The impact of pension on the health behavior of elderly rural residents: evidence from China.

BACKGROUND: Unhealthy behavior is an important factor threatening the health of older rural residents in China. We examine the effects of receiving pension on elderly rural residents' health behavior (namely conscious control of sugar, salt, and edible oil intake, as well as learning health or wellness knowledge), also including effect heterogeneity by income level and gender. METHODS: Using China Rural Revitalization Survey (CRRS) in 2020, we used the policy rule of the China's New Rural Pension Scheme that only those people who are over 60 years old can have access to pension as the natural experiment, and explore the causal effect of receiving pensions on the health behaviors by using regression discontinuity design method. RESULTS: Having access to pension can improve the health behavior of rural elderly residents, including increasing the probability of rural residents' conscious control of sugar (p < 0.1) and conscious control of salt intake (p < 0.1), which is still valid after a series of robustness tests. Heterogeneity analysis finds that access to pensions is more likely to improve the health behavior of low-income families and male rural elderly residents. CONCLUSIONS: The research has expanded the discussion on the correlation between the pension and the health of rural elderly residents, and the conclusion provides important policy implications for optimizing the rural elderly insurance system and leveraging pension to improve the health behavior of rural elderly residents.

Is Effective Recruitment Strategy Critical to Assess Brain Cognitive Function of Super Agers in Rural West Texas.

Our commentary aims to elucidate the importance of participant recruitment strategy in healthy brain aging study, particularly in rural West Texas, where more than 50% of the population are Hispanics and Latinos. The objective of our health aging study is to investigate the possible influence of biological, sociodemographic, and lifestyle factors on the occurrence of chronic diseases and dementia in the aging populations of West Texas. The success of this initiative is, in large part, reliant on high-quality, effective recruitment of participants. To that end, we propose an increase in our strategic recruitment efforts for both healthy, cognitively superior agers as well as those with mild cognitive impairment and patients with Alzheimer's disease in rural west Texas. We discussed, multi-advertising approaches, including ads in the local newspapers, local TV Channels and poster boards in senior centers.

Why elderly in rural China didn't wear masks during the COVID-19 pandemic? A qualitative narrative interview study.

BACKGROUND: During the COVID-19 pandemic, ageism and stigmatization towards the elderly have been prominent issues. In addition, there have been debates on Chinese social media as to why elderly people in rural areas are not wearing masks. While some factors that affect the mask-wearing behaviour of the elderly have been analyzed, little attention has been given to the lived experiences and behavioral intentions of rural elderly people who choose not to wear masks, despite government mandates to do so. METHOD: In this research, 50 semi-structured interviews with 30 elderly individuals in three Chinese villages were carried out using the qualitative method of semi-structured interviews. Following verbatim recording and transcription of the conversations, the subject was analyzed using the Theory of Reasoned Action. RESULTS: We identified four factors that influence the non-masking behaviour of rural elderly, including past experiences, cultural concepts, cognitive attitudes, and health and safety anxiety, and identified nine sub-themes based on the four overarching themes. Past knowledge, experience, and history have led rural elderly people to distrust the government's mandatory "mask mandate," believing that they do not need to wear masks. Rural cultural concepts and habits make the elderly feel that masks not only fail to provide protection but also become obstacles, resulting in poor daily experiences. Cognitive attitudes and emotions determine the elderly's evaluation of masks, which in turn affects their use of masks. Finally, elderly individuals'chronic diseases directly affect the physical pain and life safety caused by their use of masks, which is a major objective factor for their non-masking. CONCLUSIONS: Although numerous studies have concluded that Chinese people wore masks out of collectivism and conformity during the pandemic, marginalized groups' opposition to wearing masks also contains distinctive, individualized elements and underlying causes. By exposing these elements and reasons, we can better comprehend the peculiar behavior of particular groups while fighting the pandemic. The needs of marginalized populations should be prioritized by public health policy makers to provide more equitable services.

Erratum: Physical function, ADL, and depressive symptoms in Chinese elderly: evidence from the CHARLS.

[This corrects the article DOI: 10.3389/fpubh.2023.1017689.].

