals adapt to the digital age.

The impact of integrated urban and rural resident basic medical insurance on health service equity: Evidence from China

Background

Many countries and regions worldwide are improving their healthcare systems through the integration and unification of health insurance programs covering different groups of people. In China, the past 10 years has been the time when Chinese government promote the Urban and Rural Residents Basic Medical Insurance (URRBMI) by integrating the Urban Residents' Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS).

Objectives

To evaluate the impact of the URRBMI on equity in relation to health services.

Methods

The quantitative data used in this study were obtained from the CFPS 2014–2020 database, and all respondents with health insurance type UEBMI, URBMI, and NRCMS were included. UEBMI respondents were set as the control group and URBMI or NRCMS as the intervention group, and a DID method model was used to analyze the impact of integrating health insurance on health service utilization, costs and health status. Heterogeneity analysis was also conducted after stratifying the sample according to income level and chronic disease status. This was done to investigate whether there were differences in the effects of the integrated health insurance program across different social groups.

Results

The implementation of URRBMI is found to be associated with a significant increase in inpatient service utilization (OR = 1.51, P &lt; 0.01) among rural Chinese residents. Regression results by income stratum show that the utilization of inpatient services increased in rural areas for high-, middle- and low-income groups, with the fastest increase (OR = 1.78, P &lt; 0.05) emerging for low-income groups. Analysis by chronic disease status shows that rural residents with chronic disease are associated with a higher increase in hospitalization rates (OR = 1.64, P &lt; 0.01).

Conclusion

The implementation of URRBMI is found to have improved health insurance's ability to withstand risks and effectively improve access to health services for rural residents. In this regard, it can be considered as playing a positive role in bridging the gap in health service utilization between rural and urban areas and in improving regional equity.

Relationship between Internet Use and Negative Affect

While positive emotions like happiness and life satisfaction have received great attention, how to eliminate negative affect is largely neglected. This study contributes to the literature by examining the relationship between Internet use and people's negative affect. Unlike previous studies that consider only one indicator, we capture negative affect from different dimensions by considering loneliness, sadness, and life hardship. We employ an endogenous ordered probit model to address the selection bias of Internet use and analyze the 20,107 individual-level samples sourced from the 2020 China Family Panel Studies survey. The results show that Internet use significantly reduces people's loneliness, sadness, and life hardship. We also find that studying online and watching short videos would increase people's loneliness feeling and shopping online deepens people's life hardship. In contrast, using WeChat significantly reduces sadness and life hardship. Our findings confirm that guiding people to use the Internet appropriately is necessary to reduce negative affect and improve the quality of their life.

Internet use and life satisfaction among Chinese older adults: the mediating effects of social interaction

Internet use has been suggested to have a crucial effect on older adults' quality of life; however, few studies have investigated the underlying mechanisms in the relationship between internet use and life satisfaction among older adults. Employing multiple linear regression models and mediation analysis with 2019 Chinese Social Survey (CSS) data, this study analyzed the associations between the internet use and life satisfaction of Chinese older adults. Additionally, it explored the mediating role of social interaction, including online and offline social interactions. The results showed that internet use was positively associated with older adults' life satisfaction, and offline social interaction significantly mediated internet use. Our findings indicate that internet use could improve older adults' quality of life by promoting offline social interaction. Therefore, the government, communities, and families should create conditions for older adults to integrate into online society and participate in offline social interaction.

Does the Internet Moderate the Neighborhood Effect? Internet Use, Neighborhoods, and Mental Health among Older Adults in Shanghai

Internet use may reduce the impact of the neighborhood on residents' well-being by helping people utilize resources beyond their immediate neighborhoods or strengthen neighborhood influences by widening the digital divide across neighborhoods. This study investigates how internet use moderates neighborhood effects on mental health among older adults in Shanghai. Using data from the Shanghai Urban Neighborhood Survey (SUNS) and population census, hierarchical linear models reveal that older adults who more frequently use the internet report lower levels of mental distress. Internet use attenuates the negative effects of living in low-socioeconomic status (SES) neighborhoods. We also examine the roles of three types of internet use: social networking, leisure, and information seeking. The results show that only social networking and leisure internet use are significantly associated with improved mental health among older adults. The results suggest that social programs are needed to increase internet literacy among older adults to promote active aging, and priority should be given to relatively disadvantaged neighborhoods.

