Liu Danxia, Zhang Bo, Guo Jing
School of Public Policy and Management, Tsinghua University, Beijing, China.
Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Gen Psychiatr. 2024 Aug 9;37(4):e101562. doi: 10.1136/gpsych-2024-101562. eCollection 2024.
The triple digital divide refers to the lack of internet access, use and knowledge among specific populations. In China, middle-aged and older adults and those living in rural areas or various regions of the country are more likely to have limited internet access and skills and, thus, have less accessibility to internet services. Few longitudinal studies have explored the association between the digital divide and the progression of depressive symptoms among middle-aged and older Chinese adults. Significantly, none of the existing studies have estimated this long-term relationship from a disparity perspective.
This study investigates the association between the triple digital divide and depressive symptom trajectories among middle-aged and older adults in China during a 10-year follow-up period from 2011 to 2020.
The sample for this secondary analysis comprises 3019 urban and 10 427 rural respondents selected from the China Health and Retirement Longitudinal Study baseline survey in 2011. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale. Employing longitudinal mixed-effects models, this study explored the association between the triple digital divide and depressive symptom trajectories among middle-aged and older Chinese adults by examining gender, rural-urban and regional disparities in this relationship.
Our findings revealed a significant association between the triple digital divide and increasing trajectories of depressive symptoms, showing significant disparities based on gender, rural-urban dwelling and regional location. Notably, for both male and female participants who resided in urban areas or the central region of the country, their ability to use the internet, coupled with enhanced internet skills and greater access to internet services, was found to have a mitigating effect on the increasing trajectories of depressive symptoms.
To alleviate some of the confounding influences on the trajectory of depression in middle-aged and older adults, policymakers in China should continue to prioritise the development of internet technology, foster easy access to the internet to ensure it is 'elder-friendly', provide internet skill training platforms for this population and broaden access to various internet services appropriate for them. Additionally, the implementation of tailored interventions to address depression, especially targeting the more vulnerable cohorts, such as middle-aged and older women, those residing in rural areas and the western regions, is crucial. Such tailored approaches are essential for addressing the disparities and challenges associated with the triple digital divide.
数字鸿沟三重困境指特定人群在互联网接入、使用和知识方面的缺失。在中国，中老年人以及农村地区或国内各地区的人群更有可能面临互联网接入和技能受限的情况，因此获得互联网服务的机会较少。很少有纵向研究探讨中国中老年人数字鸿沟与抑郁症状进展之间的关联。重要的是，现有研究均未从差距视角估计这种长期关系。
本研究调查2011年至2020年10年随访期内中国中老年人数字鸿沟三重困境与抑郁症状轨迹之间的关联。
本次二次分析的样本包括从2011年中国健康与养老追踪调查基线调查中选取的3019名城市受访者和10427名农村受访者。使用流行病学研究中心抑郁量表测量抑郁症状。本研究采用纵向混合效应模型，通过考察这种关系中的性别、城乡和地区差异，探讨中国中老年人数字鸿沟三重困境与抑郁症状轨迹之间的关联。
我们的研究结果揭示了数字鸿沟三重困境与抑郁症状增加轨迹之间存在显著关联，基于性别、城乡居住情况和地区位置存在显著差异。值得注意的是，对于居住在城市地区或中国中部地区的男性和女性参与者，他们使用互联网的能力，以及增强的互联网技能和更多的互联网服务获取机会，被发现对抑郁症状增加轨迹有缓解作用。
为减轻对中老年人抑郁轨迹的一些混杂影响，中国政策制定者应继续优先发展互联网技术，促进互联网的便捷接入以确保其“对老年人友好”，为该人群提供互联网技能培训平台，并拓宽适合他们的各种互联网服务的获取渠道。此外，实施针对性干预措施以应对抑郁症，特别是针对更脆弱的群体，如中老年女性、农村地区居民和西部地区居民，至关重要。这种针对性方法对于解决与数字鸿沟三重困境相关的差异和挑战至关重要。
