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. 2025 Jul 1;25(1):877.
doi: 10.1186/s12913-025-13022-y.

The impact of community health care services on the mental health of older adults in China

Xi Yang  1 , Hailing Ke  2 , Yuting Song  3 , Honggu Han  4 , Yuxiang Zhao  1 , Saibo Shi  1
Affiliations

The impact of community health care services on the mental health of older adults in China

Xi Yang et al. BMC Health Serv Res. .

Abstract

Background: Population aging is the predominant global demographic trend of the contemporary era. However, the mental health of many older adults is not as good as it could be. Ensuring the rights and well-being of older adults is crucial for achieving sustainable and healthy aging. Numerous countries have implemented healthcare integration services tailored to their unique contexts. In 2016, China initiated community health care services for older adults.

Methods: We used panel data derived from the China Health and Retirement Longitudinal Study from 2015 to 2018 and analyses were performed using STATA, version 17. Our study employed a difference-in-differences model to assess the association of community health care services with mental health of older adults and conducted a placebo test to assess the reliability of the difference-in-differences model estimations. Additionally, subgroup regression analyses were conducted to investigate whether community health care services exert differing effects on the mental well-being of older adults across subgroups by sex, age groups, and education level.

Results: Community health care services significantly improved depression levels and cognitive function in older adults. Notably, these services exerted a more pronounced effect on alleviating depression symptoms among male older adults and more positively affected cognitive function among female older adults. Additionally, the services demonstrated greater effectiveness in improving both depression levels and cognitive function among older adults with lower educational attainment, while maintaining positive impacts on younger older adults.

Conclusions: Community health care services played a crucial role in enhancing the mental health of older adults, with varying degrees of impact across demographic groups. Our study underscores the importance of such services in promoting healthy aging and provides a foundation for the further development of hierarchical community health care services. This development is conducive to advancing community health care services, enhancing the mental well-being, and fostering healthy aging for Chinese older adults.

Keywords: Community health care services; Mental health; Older adults.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study used data from the China Health and Retirement Longitudinal Study (CHARLS), a large-scale interdisciplinary project jointly executed by Wuhan University and Peking University. CHARLS has received support from Peking University, the National Natural Science Foundation of China, the Behavioral and Social Research Division of the National Institute on Aging, and the World Bank. All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki Declaration and its later amendments. Consent for publication: No applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Parallel trend test Note: A and B show the average trends in depression levels and cognitive function in older adults, respectively, with the dashed line indicating the control group of older adults and the solid line indicating the experimental group of older adults in the figure
Fig. 2
Fig. 2
Placebo test Note: A and B show the results of placebo tests of the effects of community health care services on depression levels and cognitive functioning in older adults respectively, and report the p-values and coefficients for the interaction term between the time dummy variable and community health care services in 1000 models, whereas the vertical dashed lines represent the true coefficients for the interaction term between the time dummy variable and community health care services in the difference-in-differences model, and the horizontal dashed line represents a p-value of 0.1
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