IntroductionIn recent years, China's aging process has deepened rapidly, the disease spectrum of the population has undergone major changes, the proportion and scale of elderly patients with chronic diseases are growing rapidly, and the multidimensional health problems of the chronically ill elderly are prominent, seriously affecting the participation of the chronically ill elderly in family, community, and social development. In response, China has implemented the “active response to population aging strategy,” accelerated the development of community home elderly care services, and encouraged the chronically ill elderly to continue to play a role through social participation. So how does the community-based home-based medical care service affect the social participation of the chronically ill elderly? Is an important subject.MethodsBased on the 2018 China Longitudinal Aging Social Survey and the propensity score matching method to measure the impact of community home elderly care services on the four types of social participation of chronically ill elderly, including economic participation, family participation, voluntary participation, and political participation, and group differences, and uses the multiple mediation analysis method to explore the mechanism and effect of community home elderly care services on the four types of social participation of chronically ill elderly.Results(1) Community home elderly care services have an asymmetric impact on the social participation of the chronically ill elderly, and have generally promoted the level of social participation of the chronically ill elderly. (2) Community home elderly care services change the social participation arrangements of the chronically ill elderly by driving and inhibiting effects, so that it has a tendency to reduce economic participation and increase voluntary participation and political participation as a whole. This feature shows group differences among the chronically ill elderly of different ages, education levels, living arrangements and community types. (3) Community home elderly care services have an asymmetric impact on various social participation of the chronically ill elderly through the multidimensional health mediation mechanism.Conclusion(1) With the continuous deepening of the interweaving between the growth of chronic diseases and the aging of the population in China, the development of a positive aging society must attach great importance to the important role of social participation for the chronically ill elderly. (2) Strengthen the development of physical, psychological, and social adaptation and other health abilities of the chronically ill elderly, shape their awareness of social participation, and give the chronically ill elderly a reasonable social role orientation. (3) Through policy incentives, promote the realization of fairness, justice, adequacy, and sustainability of community home elderly care services. (4) Pay special attention to the penetration, integration, and application of digital technology into the field of community home elderly care services to effectively protect the health of chronically ill elderly, ensure that the elderly with different chronic diseases participate in social activities of high quality, enjoy a high-quality happy life, and promote the high-quality development of the aging society.

Fertility, social status, and social trust are main social choice behaviors of Chinese farmers. This paper adopts the childbearing–value logic to establish a theoretical model of farmers’ childbearing–social status–social trust choices to examine the influence of farmers’ childbearing and social status on farmers’ social trust. The theoretical model showed that farmers will rationally choose the number of children to bear, emotional value, social value, economic value, social status, and social trust. The fertility of farmers’ children is actually a trade-off between quantity and value, and the fertility behavior affects social status through the direct mechanism of the number of children and the value of the adjustment mechanism, and together with the social status, through the direct mechanism, the adjustment mechanism of the number of children, the intermediate mechanism of social status, and the mixed adjustment mechanism. Asymmetry affects social trust equilibrium. Empirical research based on the CFPS (China Family Panel Studies) data in 2018 showed that farmers’ children quantity primarily inhibits, through the adjustment mechanism of children’s value–social status, social status and social trust; it exerts no direct impact or mediating effect on the social status. The economic value of children does not affect the social status, but it affects social trust through a positive child quantity adjustment mechanism, a negative social status mediation mechanism, and a negative mixed mediation mechanism. The social value of children affects social trust by the positive direct mechanism and the negative children quantity adjustment mechanism, as well as social trust by the negative direct mechanism, children quantity adjustment mechanism, children quantity–social status mixed adjustment mediating mechanism, and the positive social status–mediated mechanism. The emotional value of children affects the social status through the positive direct mechanism, as well as social trust through the positive direct mechanism, social status–mediated mechanism, and negative child quantity adjustment mechanism, and negative mixed mediation mechanism. Furthermore, social status positively impacts social trust rather than a symmetric transmission of the mediating effect of children’s value and the quantity adjustment effect of children’s value. However, no mediating effect of social trust was observed on children quantity. Social development leads to structural changes in the fertility value of farmers’ children, which makes farmers prefer their children’s social and economic value, exerting a complex impact on their own social status and social trust.

Public health service is an important guarantee by the government to safeguard the health rights of rural migrant women. This not only concerns the health status of rural migrant women and their willingness to stay in the urban area but can also affect their fertility intention. This study systematically examined the impact of public health services on the fertility intentions of rural migrant women as well as the mechanisms, underlying these intentions based on the data from the 2018 China Migration Dynamics Monitoring Survey. Urban public health services, including health records management and health education, could effectively enhance the fertility intentions of rural migrant women. Furthermore, their health status and willingness to stay in urban areas were important mechanisms, by which, the public health services could influence the fertility intentions of rural migrant women. Additionally, urban public health services have a better effect on improving the fertility desire of rural migrant women who have no pregnancy experience, a low income level, and a short residence time in the inflow area. This study contributed to the examination and clarification of the policy effects of public health services on the fertility intentions of rural migrant women. Additionally, it also provided important evidence to support the government policies related to the optimization of the public health service system, improvement of the health status, citizenship, and fertility intentions of the rural migrant women, as well as the development of the uniform public health services.