Static and Dynamic Impacts of Internet Use on Self-Rated Health among Adults in China: A Hybrid Model Analysis Based on National Panel Survey Data

The widespread use of the Internet has a substantial impact on people's livelihoods, including health-related factors. Whether this impact is beneficial or harmful to people's health remains unclear. Some cross-sectional studies found static differences in the health status between Internet users and nonusers, whereas panel data studies found dynamic changes in an individuals' health over time, making the issue, including its causality, controversial. Therefore, we aimed to clarify the association between the use of the Internet and people's health from both static and dynamic aspects. Data were obtained for 46,460 adults from the China Family Panel Studies in 2014, 2016, and 2018. The analysis applied a logistic regression hybrid model with self-rated health as the dependent variable and Internet use as the main independent variable. In the hybrid model, time-varying independent variables were decomposed into between-individual (static) differences and within-individual (dynamic) changes over time. The results indicated that the between-individual coefficient of Internet use was significantly positive, but the within-individual coefficient was not, i.e., Internet users felt healthier than nonusers from the static aspect but starting to use the Internet did not increase the self-rated health from the dynamic aspect. These findings suggest that attention is needed in order to not confuse the static differences with dynamic change regarding the causality between Internet use and self-rated health.

The association between lifestyles and health conditions and the choice of traditional Chinese medical treatment in China: A latent class analysis

Traditional Chinese medicine (TCM) plays a major role in preventing and treating the disease, however, it is also facing a slice of challenges as fewer choices of TCM treatment. Although lifestyles and health conditions might be paramount influencing factors for the choice of TCM treatment, the relative evidence is scarce. The current observational study was designed to evaluate this association. A total of 24,173 Chinese individuals with a mean age of 47.3 years from the Chinese Family Panel Studies 2014 were selected. The choice of TCM treatment was acquired by the self-report questionnaire. Latent class analysis was employed to identify clusters of lifestyles and health conditions. The binary logistic regression model was employed to examine the association between lifestyles, health conditions and the choice of TCM treatment. Lifestyles and health conditions were classified into 3 classes with latent class analysis, healthy group, unhealthy behavior group, and physical inactivity group. After controlling for potential confounding factors, the results showed individuals in unhealthy behavior group (odds ratio = 1.51, 95% confidence interval: 1.35-1.68, P < .001) or physical inactivity group (odds ratio = 1.11, 95% confidence interval: 1.02-1.22, P = .019) were more likely to visit TCM doctors than healthy group. Sex-specific difference was observed, the relationship still existed among the males. The current study revealed the relationship between lifestyles, health conditions and the choice of TCM treatment. This will provide evidence for the TCM development and provide support for further research.

Internet Use as a Moderator of the Relationship between Age and Depression: Implications for Older Adults

Technology-based interventions have been suggested to prevent depression and loneliness. However, it is not yet well-established if internet use is a protective factor for older adults, allowing them to combat depression and loneliness. Addressing this neglected area of research, this paper examines whether frequent internet use moderated the relationship between depression and age. Using 2016 General Social Survey ( n = 869), a series of ordinary least squares regression models were employed. The findings revealed that older adults who frequently used the internet were more depressed than those who did not. This may imply that internet use by older individuals may not be an adequate source of social engagement and may even heighten existing levels of depression. Other interventions may need to be developed to compensate for the loss of physical contact and reduce the level of depression.

The impact of mobile Internet use on mental distress among Chinese adults during the COVID-19 pandemic

With the rapid development of digital technology, mobile Internet use is increasing in popularity in China. Previous studies have shown that mobile Internet use has a positive or negative effect on mental distress. Using CFPS2020 data, this paper finds that mobile Internet use significantly alleviates mental distress in Chinese adults. Heterogeneity analysis indicates that mobile Internet use can significantly alleviate mental distress among adults between the ages of 30 and 70, without a bachelor's degree or residing outside the province of Hubei. Furthermore, mobile Internet use significantly reduces mental distress through two mediators: trust and happiness. It also shows that watching short videos or learning online is associated with reduced mental distress, as opposed to online shopping, chatting, or playing games. However, the mental distress of new mobile Internet users in 2020 has not been alleviated. This paper enriches the relevant theoretical research and provides a practical reference for using the mobile Internet to ease mental distress during epidemics.

The effect and mechanism of Internet use on the physical health of the older people-Empirical analysis based on CFPS

The use of the Internet has a promoting effect on the physical health of the older people. However, previous studies are mostly focused on the perspective of the overall population, or limited to the direct effects, ignoring the exploration of the mechanism of action and the perspective of the older people. Based on the data of the China Family Panel Survey (CFPS) in 2014, 2016, 2018, and 2020, this study found that the use of the Internet has a significant effect on the physical health of the older people, especially among the population groups of females, rural residents, and those living in central and western regions of China. In addition, this study also found that the use of the Internet by the older people can increase their exercise frequency, thereby improving their physical health. Therefore, to promote active aging, this study proposes to further increase the popularity of the Internet among the older people, encourage the introduction of age-appropriate Internet systems and sports facilities, create an online fitness platform for the older people, and promote scientific fitness programs for them.

