Subjective poverty, mental health, and mortality among Chinese older people: a prospective cohort study from 2008 to 2018

Enhancing understanding of healthy aging based on time-varying dependencies among multidimensional health, life satisfaction, and health behaviors of older adults aged 60 years and over

BACKGROUND

Healthy aging is a process of not only achieving good health but also increasing the life satisfaction of older adults aged 60 years and over, in which health behaviors play an important role. There is a lack of research on the time-varying dependencies between health, life satisfaction, and health behaviors, impeding a deeper understanding of healthy aging.

PURPOSE

To develop an integrated framework for modeling the interrelationships among the components of healthy aging between multiple time slices.

METHODS

Based on the Chinese Longitudinal Healthy Living Survey (CLHLS) data in the three waves of 2011/2012, 2014, and 2017/2018, Bayesian network and dynamic Bayesian network are jointly employed to study the relationships among the components of healthy aging within one time slice, as well as to explore the time-varying dependencies among the components between time slices.

RESULTS

The results of structure learning reveal the direction of effects between different dimensions of health, with mental health and social health affecting physical health and self-rated health affecting both physical and mental health. In addition, health behaviors are found to affect mental health and social health, while self-rated health can influence life satisfaction. The parameters learned from the data show the magnitude and direction of concurrent effects, one-period lagged effects and two-period lagged effects between the factors, which find that the time-varying dependencies vary but are generally positive, long-term, and accumulative over time. In addition, the results of autoregressive effects show the positive predictive effects of health and life satisfaction.

CONCLUSIONS

It confirms the influence pathway from health behaviors to multidimensional health to life satisfaction, and the time-varying dependencies among the components of healthy aging, which facilitates a deeper understanding of healthy aging. Combining the results of autoregressive effects and descriptive statistics, it further indicates that healthy aging is a comprehensive result arising from interactions of multiple factors. Policymakers should guide older adults aged 60 years and over to adopt healthier behaviors and ensure the long-term sustainability and continuity of policies.

The Impact of Subjective Poverty on the Mental Health of the Elderly in China: The Mediating Role of Social Capital

Reducing subjective poverty among the elderly is an important aspect of poverty governance and is a necessary part of implementing the healthy aging strategy in China. In both China and the majority of low- and middle-income countries, systematic research on the relationship between subjective poverty and the mental health of the elderly needs to be expanded. In this study, we aimed to examine how social capital, including bonding and bridging social capital, mediate the relationship between subjective poverty and mental health among the elderly in China. Relying on the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) data, we used ordered probit (oprobit) regression, propensity score matching (PSM), and instrumental variable (IV) regression to estimate the effects of subjective poverty on mental health. The results indicate that subjective poverty has a significant negative impact on the mental health of the elderly in China. More importantly, social capital, including bonding and bridging social capital, partially mediates the relationship between subjective poverty and mental health. We believe that, in the process of implementing the government's healthy aging strategy in China, society and government should recognize the importance and value of subjective poverty governance for the elderly. In particular, the construction of a social relationship network that centers on bonding and bridging social capital could be instrumental in dealing with subjective poverty among the elderly and safeguarding their mental health and wellbeing.