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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1435263
This article is part of the Research Topic Environmental Risk Factors for Depression: Unveiling Pathways to Resilience and Public Mental Health Equity View all 6 articles

Macro-Level Socioeconomic factors and Mental Health in Midlife and Older Adults in China: A Multilevel Analysis

Provisionally accepted
Guannan Li Guannan Li 1Gindo Tampubolon Gindo Tampubolon 2Asri Maharani Asri Maharani 3Chenglin Tu Chenglin Tu 1*
  • 1 Guangzhou Development Academy, Guangzhou University, Guangzhou, China
  • 2 Global Development Institute, The University of Manchester, Manchester, England, United Kingdom
  • 3 Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, United Kingdom

The final, formatted version of the article will be published soon.

    Objective: This 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.We 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.Results: There 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.The 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.

    Keywords: Mental Health1, depression2, cognitive function3, life satisfaction4, economic development5, economic inequality6, health infrastructure7

    Received: 20 May 2024; Accepted: 04 Dec 2024.

    Copyright: © 2024 Li, Tampubolon, Maharani and Tu. 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: Chenglin Tu, Guangzhou Development Academy, Guangzhou University, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.