The Effect of Health Status on Urban Adaptation of the Rural Elderly after Migration.

As urbanization accelerates in China, more and more rural elders are moving to cities to live with their children. However, they face challenges in overcoming cultural, social, and economic disparities and maintaining health in urban life, and health is important human capital that may have a significant impact on the urban adaptation of rural elderly migrants (REMs). Based on the 2018 China Health and Retirement Longitudinal Study (CHARLS), this paper constructs an indicator system to measure the level of urban adaptation of REMs. The health level and urban adaptation of REMs are studied in depth, and how to better help them adapt to urban life in order to provide a healthy living environment and a good lifestyle is explored. The empirical analysis finds the following: (1) good health helps REMs achieve a better level of urban adaptation. (2) REMs with good health status are more likely to go to community clubs for activities and do physical activities and thus improve their urban adaptation level. (3) There are significant differences in the effects of health status on urban adaptation among REMs with different characteristics. REMs with better health status in the central and western regions have significantly higher levels of urban adaptation than those in the eastern regions, and men have higher levels of urban adaptation than women. Therefore, the government should construct classification measures according to the differentiated characteristics of rural elderly migrants' urban adaptation, and guide and support their stratified and orderly adaptation to urban society.

Promoting the well-being of rural elderly people for longevity among different birth generations: A healthy lifestyle perspective.

Background: Wellbeing may have a protective role in health maintenance. However, no specific study clarified the particular protective effect of the subjective wellbeing of rural elderly people on survival probability. Few studies have examined the effect of the lifestyle of rural elderly people on their subjective wellbeing from different perspectives. We investigated whether improving subjective wellbeing increased the probability of longevity of rural elderly people and the effects of lifestyle behaviors on the subjective wellbeing of rural elderly people in different birth generations. Materials and methods: Data were derived from the China Health and Nutrition Survey (CHNS), which is an ongoing open cohort study that adopts a multistage, random clustered sampling process. We used the data of elderly people who were aged 65 or over during 2006-2015 for analysis. The Kaplan-Meier method and log-rank test found that the survival probability of rural elderly people was significantly lower than urban elderly people. Based on a sample of rural elderly people, Cox regression and generalized estimating equations were performed as further analyses. Results: A total of 892 rural elderly people aged 65 or over were included in the sample in 2006. High subjective wellbeing was a protective factor against death. The subjective wellbeing of rural elderly people born in the 1940s/1930s/1908-1920s birth generations first decreased then increased. For rural elderly people born in the 1940s, there were significant positive effects of a preference for eating vegetables and walking/Tai Chi on subjective wellbeing. For rural elderly people born in the 1930s, preferences for eating vegetables, reading, and watching TV all had significant positive effects on subjective wellbeing. Rural elderly people born in the 1908-1920s who preferred watching TV had more subjective wellbeing. Conclusion: Improving subjective wellbeing extended the life span and reduced mortality risk in rural elderly people and may be achieved by the shaping of a healthy lifestyle, such as preferences for eating vegetables, walking/Tai Chi, and reading.

Physical function, ADL, and depressive symptoms in Chinese elderly: Evidence from the CHARLS.

