Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China.
Department of Health Economy and Social Security, College of Humanities and Management, Guilin Medical University, Guilin, China.
Front Public Health. 2022 Sep 29;10:967170. doi: 10.3389/fpubh.2022.967170. eCollection 2022.
With the surging number of older people living alone, their lifestyles and health status have aroused increasing concern. This study aims to investigate whether a leisure and entertainment lifestyle (LEL) can improve the multidimensional health among older people living alone and try to identify the latent mechanisms among them.
For this purpose, we extracted data from the Chinese General Social Survey (CGSS) and established a simultaneous equations model, comprising ordinary least square regression (OLS), two-stage least squares (2SLS), and the mediating effect model.
Older people living alone in China reported relatively better mental health status (3.64 ± 1.07), followed by physical health (3.41 ± 1.26) and social health (2.75 ± 1.18). In the OLS model, LEL significantly improved the social health of older people living alone (β = 0.054, < 0.01), followed by physical health (β = 0.042, < 0.01) and mental health (β = 0.027, < 0.01). After endogenous tests from 2SLS model and robustness tests, we found that more active LEL was associated with higher levels of physical health and mental health. However, LEL had no significant effect on the improvement of the social health of the older people living alone. Using the mediation analysis, exercise efficacy partially mediated the relationship of LEL with physical health and mental health, and the ratios were 19.75 and 24.85%, respectively. Similarly, positive life attitudes partially mediated the relationship between LEL and physical health, and LEL and mental health, with ratios of 10.65 and 26.83%, respectively.
Our findings suggested that LEL is significantly associated with better physical and mental health for older people living alone in China, and the association is mediated by exercise efficacy and positive attitudes toward life. Promoting more leisure and recreational activities, upgrading exercise efficacy, and encouraging positive life attitudes are necessary health promotion measures in active aging policies for the wellbeing of older people living alone.
随着独居老年人数量的不断增加，他们的生活方式和健康状况引起了越来越多的关注。本研究旨在探讨休闲娱乐生活方式（LEL）是否能改善独居老年人的多维健康，并试图确定其中的潜在机制。
为此，我们从中国综合社会调查（CGSS）中提取数据，并建立了一个联立方程模型，包括普通最小二乘法回归（OLS）、两阶段最小二乘法（2SLS）和中介效应模型。
中国独居老年人的心理健康状况（3.64±1.07）较好，其次是身体健康状况（3.41±1.26）和社会健康状况（2.75±1.18）。在OLS 模型中，LEL 显著提高了独居老年人的社会健康（β=0.054，<0.01），其次是身体健康（β=0.042，<0.01）和心理健康（β=0.027，<0.01）。经过 2SLS 模型的内生性检验和稳健性检验，我们发现更积极的 LEL 与更高的身体健康和心理健康水平相关。然而，LEL 对独居老年人社会健康的改善没有显著影响。通过中介分析，运动效能部分中介了 LEL 与身体健康和心理健康的关系，比例分别为 19.75%和 24.85%。同样，积极的生活态度部分中介了 LEL 与身体健康和心理健康的关系，比例分别为 10.65%和 26.83%。
我们的研究结果表明，LEL 与中国独居老年人的身心健康有显著的关联，这种关联是通过运动效能和积极的生活态度来介导的。促进更多的休闲娱乐活动、提高运动效能和鼓励积极的生活态度是积极老龄化政策中促进独居老年人健康的必要健康促进措施。
