Xiaodong Zhang

Social participation is crucial for enhancing senior’s well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life.

Background: Globally, nearly 15% of people suffer from various kinds of disabilities, and China has the largest disabled population in the world. The poor mental health status of people with disabilities has become an essential issue in most countries. The main aim of this study was to explore the potential impact of internet use on depression risk among middle-aged and older adults with different types of disabilities. Methods: The data used in this study were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) collected by Peking University. A binary logit model was used to analyze the impact of internet use on the depression risk among adults with disabilities, and the substitute variable method and the propensity score matching method were used to examine the robustness of the results. Results: (1) Internet use was negatively associated with depression risk among disabled people, and the higher the frequency of their internet use, the lower the probability of their depression risk. (2) Different social activities related to the internet had different impacts on the depression risk, and the decline in depression risk was mainly related to watching videos, watching news, and chatting via the internet. (3) Internet use reduced the depression risk of adults with physical disabilities, but had no impact on those with other types of disabilities. Conclusions: Our study suggests that internet use may have a positive spillover effect on decreasing the depression risk of disabled people, but the reduction effect is significantly affected by the social activities related to the internet and the types of disabilities.

Background: In an aging and digital society, Internet use is significantly associated with residents’ physical exercise. This study aimed to explore the association between Internet use and physical exercise among Chinese middle-aged and older adults in two respects: Internet use and the purpose of Internet use. Methods: The data used in this study were obtained from the 2018 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. The logit model and the ordered probit model were used to analyze the association between Internet use and physical exercise, and the substitution variable method was used to examine the robustness of the results. Results: (1) Internet use and the frequency of Internet use significantly increased the probability and frequency of middle-aged and older adults’ participation in physical exercise (p < 0.001). (2) “Watching news”, “chatting” and “watching videos” via the Internet were positively associated with physical exercise, while “playing games” had no impact. (3) Internet use had a greater impact on physical exercise participation among middle-aged adults and those living in urban areas than among older adults and those living in rural areas. Conclusions: This study suggests that Internet use among middle-aged and older adults is positively associated with their participation in physical exercise; the government should try to increase the popularity of Internet use to encourage their participation in physical exercise.

As an important source of income for elderly people, pensions have a great impact on their wellbeing. There are three different pension systems in China (the Old-age Insurance System for Government Agencies and Institutions (OISGAI), the Basic Old-age Insurance System for Urban Employees (BOISUE) and the Social Insurance of the Old-age Pension for Urban and Rural Residents (SIOPURR)). This study empirically analyses the impact of various pension types on the happiness of elderly people in China and further explores the potential impact mechanism using the 2014 China Family Panel Studies data. The study suggests that first, receiving pensions from OISGAI, BOISUE and SIOPURR is positively correlated with the happiness level of elderly people. Second, the sense of happiness of elderly people who receive BOISUE is higher than that of those receiving SIOPURR, which is mainly caused by the difference in the level of pension benefits. When the level of benefits is controlled for, there is no significant difference between these two groups. Third, when they have the same level of pension benefits, the happiness of elderly people who receive OISGAI is significantly higher than that of those who receive pensions from the other two systems, which is possibly related to the hidden ‘special’ government guarantee and the difference of the growth rate of the benefit level.

Purpose: Medical insurance is a disease risk-sharing mechanism that can improve residents’ financial access to medical treatment and thus increase their utilization of health services. This paper aims to identify the impact of different kinds of medical insurances on the use of healthcare for Chinese mid-aged and older urban residents from four aspects: outpatient behaviour, outpatient costs, inpatient behaviour and inpatient costs. Materials and Methods: The data used in this study were from 2015 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. Binary logit model and multiple linear regression model were used to analyse the impact of health insurance on the use of healthcare, and the PSM method was used to test the robustness of the results. Results: Participating in either BMIUSE or BMISURR can significantly improve all kinds of healthcare utilization for mid-aged and older urban groups. However, there are huge differences on the healthcare utilization between BMISUE and BMISURR. Specifically, the probability of using inpatient care and inpatient costs of urban residents enrolled in the BMISUE are 4.2% and 45% higher, respectively, than those covered by the BMISURR, but there are no differences in outpatient care utilization and outpatient costs between these two health insurance programs. Conclusion: This paper suggests that the large gaps between BMISUE and BMISURR only reflect on inpatient care and inpatient costs, there is no difference in outpatient services between these two health insurance programs. “Excessive demand”, “induced demand” and other moral hazard phenomena in BMISUE should be avoided when receiving hospitalization services.

Background: The rapid rise of medical expenditure is a common problem in the field of public health around the world, but the challenges for the Chinese government are even greater. How to control the rapid rise in medical expenditure and reduce individuals’ economic burden when receiving medical treatment has become one of the core issues that the Chinese government urgently needs to solve. The aim of this study was to evaluate the impact of Internet use on individuals’ medical expenditure and further discuss the potential impact mechanism. Methods: The data used in this study were from the 2018 China Family Panel Studies (CFPS) conducted by Peking University. The Heckman sample selection model was used to analyse the impact of Internet use on individuals’ medical expenditure. Results: Internet use reduced the medical expenditure of individuals by 6.19%; high frequency Internet use reduced the medical expenditure of individuals by 15.1%, while low frequency Internet use had no impact. In addition, Internet use had different impacts on individuals’ medical expenditure at different levels of hospitals. Specifically, Internet use reduced the medical expenditure of individuals who received medical treatment at general hospitals by 9.63%, and high frequency Internet use reduced the medical expenditure of individuals by 22.2%. However, Internet use had no impact on the medical expenditure of individuals who received medical treatment at primary hospitals. Conclusions: Findings from this study underscore the importance of Internet use as an important role in reducing individuals’ medical expenditure. The use of the Internet can significantly reduce the level of individuals’ medical expenditure, and high frequency Internet use has a greater effect. However, Internet use has different impacts on individuals’ medical expenditure among different levels of hospitals. The reduction effect of Internet use on individuals’ medical expenditure is mainly concentrated in general hospitals but has no effect in primary hospitals.