Background: Depressive symptoms are a serious public health problem that affects the mental health of older adults. However, current knowledge of the association between ADL disability and physical dysfunction and depressive symptoms in Chinese adults is insufficient. We intend to analyze the association between physical function, ADL, and depressive symptoms in older Chinese adults. Methods: The data obtained from the China Health and Retirement Longitudinal Survey (2015 and 2018) (CHARLS). This includes 3,431 in 2015 and 3,258 in 2018 over the age of 60. Comparing 2015 and 2018 data, multivariate logistic regression models were used to explore the relationship between physical function, ADL, and depressive symptoms in urban and rural older adults, adjusting for sociodemographic factors associated with depression in older adults. Results: The prevalence of depressive symptoms among older adults in China was 33.8 percent in 2015 and 50.6 percent in 2018. In baseline data from 2015 and 2018, residence, gender, marital status, drinking, physical function, ADL, and self-rated health were all found to be significantly associated with depressive symptoms in older adults. The differences in physical function, ADL and depressive symptoms among older adults in 2015 and 2018 were further analyzed based on urban and rural stratification. Both physical dysfunction and ADL disability were significantly associated with depressive symptoms in rural older adults in 2015 and 2018. And in urban areas, ADL was found to be significantly associated with depressive symptoms in urban older adults. Multivariate logistic regression analysis demonstrated that ADL disability was significantly associated with depressive symptoms among older adults in both urban and rural areas. Physical dysfunction was only significant in rural areas with depressive symptoms. The alpha level was instead set to 0.05 for all statistical tests. Conclusion: Rural, female, 60-70 years of age, primary school or below, married, non-smoking, non-drinking, physical dysfunction, ADL disability and self-rated poor health make-up a higher proportion of depressed older adults. ADL disability and physical dysfunction were more likely to be associated with depressive symptoms in rural Chinese older adults. Therefore, the physical and mental health of rural elderly should be of concern. The rural older adults should receive additional support from the government and society.

Cardiovascular health profiles, systemic inflammation, and physical function in older adults: A population-based study.

We examined the association of modifiable cardiovascular health (CVH) metrics with physical function among rural older adults in China and the potential role of inflammatory mechanisms in the association. This study included 3733 stroke- and dementia-free participants (age ≥65 years; 56.9% women) in the baseline survey of a multimodal intervention study in rural China. From March-September 2018, data were collected via face-to-face interviews, clinical assessments, and laboratory tests. The Short Performance Physical Battery (SPPB) test was performed to assess physical function. We defined six modifiable CVH metrics according to the modified American Heart Association's recommendations. Serum interleukin (IL)-6 was measured in a subsample (n = 1156). Data were analyzed with multiple general linear and logistic regression models and structural equation modeling. Poor physical function (SPPB score ≤9) was defined in 1443 participants. Ideal CVH (vs. poor CVH) was associated with multivariable-adjusted odds ratio of 0.60 (95%CI 0.48-0.75) for poor physical function. Ideal CVH was significantly associated with higher scores on balance, chair stand, and walking speed tests (all p < 0.05). Moreover, ideal CVH profile was associated with lower serum IL-6 (multivariable-adjusted ß=-0.04; 95% CI -0.06, -0.01). Mediation analysis revealed that serum IL-6 accounted for 14% of the association of CVH with total SPPB score and 10% of the association with walking speed score (p < 0.05). This study suggests that an ideal CVH profile is associated with better physical function among stroke- and dementia-free older adults, partly via inflammatory mechanisms. The preventive implications of these findings warrant further investigation in cohort studies.

Health Services Utilization Barriers for Rural Elderly Women in Bangladesh: Narratives of Clinicians, Pharmacists and Public Health Assistants.

Bangladesh has the third largest population of poor older adults in the world and 73% of them live in rural areas. Disparity in the country's health services is evident that creates a substantial pressure, especially on rural elderly women who live in a compromised socio-cultural atmosphere. This is true that we know about rural elderly women's self-reported health and service use barriers, but no studies captured the views of health staff. This study presents a qualitative exploration of the views held by rural health staff whose role is to provide care to local elderly women. We conducted 11 interviews with clinicians, pharmacists and public health assistants in Sylhet district, Bangladesh. A critical thematic discourse analysis, using the critical social constructs of Habermas and Honneth, of the data informed the women's inadequate healthcare access and associated barriers that were complex and overlapping but had explicit institutional, subjective and material consequences. Five major themes emerged including: unequal distribution of health services; marginalization in patient-staff relationships; living with poverty; social relegation; and mistrust of clinical treatment. Rural areas were viewed with inequitably distributed health services and traditionally a large proportion of elderly women living in poverty who lacked social support and demonstrated a mistrust towards healthcare system. No recognition of the women and power differences were underpinned by economic factors and cultural societal values. The findings suggest a need for health policy solutions and education of healthcare staff and elderly women regarding accessing healthcare.

Factors related to self-rated health of older adults in rural China: A study based on decision tree and logistic regression model.