How Does Internet Use Improve Mental Health among Middle-Aged and Elderly People in Rural Areas in China? A Quasi-Natural Experiment Based on the China Health and Retirement Longitudinal Study (CHARLS)

One of the most significant public health issues in rural China is how to improve the mental health of middle-aged and older individuals. Using 2013, 2015, and 2018 CHARLS panel data, this paper properly examined the effects of Internet use on the mental health of middle-aged and elderly people in rural China based on the difference-in-differences method. The findings are as follows: (1) Internet use effectively improves the mental health status of middle-aged and elderly people in rural China; (2) compared to the middle-aged group, Internet use has a more obvious effect on the mental health of the elderly; (3) further analysis showed that reading news, watching videos, and playing games online could significantly improve the mental health status of middle-aged and elderly people in rural China, while chatting online and other Internet activities cannot significantly improve mental health status; and (4) playing games, watching videos, and reading news have different effects on the mental health of middle-aged and elderly people in rural China. The results indicate that playing games have a better effect on depression levels than watching videos. In contrast, watching news had the lowest effect on depression levels among middle-aged and elderly people in rural China. The results of this study also show the latest evidence that Internet use can help China's rural middle-aged and elderly populations to reduce social isolation, establish new social connections, gain social support, and, ultimately, achieve active ageing. Therefore, promoting multiple forms of interaction is an effective path to prevent loneliness, which has become the new policy direction of the government to create an age-friendly Internet environment using various measures in the future to eliminate the barriers to Internet access affecting the middle-aged and elderly in rural China.

Measurement and Decomposition of the Health Poverty of Rural Residents in China

Narrowing the health gap and promoting health equality is the key to effectively blocking the intergenerational transmission of rural poverty. Previous studies have mainly focused on the relationship between health and poverty, but assessments of health poverty are lacking, especially with regard to the health poverty of rural residents. Based on China's large sample household survey data, this study uses the Alkire-Foster (AF) method to measure and decompose the health poverty of rural residents. The results show that the health poverty of Chinese rural residents greatly improved from 2016 to 2018. However, significant regional differences exist with regard to the level of health poverty. The marginal contribution of economic poverty alleviation is diminishing; the equalization of health services and security has shifted to a policy focus. Community environmental management has also become an important aspect of health poverty governance, and individual health literacy and behavior have played an important role in endogenous poverty alleviation. Ultimately, this paper offers some insightful policy implications. This study extends the multidimensional poverty measurement system and reveals the relationship between health poverty and regional economic and social development. The findings also enhance the understanding of the health poverty of rural residents in developing countries.

Internet Use and Job Satisfaction: Evidence from China

We explore the causal effects of Internet use on job satisfaction using a sample of 83,012 Chinese labor force members aged 16-64 years from the China Family Panel Studies (CFPS) from 2010 to 2018. We use ordered logistic estimation and find that Internet use significantly increases job satisfaction by 3.2%. Heterogeneity analysis shows that the Internet has a more positive impact on those who are in urban areas and have higher incomes and higher education. Our results are robust after eliminating endogeneity using instrumental variables and solving the self-selection problem using the PSM method. Our mechanistic analysis leads to similar conclusions to mainstream research, where Internet use induces job satisfaction by increasing time efficiency and enhancing job autonomy. Specifically, shorter working hours boosted job satisfaction by approximately 0.3%, while working in informal places boosted job satisfaction by 5.4%. Thus, employers may consider encouraging employees to access the Internet.

Associations between Mobile Internet Use and Self-Rated and Mental Health of the Chinese Population: Evidence from China Family Panel Studies 2020

With societal and technological developments, mobile Internet has become the most popular and widespread means to use the Internet in China. Thus, exploring the relationship between mobile Internet use and the self-rated health and mental health of the Chinese population is of great importance. This study empirically examined the impact of mobile Internet use on residents’ health using data from the China Family Panel Studies 2020 and conducted a heterogeneity analysis. The results revealed a significant negative association between mobile Internet use and the self-rated health of the population, but a significant positive association was found relative to their mental health. The results of this analysis passed a robustness test. The results of the heterogeneity analysis showed that mobile Internet use had a more significant association with the health of residents with secondary school education and university education compared to those with primary school education or below and graduate education. Furthermore, this study addresses the endogeneity problem using the propensity-score matching model, which is shown to be better at eliminating sample selectivity bias. If endogeneity is not addressed, the negative association with mobile Internet use on residents’ self-rated health will be underestimated and its positive association with their mental health will be overestimated. The Chinese government should issue guidelines on the duration of Internet use, strictly regulate exaggerated and harmful content on mobile network platforms, and strengthen people’s online skills through training to improve their digital literacy, especially for rural populations.

