Faculty of Social Sciences, University of Toyama, Gofuku 3190, Toyama, 930-8555, Japan.
School of Engineering, Kyushu University, 744 Motooka, Nishi-ku, Fukuoka, 819-0395, Japan.
BMC Public Health. 2020 Apr 15;20(1):502. doi: 10.1186/s12889-020-08650-4.
Social participation (SP) is known to have a favourable impact on health. However, studies on this issue have been conducted mainly in advanced countries, and results in China have been mixed. This study examined the impact of SP on health outcomes of middle-aged and elderly adults in China, adjusted for simultaneity and heterogeneity biases.
In total, 57,417 observations of 28,935 individuals obtained from the population-based, three-wave panel survey, Chinese Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015 were used. The associations between one- or two-wave-lagged SP and health outcomes (mental health, self-rated health [SRH], activities of daily living [ADL], and diagnosed diseases) were examined by linear regression models. Individual-level heterogeneity was addressed by the random-effects estimation method.
SP was found to have a positive impact on mental health and ADL. Specifically, one-wave-lagged SP improved mental health measure (range: 10-70) by 0.820 (standard error [SE]: 0.199, p < 0.001), the basic ADL measure (range: 6-24) by 0.147 (SE: 0.043, p < 0.001), and the instrumental ADL measure (range: 5-20) by 0.159 (SE: 0.035, p < 0.001). In contrast, SP did not significantly affect SRH or diagnosed diseases. The impact of SP differed by SP type; playing Mah-jong (Chinese traditional game), chess, or cards, or going to the community club had the most favourable effect. The impact of SP on health was also greater for women than men and greater for individuals aged 60-69 years than those aged 45-59 years and aged 70 and older.
SP had a positive, albeit selective, impact on health outcomes among middle-aged and elderly adults in China. The results suggest that policy measures to encourage these individuals to engage in SP are needed to enhance their health.
社会参与（SP）对健康有积极影响。然而，关于这个问题的研究主要在发达国家进行，而中国的研究结果则参差不齐。本研究通过调整同时性和异质性偏差，检验了 SP 对中国中老年人群健康结果的影响。
本研究使用了 2011 年、2013 年和 2015 年进行的基于人群的三波面板调查——中国健康与退休纵向研究（CHARLS）中获得的 28935 名个体的 57417 个观测值。通过线性回归模型检验了单波或两波滞后 SP 与健康结果（心理健康、自评健康[SRH]、日常生活活动[ADL]和诊断疾病）之间的关联。采用随机效应估计方法解决个体水平的异质性问题。
SP 对心理健康和 ADL 有积极影响。具体来说，单波滞后 SP 使心理健康指标（范围：10-70）提高了 0.820（标准误差[SE]：0.199，p<0.001），基本 ADL 指标（范围：6-24）提高了 0.147（SE：0.043，p<0.001），工具性 ADL 指标（范围：5-20）提高了 0.159（SE：0.035，p<0.001）。相比之下，SP 对 SRH 或诊断疾病没有显著影响。SP 的影响因 SP 类型而异；玩麻将、棋或牌，或去社区俱乐部的影响最大。SP 对女性的健康影响大于男性，对 60-69 岁人群的影响大于 45-59 岁和 70 岁及以上人群。
SP 对中国中老年人群的健康结果有积极的、选择性的影响。研究结果表明，需要采取政策措施鼓励这些人参与 SP，以提高他们的健康水平。