Objective: This study aimed to explore the related factors of self-rated health (SRH) by using decision tree and logistic regression models among older adults in rural China. Methods: Convenience sampling was employed with 1,223 enrolled respondents who met the inclusion criteria from 10 randomly selected villages in M County in China. The content of the questionnaire covered demographic characteristics, physical and mental health, sleep status, and risk of falling. The Pittsburgh Sleep Quality Index (PSQI) and the Morse Falls Risk Scale (MFS) were used to evaluate sleep status and risk of falling, respectively. The decision tree and logistic regression models were employed to analyze the related factors of SRH. Results: Notably, 817 (68.7%) subjects had good SRH. The logistic regression model showed that living standard, alcohol consumption, sleep quality, labor, hospitalization, discomfort, the number of chronic diseases, and mental health were associated with SRH (P-value < 0.05), while the decision tree model showed that the number of chronic diseases, sleep quality, mental health, hospitalization, gender, and drinking were associated with SRH. The sensitivity and specificity of the logistic regression model were 67.7 and 75.5%, respectively, and the area under the ROC curve was 0.789 (0.763, 0.816); the sensitivity and specificity of the decision tree model were 71.5, and 61.4% respectively, and the area under the ROC curve was 0.733 (0.703, 0.763). Conclusion: Decision tree and logistic regression models complement each other and can describe the factors related to the SRH of the elderly in rural China from different aspects. Our findings indicated that mental health, hospitalization, drinking, and sleep quality were the important associated factors.

A study on digital inclusion of Chinese rural older adults from a life course perspective.

Digital inclusion is viewed as a crucial strategy for promoting social inclusion and addressing issues related to aging. This study focuses on the digital inclusion practices of rural senior citizens and introduces a life course research perspective to move the study of influencing factors from the proximal to the distal end. The motivations, trajectories, and barriers to digital inclusion among rural elderly groups are presented through participant observation and semi-structured interviews with 34 elderly people in a village in northern China. It was discovered that digital inclusion or exclusion is the cumulative result of life events, social roles, and personal agency in the life course, while it is difficult for the elderly to break away from traditional culture and social relations in rural areas in the digital age. The digital practice is not only an inner adjustment in the process of life stage transition for rural seniors but also an individual pursuit of active aging.

Accelerometer-assessed sedentary behaviour among Chinese rural older adults: Patterns and associations with physical function.

Sedentary behaviour is associated with a range of adverse health conditions. Population-based studies have rarely examined the distribution and associated factors of accelerometer-measured sedentary behaviour patterns in rural-dwelling older adults. This population-based study included 2096 rural-dwelling older adults (age ≥60 years; 59.0% women) derived from baseline participants of the MIND-China Study. Total sedentary time and patterns (e.g., uninterrupted bouts and breaks) were derived from the hip-worn accelerometers for 7 days. Physical function was assessed using the Short Physical Performance Battery test. Data were analysed using general linear models. Overall, participants spent 58.8% of daily waking time in sedentary behaviour, with nearly half of sedentary time being accumulated through sedentary bouts of 30+ minutes. Men spent more total and accumulated sedentary time than women in each sedentary bout duration, while women had more daily 1+ minute sedentary bouts than men (all P < 0.001). Controlling for moderate-to-vigorous physical activity and other confounders, more prolonged sedentary time and fewer breaks were significantly associated with poor physical function, balance, lower limb strength, and walking speed (all P < 0.001). In older adults living in rural communities, prolonged sedentary behaviour and less frequent breaks are associated with poor physical function.

The impact of informal social support on the health poverty vulnerability of the elderly in rural China: based on 2018 CHARLS data.

