Tingshuai Ge

Population aging in rural China has increased caregiving demands for older adults living with disabilities, while formal long-term care resources remain limited. Evidence remains insufficient regarding how multidimensional caregiving burden is associated with depressive symptoms and whether formal and informal support buffer these associations. To examine the associations between multidimensional caregiving burden and depressive symptoms among rural caregivers and to investigate the buffering roles of formal and informal support, including heterogeneity by gender and educational attainment. Cross-sectional data from 781 rural caregivers in China were analyzed using multivariable linear regression models. Caregiving burden included overall burden and five dimensions: physical burden, psychological burden, financial burden, time-dependence burden, and social isolation. Formal support was measured by the availability of community care services, and informal support by caregivers' social networks. Stratified analyses were conducted by gender and educational attainment. All dimensions of caregiving burden were significantly associated with higher depressive symptoms. Financial burden and social isolation showed the strongest associations. Informal social support buffered the adverse effects of all burden dimensions, whereas formal community services mainly buffered physical and financial burden. Male caregivers benefited from both forms of support, while female caregivers relied primarily on informal support. Buffering effects were stronger among caregivers with lower educational attainment. Depressive symptoms among rural caregivers are closely associated with multidimensional caregiving burden. Policies should prioritize reducing financial strain and social isolation while strengthening both formal and informal support systems, particularly for women and less educated caregivers.

Background: Child health and gender inequalities are significant global public health issues that demand immediate action, particularly in South and Southeast Asian (SSEA) countries where both challenges are prevalent. This study examines the association between women’s empowerment and child vaccination coverage in 11 SSEA low- and middle-income countries. Methods: Using population-level cross-sectional data from Demographic and Health Surveys across 11 SSEA countries, we developed an Individual-Level Women’s Empowerment Index (ILWEI) based on three dimensions of women’s empowerment: decision-making autonomy, attitude towards intimate partner violence and social independence. A three-stage mixed-effect individual participant data meta-analysis was employed to assess the association between ILWEI and childhood immunisation coverage. Results: In India, 81.28% of women reported participation in three to four decision-making areas, followed by 62.07% in Bangladesh. Full immunisation coverage ranged from 32.43% in Afghanistan to 63.30% in Bangladesh. The association between women’s empowerment and vaccination coverage varied across South and Southeast Asia, with the strongest positive associations observed in Pakistan. However, mixed or negative associations were found in countries such as India and Timor-Leste. Conclusion: Our findings indicate that in several SSEA countries, including Pakistan, Cambodia, the Philippines and Afghanistan, higher levels of individual women’s empowerment are positively associated with an increased likelihood of childhood immunisation coverage. However, in countries such as India, Myanmar and Timor-Leste, higher women’s empowerment was associated with lower odds of childhood immunisation, highlighting potential contextual or systemic barriers that may hinder vaccination uptake. This underscores the critical role of women’s empowerment in enhancing childhood vaccination intake while also emphasising the need for targeted interventions to address country-specific challenges. Coordinated, multifaceted strategies are essential to empower women and thereby support the immunisation of children across regions.

Knowledge about life course trajectories and intercohort changes in mental health is limited mainly to Western populations. To address this gap, our study analyzes mental health trajectories in China, drawing on data on depressive symptoms from the China Family Panel Studies over the period 2012–2020 (N = 31,700 individuals aged 16–70; N = 87,787 person‐years). Employing hierarchical linear regression models, our findings reveal moderate increases in depressive symptoms over the life course and across cohorts. Subgroup analyses indicate that women, people with lower educational attainment, and people with rural hukou experienced more depressive symptoms and a more pronounced increase in depressive symptoms with age. These disparities narrowed across cohorts. We discuss these patterns in the context of Chinese cultural dynamics, including son preference, the impact of education and hukou on the accumulation of stress over the life course, family policy and equity policy transitions, and the changing stigma of mental health.

Background: Depression has become a challenging public health problem, and the loss of a spouse is one of the main causes of depression in older adults. Social participation and psychological resilience are protective factors that reduce depressive symptoms in adults. The purpose of this study was to explore the influences of social participation and psychological resilience on the depression of Chinese widowed older adults. Methods: We carried out a cross-sectional study on 790 community-dwelling widowed older adults in Shaanxi, China, in 2019. A structured face-to-face interview was used to collect data. We used the ordinary least squares model (OLS), the generalized propensity score matching (GPSM) and the mediation model to test the relationship between social participation, psychological resilience and depression. Results: We find a U-shaped relationship between social participation and depression, with the increase in social participation scores, the average depression level decreased and then increased. The psychological resilience of the widowed older adults was negatively associated with depression. The higher their psychological resilience, the lower their depression level. Among the four factors of psychological resilience, factor 2 (optimism and positive acceptance of change) and factor 3 (secure relationships and tolerance of negative affect) of psychological resilience were protective factors for depression after adjusting for demographic variables and physical health conditions. Psychological resilience plays a mediating role, as evident in factor 2 and factor 3 mediating the relationship between social participation and depression. Conclusion: An appropriate level of social participation will relieve the depression of widowed older adults. Social participation can reduce the depression level of widowed older adults by improving their psychological resilience. Community and family could reduce depression by intervening in the social participation of widowed older adults. Active social participation is crucial because it has a protective and resilient impact, which can help people recover from the stress of losing a spouse.

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.

Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.

There has been some research on factors affecting China’s rising sex ratio at birth (SRB), but the spatial dependence has been largely neglected. With China’s census and sample survey data and the dynamic spatial Durbin model; we analyzed the changes in SRB in China. We found that SRB and its influencing factors were spatially correlated at the provincial level. For direct effects; urbanization significantly reduced SRB in this region; while strict family planning policies increased SRB in the local region. For indirect effects; the increase in per capita Gross Domestic Product and urbanization led to an increase in the SRB of the neighboring regions through population mobility. By comparison; educational improvement in one region benefited the neighboring provinces and reduced SRB.