Background This study aimed to investigate the effect of social participation on income-related inequality in health outcome among older adults in China. Methods The panel data used in this study were sourced from the 2011 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Furthermore, this study employed a concentration index to assess the income-related inequality in health outcome. Moreover, this study used the decomposition method of concentration index to analyse the effect of social participation on income-related inequality in health outcome. Results The total concentration index of Instrumental Activity of Daily Living (IADL) status decreased from 0.0257 in 2011 to 0.0172 in 2014. Furthermore, the total concentration index of psychological health decreased from 0.0309 in 2011 to 0.0269 in 2014. The decomposition analysis indicates that social participation made a major contribution to the pro-rich inequality in IADL status. Moreover, the results also indicate that social participation made a minor contribution to the pro-rich inequality in psychological health. Conclusions This study demonstrated that overall there were pro-rich inequalities in IADL status and psychological health among older adults in China. Moreover, social participation made a major contribution to the pro-rich inequality in IADL status, while it made a minor contribution to the pro-rich inequality in psychological health.

Background and Aim: Health equity is an important goal of health policy, and the equalization of access to health care plays a vital role in guaranteeing it. The aim of this study was to use the cross-sectional data to explore the effect of New Rural Cooperative Medical Scheme (NRCMS) on the socioeconomic inequality in inpatient service utilization among the elderly in china. Methods: The data of this study were obtained from the 2018 wave of China Family Panel Studies (CFPS), involving 3645 older adults aged 60 and above. Furthermore, concentration index and concentration curve were employed to measure the socioeconomic inequality in inpatient service utilization. Moreover, this study used multiple linear regression model to explore the effect of NRCMS on inpatient service utilization. In addition, this study adopted the decomposition of concentration index to investigate the effect of NRCMS on the socioeconomic inequality of inpatient service utilization. Results: The concentration index of inpatient expense for the older people was 0.0538, and its concentration curve lays below the diagonal. The regression result indicates that NRCMS was significantly associated with higher inpatient expense among the elderly (coefficient = 0.8749, p < 0.01). The decomposition result reveals that the contribution rate of NRCMS to concentration index was −2.29%, which indicates that its contribution on reducing pro-rich inequality in inpatient service utilization was limited. Conclusion: This study demonstrates that there was a pro-rich inequality in inpatient service utilization among the elderly. Furthermore, NRCMS was significantly associated with higher inpatient expense. Moreover, NRCMS only played a limited role in reducing prorich inequality in inpatient service utilization.

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