Background The number of empty nesters in China is increasing and their health status is poor relative to that of non-empty nesters. However, older adults are not yet aware of the direct and indirect health-promoting effects of social engagement. Methods This study used data from the 2018 China Health and Aging Tracking Survey (CHARLS2018) to first conduct a descriptive analysis of the social engagement status and health status of empty nesters, then analyze the effect of social engagement on the health of empty nesters using a multiple regression model, and conduct robustness tests using propensity score matching methods, and then use a mediating effects model to explore the effect of social engagement on Then, we used the mediating effect model to explore the mechanism of social participation on the health of empty nesters, and finally, we used subsample regression to analyze the heterogeneity of different groups of empty nesters. Results First, there is a significant effect of social participation on the health status of the empty nesters, and the effects of various types of health still hold after using the propensity score matching method to deal with the endogeneity problem caused by sample selection; Second, economic income and cognitive ability have a significant mediating effect in the process of social participation affecting the health of the empty nesters; Third, there is age, urban and rural heterogeneity in the effect of social participation on the health of the empty nesters heterogeneity, i.e., social participation had a greater impact on the health of urban empty nesters and social participation had the greatest impact on the health of empty nesters aged 70–79. Conclusions These results highlight the facilitative effect of social participation on the health status of empty nesters and clarify the mediating role of cognitive ability and economic income in the influence process.
The impact of the medical insurance system (MIS) on the health of older adults is a key element of research in the field of social security. Because China’s MIS consists of different types of insurance, and the benefits and levels of coverage received by participating in different medical insurance vary, different medical insurance may have a differential impact on the health of older adults. This has rarely been studied before. In this paper, the panel data of the third phase of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015 and 2018 were used to investigate the impact of participation in social medical insurance (SMI) and commercial medical insurance (CMI) on the health of urban older adults and its mechanism relationship. The study found that SMI had a positive impact on the mental health of older adults, but only in the eastern region. Participation in CMI was positively correlated with the health of older adults, but this association was relatively small and was only observed in the sample of older adults aged 75 years and above. In addition, future life security plays an important role in the process of improving the health of older adults through medical insurance. Both research hypothesis 1 and research hypothesis 2 were verified. The results of this paper show that the evidence of the positive effect of medical insurance on the health of older adults in urban areas proposed by scholars is not convincing enough. Therefore, the medical insurance scheme should be reformed, focusing not only on coverage, but on enhancing the benefits and level of insurance, so as to enhance its positive impact on the health of older adults.
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