OBJECTIVE: From the perspective of informal social support, this paper analysed the impact of factors such as "Relationship with spouse", "Relationship with Children", "Financial support from children", "Sibling support", "Support from other friends and relatives" and "Borrowing costs" on the health poverty vulnerability of elderly people in rural China. METHODS: Based on the data of the China Health and Retirement Longitudinal Study (CHARLS) in 2018, the vulnerability of the rural elderly to health poverty was measured from two dimensions of health status and influencing factors of health status by the three-stage feasible generalized least square method. A quantile regression model was used to analyse the impact of six variables in the informal social support network on health poverty vulnerability: "Relationship with spouse", "Relationship with children", "Financial support from children", " Sibling support", " Support from other friends and relatives", and "Borrowing costs". RESULTS: When the poverty line standards were 2995 CNY/year and 4589 CNY/year, the health poverty vulnerability of the elderly population in rural China was 0.397 and 0.598 in 2018. In the analysis of informal social support, factors such as the relationship with spouse, relationship with children, borrowing costs, support from other friends and relatives, and sibling support had different impacts on the health poverty vulnerability of the rural elderly, who were classified into three groups according to their different vulnerabilities. CONCLUSION: According to the analysis of the 2018 CHARLS database, the health poverty vulnerability of the elderly population was related to the informal social support network, and it is necessary to pay attention to the role of informal channels such as children, spouses, relatives and friends in daily care and financial support for rural elderly individuals. Meanwhile, the government and other formal organizations should also give full play to their supporting role for elderly individuals, who are highly vulnerable to health poverty, and their families.

Effective interventions on health effects of Chinese rural elderly under heat exposure.

Due to climate change, the heatwave has become a more serious public health threat with aging as an aggravating factor in recent years. There is a pressing need to detect the most effective prevention and response measures. However, the specific health effects of interventions have not been characterized on an individual scale. In this study, an intervention experiment was designed to explore the health effects of heat exposure at the individual level and assess the effects of different interventions based on a comprehensive health sensitivity index (CHSI) in Xinyi, China. Forty-one subjects were recruited randomly, and divided into one control group and three intervention groups. Interventions included education (Educate by lecturing, offering relative materials, and communication), subsidy support (offer subsidy to offset the cost of running air conditioning), and cooling-spray (install a piece of cooling-spray equipment in the yard). Results showed that systolic blood pressure (SBP) and deep sleep duration (DSD) were significantly affected by short-term heat exposure, and the effects could be alleviated by three types of interventions. The estimated CHSI indicated that the effective days of the education group were longer than other groups, while the lower CHSI of the subsidy group showed lower sensitivity than the control group. These findings provide feasible implementation strategies to optimize Heat-health action plans and evaluate the intervention performance. Electronic Supplementary Material: Supplementary material is available in the online version of this article at 10.1007/s11783-022-1545-4 and is accessible for authorized users.

Does Social Pension Expansion Relieve Depression and Decrease Medical Costs? Evidence From the Rural Elderly in China.

Objectives: This study was designed to explore the effect of the New Rural Pension Scheme on depressive symptoms or medical costs induced by depression. Methods: We used the Logit, OLS and 2SLS models to explore the impact of the pension on depression and medical costs. We also adopt the method of quantile regression and discontinuity regression to verify the causal relationship between the New Rural Pension Scheme and depression or medical costs induced by depression of the rural elderly. Results: We have found that the New Rural Pension Scheme decreases depressive symptoms of elderly in rural China (OR = 0.90), and the medical costs induced by depressive symptoms by 4.6%. Regression discontinuity results showed that pension significantly reduced the depressive symptoms (depression) and the medical expenditure caused by depressive symptoms (depression) by using parametric and non-parametric methods, and performing a placebo test. The mediating effect results showed that pension may improve mental health by increasing confidence about the future. Conclusion: We demonstrate that the pension significantly decreased both mental health problems and the medical expenses due to depressive symptoms and depression of elderly in rural China. Therefore, our results suggest that the Chinese government should perfect the New Rural Pension Scheme to eliminate barriers to mental health resources, especially for the rural elderly.

Poverty Vulnerability and Health Risk Action Path of Families of Rural Elderly With Chronic Diseases: Empirical Analysis of 1,852 Families in Central and Western China.

