As the aging continues, China has become the country with the largest older population. In order to ensure the well-being of older adults in their later years, the whole society is increasingly concerned about the mental health of older adults. In 2019, we conduct a questionnaire survey in Shaanxi Province. Stratified random sampling is used to select three representative cities, and 677 samples are selected from the survey results for research. By using the structural equation model, we aim to reveal the mechanism of leisure activities’ influence on mental health of the older adults and verify whether social support and perceived stress play a mediating role. The study finds that the older adults’ leisure activities have no significant direct impact on mental health. Social support has a significant mediating effect between leisure activities and mental health of the older adults. Leisure activities indirectly affect the mental health of the older adults through social support, and participation in leisure activities can improve the social support of the older adults, thus improving the mental health level of the older adults. Perceived stress plays a significant mediating role between leisure activities and mental health of the older adults. By participating in leisure activities, the perceived stress of the older adults will be reduced, thus improving their mental health. Social support and perceived stress play a sufficient mediating role in the influence of leisure activities on mental health.
With the increase in aging in China, the health problems of older adults, especially mental health problems, have become a concern for the whole society. This article selected urban and rural older adults and analyzed the impact of social support on their mental health using a binary logistic model. It was found that under the current urban–rural dichotomy, the effects of social support on the mental health of urban and rural older adults are significantly different. In social support, first, the fairness and satisfaction with the social security system only had a significant effect on the mental health of urban older adults and had no significant effect on the rural older adults. Second, the closeness of contact with grassroots community workers had a significant impact on the mental health of older adults in urban and rural areas. From informal social support, the mental health of rural older adults was mainly influenced by the support of their children, reflecting the influence of the traditional culture of “filial piety”. Furthermore, the mental health of urban older adults was mainly influenced by neighborhood support, reflecting the importance of “close neighbors are better than distant relatives”. Based on the results of the empirical study, this article suggests that to promote the mental health of older adults, we should start by strengthening the formal social support system, establishing high-quality community service facilities, and emphasizing the role of informal social support.
Background: With the rapidly aging of Chinese society and the change of Chinese residents’ disease spectrum, the older adults utilization of the healthcare services surges as well. Studies on factors that potentially influence the utilization of healthcare services for the older adults becomes increasing important, which could benefit improving the service effect and the quality of life of the older adults in later life. This article compares and analyzes the differences in the using of healthcare services by the older adults in urban and rural areas based on the supply and demand of healthcare services for the older adults and analyzes the reasons for potential differences. Methods: Using data from a survey conducted in three cities in Shaanxi Province in 2019. All authors participated in the questionnaire survey. We obtained a total of 948 questionnaires. Multivariate regression model and Oaxaca-Blinder decomposition model are used to analyze the difference between the supply and demand of medical services for the older adults in urban and rural areas.Results: The results find that age, household register, living activities of daily living (ADL), (P<0.01) and healthcare treatment insurance significantly impact the older adults use of healthcare services. Meanwhile, factors from the supply and demand factors have a significant correlation with the utilization of services for the older adults, including the healthcare service quality(P<0.01), the diversity of service content(P<0.01), the rationality of service charge(P<0.01), service satisfaction(P<0.01), family support (P<0.1) level and the main illness(P<0.05). Moreover, the results show a significant difference in the use of healthcare services for the older adults between urban and rural areas. Specifically, in urban areas, the influences of service quality, the diversity of service content and the rationality of service from the supply have a significant correlation with the utilization of services for the older adults. The service satisfaction, service demand and family support in the demand factors have a significant correlation with the utilization of services for the older adults. In comparisons, for the older adults in rural areas, the diversity of service content from the supply factors as well as economic level and main illness from the demand factors have a significant correlation with the utilization of services for the older adults.Conclusions: From the perspective of supply and demand, this paper constructs an analytical framework of the determinants of healthcare services for the older adults from a new perspective. Based on the analysis framework and from the perspective of supply and demand of healthcare services utilization, the differences between urban and rural areas in the utilization of medical care for the older adults and the influencing factors are studied. It provides a new research perspective to explore the influencing factors of healthcare services utilization for the older adults. Supply factors and demand factors have a significant correlation with the utilization of healthcare services for the older adults. There are also significant differences in the factors influencing the utilization of health services by urban and rural older adults. When strengthening and improving the supply of healthcare services for the older adults, the previous thinking of “top-down” and “service-centered” should be changed, and gradually transformed into “bottom-up” and “demand-centered”.
Background Along with the increasing number of older adults in China, the demand for older adults services of China's aging population has been transformed and upgraded, and the demand for community cultural and leisure services of the older adults has become increasingly prominent. The research on the influencing factors of the utilization of community cultural and leisure services of the older adults can help improve the service effect and enhance the quality of life of the older adults. Based on Anderson's model, we constructed an analytical framework of the influencing factors of the utilization of community cultural and leisure services for the older adults from both the supply and demand sides, and then used Poisson regression method to empirically test the analytical framework based on the survey data of three cities in Shaanxi Province in 2019. Results The results found that supply-side factors significantly influenced the utilization of community cultural and leisure services by the older adults, mainly including service facility supply, service content supply, and service location accessibility; demand-side factors significantly influenced the utilization of community cultural and leisure services by the older adults, mainly including service acceptability, service satisfaction, and service need. The study also found that, unlike the results of previous studies, the use of community cultural and leisure services by older adults was not constrained by economic level. Conclusions Both supply-side factors and demand-side factors significantly affect the utilization of community spiritual culture services by the older adults. In strengthening and improving the supply of community cultural and leisure services, the previous "top-down" and "service-centered" approach should be changed to a "bottom-up" and "demand-centered" approach. In the past, the supply of community spiritual culture services should be changed from a "top-down" and "service-centered" approach to a "bottom-up" and "demand-centered" approach, and attention should be paid to the urban-rural differences in supply.
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