Happiness, depression, physical activity and cognition among the middle and old-aged population in China: a conditional process analysis

Background

Happiness is one variable of subjective well-being, which has been increasingly shown to have protective effects on health. Although the association between happiness and cognition has been established, the mechanism by which happiness leads to cognition remains unclear. Since happiness, depression, and physical activity may all be related to cognition, and happiness is related to depression and physical activity, this study explored the effect of depression and physical activity on the relationship between happiness and cognition among middle and old-aged individuals in China.

Methods

Data on 14,344 participants above 45 years of age were obtained from the 2018 China Family Panel Studies survey. A multiple linear regression analysis was performed to identify the correlation factors of cognition. The conditional process analysis was used to assess the mediatory effect of depression and physical activity on the relationship between happiness and cognition.

Results

Residence, age, sex, income level, social status, smoking, napping, reading, education, exercise times, satisfaction, happiness, and depression had associations with cognition. When other variables were held constant, cognition score increased by 0.029 standard deviation(SD) for every 1 SD increased in happiness. Mediation analysis showed that happiness had a significant positive total effect on cognition. The direct effect of happiness was significant and accounted for 57.86% of the total effect. The mediatory effect of depression (path of happiness→depression→cognition) accounted for 38.31% of the total effect, whereas that of physical activity (path of happiness→exercise times→cognition) accounted for 3.02% of the total effect.

Conclusion

Happiness has a positive correlation with cognitive function, and depression and physical activity play mediatory roles in this association. Effective interventions to improve happiness levels of middle and old-aged population will not only improve their subjective well-being but also improve their cognitive function, which carries great potential for reducing public health burdens related to cognitive aging.

Does Internet Use Impact the Health Status of Middle-Aged and Older Populations? Evidence from China Health and Retirement Longitudinal Study (CHARLS)

In the context of both rapid technological development and increasing aging, the relationship between technological development and the health of the middle-aged and older population is gradually receiving academic attention. This study empirically examined the health consequences of the Internet for the middle-aged and older population in China using data from the 2018 China Health and Retirement Longitudinal Study. The results indicated that Internet use was effective in improving the self-assessed health and chronic disease status of the middle-aged and older population. However, the effect of Internet use on the improvement of chronic disease conditions in this population was more pronounced than self-assessed health. In the heterogeneity analysis, the effect of Internet use on the health of female and middle-aged adults was more significant than that of male and older adults aged >60 years. This paper also used a propensity score matching model to eliminate the endogeneity problem caused by sample selectivity bias. The results revealed that the propensity score matching model analysis was more robust. Moreover, if sample selectivity bias was not eliminated, the effect of Internet use on the improvement of self-assessed health in the middle-aged and older population would be underestimated, whereas the effect of Internet use on the chronic disease status of the middle-aged and older adults would be overestimated.

Impact of Natural Disasters on Mental Health: A Cross-Sectional Study Based on the 2014 China Family Panel Survey

Mental health problems are a leading cause of disability in both developed and developing countries, and the consequences of mental health disorders for individuals, families, and society as a whole could be severe and costly. To supplement relevant research and provide insightful policy suggestions to families, government and societies, this study investigates the nexus between natural disasters and mental health for middle-aged and older adults in rural China. Based on data of 8721 observations from the 2014 China Family Panel Studies, we estimate the effects of natural disasters on mental health using ordinary least squares and propensity score matching. Our findings suggest that natural disasters have a significant negative effect on middle-aged and older adults' mental health in the case of rural China. This effect is heterogeneous depending on individuals' education level and their agricultural production status. Finally, individuals' happiness and life satisfaction are shown to be the potential mechanism through which the effect of natural disasters on mental health operates.

Screen time and depression risk: A meta-analysis of cohort studies

BACKGROUND

The impact of screen time on mental health, including depression, has attracted increasing attention from not only children and adolescents but also the elderly. Thus, we conducted a meta-analysis of cohort studies to evaluate the association between screen time and depression risk.

METHODS

The PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases were searched for cohort studies up to May 2022, and the reference lists of the included studies were also retrieved. A random-effect model was used to estimate the combined effect size. Heterogeneity was assessed with the I ² statistic. Potential publication bias was evaluated using a funnel plot and Begg's and Egger's tests.

RESULTS

The final analysis included 18 cohort studies with a combined total of 241,398 participants. The pooled risk ratio (RR) was 1.10 (95% confidence interval: 1.05-1.14), with significant heterogeneity (I ² = 82.7%, P < 0.001). The results of subgroup analyses showed that the pooled RRs varied according to geographic locations, gender, age group, screen time in the control group, depression at the baseline, and whether the study was conducted during the COVID-19 pandemic. No obvious evidence of publication bias was found.

CONCLUSION

This study indicates that screen time is a predictor of depressive symptoms. The effects of screen time on depression risk may vary based on the participant's age, gender, location, and screen time duration. The findings could have important implications for the prevention of depression.