Health poverty has become the most important cause of poverty and return to poverty. Understanding the health risk factors and action paths of poverty in families of rural elderly with chronic diseases is important to alleviate return to poverty because of illness. This study selected families with at least one elderly member (over 60 years old) with chronic diseases (sample size was 1,852 families) in two provinces and four counties in central and western China. The three-stage feasible generalized least square method was adopted, and the appropriate poverty line standard was selected to measure the poverty vulnerability index. A poverty vulnerability index ≥50% was considered to indicate vulnerability. The poverty vulnerability index and actual income status were combined to classify the samples. A structural equation model was established to explore the path of each health risk factor on the entire sample and various types of poverty vulnerabilities. The mean poverty vulnerability of 1,852 families was 0.5974 ± 0.25213, and among which, 1,170 households had a poverty vulnerability value ≥0.5, accounting for 63.17% of the entire sample. The incidence of poverty was higher among people with low vulnerability to poverty. Health shock was the direct cause of poverty for people with potential and avoidance poverty. The mediating roles of family and community significantly differed in various types of poverty vulnerability. The social and economic environment in rural areas should be enhanced in a diversified manner, and the income-generating ability of rural households should be improved based on actual local conditions. Moreover, the prevention and control of poverty vulnerabilities should be diversified and targeted. Policies implemented should be based on people and localities, the causes of poverty and returning to poverty, and the types of poverty vulnerabilities. The use efficiency of medical insurance should be further improved, and the responsibility of medical insurance targeted poverty alleviation must be clarified.

The Influence of Disease Status on Loneliness of the Elderly: Evidence from Rural China.

At present, the dual pressure of rural labor outflow and population aging in China makes the problems of the rural elderly population increasingly prominent, and its health problem is particularly prominent. Based on the 2014 China elderly population health survey data (CLHLS), this paper finds that the physical health status of the rural elderly has a significant positive impact on their loneliness; that is, the rural elderly with poor health status are more likely to feel lonely. At the same time, the age of the elderly has a significant positive impact on their loneliness. On the contrary, gender, personality, family income and intergenerational support of the elderly have a negative impact on their loneliness. Chronic diseases such as hypertension and diabetes have no significant effect on the loneliness of the elderly in rural areas, but there is a "severe disease effect"; that is, when chronic diseases develop into serious diseases or acute serious diseases, it can negatively impact the elderly psychologically and produce or deepen their sense of loneliness. Based on the above conclusions, this paper further puts forward relevant policy suggestions from three aspects: constructing a disease prevention and control system for the rural elderly, improving the care and service system for the rural elderly, reshaping rural filial piety culture, and creating a good atmosphere of "respecting, loving and respecting parents" in rural areas.

Correlation between functional disability and quality of life among rural elderly in Anhui province, China: a cross-sectional study.

OBJECTIVE: We aimed to explore the correlation between functional disability and quality of life (QoL). And exploring the interaction of functional disability, basic demographic characteristics and health-related information on QoL among the rural elderly in Anhui Province. METHODS: This study used multi-stage stratified cluster sampling in rural Anhui Province from January to July 2018 to conduct a cross-sectional survey of older adults who met the inclusion criteria. The Five-Dimensional European Quality Of Health Scale (EQ-5D) and the WHO Disability Assessment Schedule (WHODAS2.0) scale were used to evaluate the QoL and functional disability, and the basic demographic characteristics of the survey subjects were also collected. Using binary logistic and Classification and regression tree model (CART) models to analyze the data, explore the relationship between functional disability and QoL in the elderly. RESULTS: A total of 3491 older adults were included in the survey, and 3336 completed the entire survey, with an effective response rate of 95.56%. After adjusting for covariables, those who had limited in dimension of mobility (AOR=2.243, 95%CI: 1.743-2.885), getting along (AOR=1.615, 95%CI: 1.173-2.226), life activities (AOR=2.494, 95%CI:1.928-3.226), and social participation (AOR=2.218, 95%CI: 1.656-2.971) had a lower QoL. However, the dimension of cognition (AOR=0.477, 95%CI: 0.372-0.613) is a protective factor for QoL. Additionally, we also observe that 96.3% of those who were unemployed and limited in both mobility and life activities dimensions had a lower QoL, but among those who were robust in both mobility and social participation dimensions and not suffer from chronic diseases, 56.3% had a higher QoL. CONCLUSIONS: Our findings indicate that special attention should be paid to the elderly who are unemployed, have limited in cognition, getting along, social participation, mobility, life activities and cognition robust to improve their QoL. This research is of great significance for formulating targeted strategies and measures to improve the QoL for rural elderly.

