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      Impact of social participation on health among middle-aged and elderly adults: evidence from longitudinal survey data in China

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          Abstract

          Background

          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.

          Methods

          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.

          Results

          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.

          Conclusions

          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.

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          Most cited references7

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          Cross-validation of a short form of the CES-D in Chinese elderly.

          To establish the reliability and validity of a 10-item short form of the CES-D (CESD-10). Cross-sectional and longitudinal follow-up over 3 years. Standardized questionnaire and face-to-face interview were conducted. Community and psychogeriatric assessment clinic of a voluntary organization. Five hundred and fifty-four elderly in the general community, 30 elderly from a community centre and 31 elderly patients with depressive symptoms. Instruments other than the CESD-10 included Activities of Daily Living (ADL), the Life Satisfaction Scale (LSS), the Lubben Social Network Scale, a single-item measure of self-rated health. Reliability of the CESD-10 in terms of internal consistency was satisfactory (Cronbach alpha = 0.78-0.79). Moderate consistency over a period of 3 years was also found to be significant (r = 0.44, p < 0.01). The CESD-10 showed comparable accuracy to the original CES-D in classifying cases with depressive symptoms (kappa = 0.84, p < 0.01). Significant relationships of the CESD-10 with impairments of daily functioning, life satisfaction, social support, and self-rated health were established. The CESD-10 also differentiated significantly between groups of 'normal' and clinically depressed elderly. The CESD-10 attained satisfactory content and temporal reliability. Its construct and concurrent validity were established. With its brevity, it should prove a useful mental health measure for the elderly.
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            Leisure, Home Production, and Work--the Theory of the Allocation of Time Revisited

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              Social participation and the health and well-being of Canadian seniors.

              H. Gilmour (2012)
              Social participation has been associated with health and well-being in older adults. Data from the 2008/2009 Canadian Community Health Survey (CCHS)-Healthy Aging were used to examine the relationship between frequent social participation and self-perceived health, loneliness and life dissatisfaction in a sample of 16,369 people aged 65 or older. Multivariate logistic regression was used to identify significant relationships, while adjusting for potential confounders. The mediating role of social support and the prevalence of reported barriers to greater social participation were also examined. An estimated 80% of seniors were frequent participants in at least one social activity. As the number of different types of frequent social activities increased, so did the strength of associations between social participation and positive self-perceived health, loneliness, and life dissatisfaction. The associations generally remained significant, but were attenuated by individual social support dimensions. The desire to be more involved in social activities was reported by 21% of senior men and 27% of senior women. Social participation is an important correlate of health and well-being in older adults. It may be that social support gained through social contacts is as important in these associations as the number of activities in which one participates frequently.
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                Author and article information

                Contributors
                xxma@eco.u-toyama.ac.jp
                piao.xiangdan@doc.kyushu-u.ac.jp
                oshio@ier.hit-u.ac.jp
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 April 2020
                15 April 2020
                2020
                : 20
                : 502
                Affiliations
                [1 ]GRID grid.267346.2, ISNI 0000 0001 2171 836X, Faculty of Social Sciences, , University of Toyama, ; Gofuku 3190, Toyama, 930-8555 Japan
                [2 ]GRID grid.177174.3, ISNI 0000 0001 2242 4849, School of Engineering, , Kyushu University, ; 744 Motooka, Nishi-ku, Fukuoka, 819-0395 Japan
                [3 ]GRID grid.412160.0, ISNI 0000 0001 2347 9884, Institute of Economic Research, , Hitotsubashi University, ; 2-1, Naka, Kunitachi, Tokyo, 186-8603 Japan
                Article
                8650
                10.1186/s12889-020-08650-4
                7161098
                32295560
                448afa22-533d-4c7b-8f0f-9703a7833109
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 21 October 2019
                : 2 April 2020
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001691, Japan Society for the Promotion of Science;
                Award ID: 17H00991 and 18K19699
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                china,health outcomes,middle-aged and elderly,lagged variables,social participation
                Public health
                china, health outcomes, middle-aged and elderly, lagged variables, social participation

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