Internet behaviors and the health of older adults in China: The mediating role of leisure activities.
Abstract
Background
China is experiencing population aging and societal digitalization at the same time. Health problems among older adults are becoming increasingly prominent, and the Internet is penetrating ever more deeply into their daily lives. Whether Internet use can improve the health of older adults, and through which channels, still requires more systematic empirical evidence. Using nationally representative survey data, this study examines the relationship between Internet use frequency and the physical and mental health of older adults, with a focus on comparing the mediating roles of three types of leisure activities, namely social, recreational, and educational activities, and on testing group differences across gender and hukou status.
Methods
This study uses data from the 2021 Chinese General Social Survey (CGSS), with an analytical sample of 2675 adults aged 60 years and above. Ordered probit models are employed to estimate the relationship between Internet use frequency and health status. An instrumental variable approach based on the extended ordered probit model (Eoprobit) and Oster's omitted variable test are used to mitigate endogeneity concerns. Subgroup regressions by gender and hukou type are conducted, and the Karlson-Holm-Breen (KHB) method is applied to decompose the mediating effects of the three types of leisure activities.
Results
Internet use frequency is significantly and positively associated with both the physical and mental health of older adults. This result remains robust after applying the instrumental variable approach and passing the omitted variable test. Subgroup results show that the association is more pronounced for the physical health of older men and the mental health of older women, with no clear difference between rural and urban groups. Mechanism analysis indicates that social and educational activities exert significant mediating effects on both health outcomes, whereas recreational activities mediate only the association with mental health. Among the three pathways, educational activities exhibit the largest indirect effect.
Conclusion
Based on cross-sectional data, this study provides robust associational evidence consistent with the view that Internet use promotes the health of older adults. The findings suggest that advancing digital inclusion and digital education for older adults may be a feasible avenue toward healthy aging. Governments and enterprises should lower the barriers older adults face in getting online, develop online learning and social services tailored to older adults, and attend to the differentiated needs of different groups of older adults.