Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis

ObjectiveThis study explores the associations between four macro-level factors—Economic Development (ED), Economic Inequality (EI), Governmental Willingness and capacities to invest in Public Health (GWPH) and Public Health-Related Infrastructures (PHRI)—and three mental health indicators: depressiv...

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Main Authors: Guannan Li, Gindo Tampubolon, Asri Maharani, Chenglin Tu
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2024.1435263/full
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author Guannan Li
Gindo Tampubolon
Asri Maharani
Chenglin Tu
author_facet Guannan Li
Gindo Tampubolon
Asri Maharani
Chenglin Tu
author_sort Guannan Li
collection DOAJ
description ObjectiveThis study explores the associations between four macro-level factors—Economic Development (ED), Economic Inequality (EI), Governmental Willingness and capacities to invest in Public Health (GWPH) and Public Health-Related Infrastructures (PHRI)—and three mental health indicators: depressive symptoms, cognitive function and life satisfaction, among middle-aged and older adults in China.Materials and methodsWe obtained individual-level data from the Harmonised China Health and Retirement Longitudinal Survey (H-CHARLS) 2018 and acquired our provincial-level data from the Chinese Statistical Yearbook. Two-level linear mixed models are used to examine the associations. Supplementary analyses are carried out to test the robustness of the study.ResultsThere are provincial variations in macro-level factors. Depressive symptoms and cognitive functions also vary across provinces, whereas life satisfaction does not. We find that ED contributes to better depressive status. EI contributes to worse cognitive functions and life dissatisfaction. GWPH and PHRI are not associated with mental health.ConclusionThe study suggests that macro-level ED contributes to better depressive status. EI and potential systematic inequality lead to worsened cognitive functions and life dissatisfaction. It is too soon to generalise whether institutional factors like GWPH and PHRI are good or bad for mental health, but the current public health system in China does not adequately support mental and cognitive health.
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spelling doaj-art-852ec46400da4cfa93e40ac6d6a6c3b02025-08-20T02:40:26ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-12-011210.3389/fpubh.2024.14352631435263Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysisGuannan Li0Gindo Tampubolon1Asri Maharani2Chenglin Tu3Global Development Institute, School of Environment, Education and Development, The University of Manchester, Manchester, United KingdomGlobal Development Institute, School of Environment, Education and Development, The University of Manchester, Manchester, United KingdomDivision of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United KingdomGuangzhou Development Academy, Guangzhou University, Guangzhou, ChinaObjectiveThis study explores the associations between four macro-level factors—Economic Development (ED), Economic Inequality (EI), Governmental Willingness and capacities to invest in Public Health (GWPH) and Public Health-Related Infrastructures (PHRI)—and three mental health indicators: depressive symptoms, cognitive function and life satisfaction, among middle-aged and older adults in China.Materials and methodsWe obtained individual-level data from the Harmonised China Health and Retirement Longitudinal Survey (H-CHARLS) 2018 and acquired our provincial-level data from the Chinese Statistical Yearbook. Two-level linear mixed models are used to examine the associations. Supplementary analyses are carried out to test the robustness of the study.ResultsThere are provincial variations in macro-level factors. Depressive symptoms and cognitive functions also vary across provinces, whereas life satisfaction does not. We find that ED contributes to better depressive status. EI contributes to worse cognitive functions and life dissatisfaction. GWPH and PHRI are not associated with mental health.ConclusionThe study suggests that macro-level ED contributes to better depressive status. EI and potential systematic inequality lead to worsened cognitive functions and life dissatisfaction. It is too soon to generalise whether institutional factors like GWPH and PHRI are good or bad for mental health, but the current public health system in China does not adequately support mental and cognitive health.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1435263/fullmental healthdepressioncognitive functionlife satisfactioneconomic developmenteconomic inequality
spellingShingle Guannan Li
Gindo Tampubolon
Asri Maharani
Chenglin Tu
Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
Frontiers in Public Health
mental health
depression
cognitive function
life satisfaction
economic development
economic inequality
title Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
title_full Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
title_fullStr Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
title_full_unstemmed Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
title_short Macro-level socioeconomic factors and mental health in midlife and older adults in China: a multilevel analysis
title_sort macro level socioeconomic factors and mental health in midlife and older adults in china a multilevel analysis
topic mental health
depression
cognitive function
life satisfaction
economic development
economic inequality
url https://www.frontiersin.org/articles/10.3389/fpubh.2024.1435263/full
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AT gindotampubolon macrolevelsocioeconomicfactorsandmentalhealthinmidlifeandolderadultsinchinaamultilevelanalysis
AT asrimaharani macrolevelsocioeconomicfactorsandmentalhealthinmidlifeandolderadultsinchinaamultilevelanalysis
AT chenglintu macrolevelsocioeconomicfactorsandmentalhealthinmidlifeandolderadultsinchinaamultilevelanalysis