Social Capital and the Realization of Mutual Assistance for the Elderly in Rural Areas-Based on the Intermediary Role of Psychological Capital.

BACKGROUND: Mutual assistance for the elderly is a new pension model that has been widely valued and discussed in China, especially in rural areas. The social and psychological capital owned by the elderly in rural areas promotes their participation and affects the realization of mutual assistance for the elderly. Based on this, this paper proposes the following hypotheses: H1: Bonding social capital positively affects the realization of mutual assistance for the elderly in rural areas; H2: bridging social capital positively affects the realization of mutual assistance for the elderly in rural areas; H3: linking social capital positively affects the realization of mutual assistance for the elderly in rural areas; and H4: psychological capital plays an intermediary role in the process of social capital influencing the realization of mutual assistance for the elderly in rural areas. The empirical research is carried out around these hypotheses. METHODS: In this paper, the 2019 China General Survey of Social Conditions (CSS) database was used as the data source for empirical analysis. Social capital can be divided into bonding social capital, bridging social capital, and linking social capital, while psychological capital can be divided into four dimensions: self-efficacy, optimism, hope, and resilience. Our evaluation was performed using LOGIT regression analysis with STATA16 software. First, the correlation of social capital to the realization of mutual assistance for the elderly in rural areas was verified. Next, the mediation effect was verified using the KHB regression method, and the influence of psychological capital as an intermediary variable on the realization of mutual assistance for the elderly in rural areas was demonstrated. RESULTS: Social capital had a significant positive effect on mutual assistance for the elderly in rural areas. Psychological capital played an intermediary role in the relationship between the three types of social capital and rural mutual assistance for the elderly. Among the four dimensions of psychological capital, self-efficacy, optimism, and tenacity played a partial mediating role in the relationship between social capital and mutual assistance for the elderly in rural areas, while the mediating role of hope was not significant. CONCLUSIONS: (1) All three types of social capital have a significant promoting effect on the realization of mutual assistance for the elderly in rural areas, among which bridging social capital has the most significant effect. (2) Psychological capital plays a partial mediating role in the three kinds of social capital's influence on the realization of mutual assistance for the elderly in rural areas, and the intermediary role is the strongest in the effect of linking social capital on the realization of mutual assistance for the elderly in rural areas, but the overall effect is not high. (3) Among the four dimensions of psychological capital, self-efficacy, optimism, and tenacity all have certain intermediary effects, but the intermediary effect of hope is not significant. (4) There are significant gender and regional differences in the impact of social capital and psychological capital on the realization of mutual assistance for the elderly in rural areas.

Does the energy consumption revolution improve the health of elderly adults in rural areas? Evidence from China.

About 2.8 billion people around the world still depend on biomass as their primary energy source. This traditional custom affects the environment and severely impacts the health and life quality of the rural residents, especially in the elderly group. Based on the published data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2018, this paper carefully explores the impact of the energy consumption revolution on the health of rural elderly adults and its response mechanism. The results from the empirical analysis show that: (1) The positive response of rural families to the energy consumption revolution can significantly improve the elderly adults' health condition; (2) The energy consumption revolution can improve the rural elderly adults' health by enhancing the home environmental sanitation (home environmental effect) and life satisfaction (psychological effect); (3) In the process of energy consumption revolution affecting the rural elderly's health, the factor age plays a negative regulatory role, in other words, the older the elderly, the lower the marginal effect of energy consumption revolution on their health improvement. This paper uses the propensity score matching method to deal with the endogenous problem of the regression model, and uses a placebo test and the substitution estimation method to check the robustness of the empirical results. As well, this research puts forward some policy suggestions, such as increasing investment in energy infrastructure in rural areas, reducing the cost of using clean energy, combining environmental energy protection with increasing energy income, and improving medical security conditions in rural areas.