Ximin Ma
Qi Hu
*
Kexin Chen
The final, formatted version of the article will be published soon.
ORIGINAL RESEARCH article
Front. Public Health
Sec. Digital Public Health
Volume 12 - 2024 |
doi: 10.3389/fpubh.2024.1429983
This article is part of the Research Topic Health Literacy and Digital Health Literacy among Older Adults: Public Health Interventions View all 5 articles
Association of internet use and health service utilization with self-rated health in middle-aged and older adults: Findings from a nationally representative longitudinal survey Authors' information
Provisionally accepted- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Objective: This study aims to explore the relationship between internet use and self-rated health among middle-aged and older adults and further investigates the mediating role of health service utilization between internet use and self-rated health, providing a reference for more effectively utilizing the internet to improve the health status of middle-aged and older adults. Method: We analyzed data from the 2018 and 2020 waves of the China Health and Retirement Survey (CHARLS), covering approximately 17,091 residents aged 45 years and older. To explore the relationship between internet use and self-rated health, we employed propensity score matching (PSM) and instrumental variable regression analysis, accounting for a wide range of potential covariates. Additionally, the Sobel test was used to examine the mediating effect of health service utilization on this relationship. Results: According to the fully adjusted propensity score matching and instrumental variable regression model, internet use significantly enhanced self-rated health among middle-aged and older adults (β=0.348, P<0.01; β=0.293, P<0.1). However, subgroup analyses revealed that this positive effect was not significant among middle-aged and older adults who were divorced (β=0.190, P>0.05) or lacked medical insurance (β=0.314, P>0.05). Furthermore, mediation analysis revealed that inpatient services (β=0.0215, P<0.01) acted as a mediator in the relationship between internet use and self-rated health. Conclusion: internet use positively correlates with self-rated health among middle-aged and older adults. Additionally, the utilization of health services can significantly influence this relationship. These findings underscore the importance of developing targeted government strategies to promote internet access and create a supportive online environment, thereby enhancing the health outcomes of this demographic group.
Keywords: Internet use, self-rated health, Middle-aged and older adults, Propensity score matching, Instrumental variable, Mediating effect
Received: 09 May 2024; Accepted: 27 Aug 2024.
Copyright: © 2024 Ma, Hu, He, Wang, Chen and Qiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Qi Hu, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Jiahui He, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Wenlong Wang, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Hui Qiao, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
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