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The purpose of this study was to examine the effects of co-residence on the parental subjective well-being among older Chinese parents. Our analysis included 2968 elderly parents. Parental subjective well-being was stratified into positive well-being (PWB) and negative well-being (NWB). Positive well-being was assessed through questions about life satisfaction, optimism, and happiness and NWB was measured by questions about fear, loneliness, and feelings of uselessness. We found co-residence with adult children resulted in a significant average increase in PWB by 0.17 points relative to those who did not cohabitate. In rural China, co-residence with adult children significantly increased PWB by 0.19 points, and co-residence with a son significantly increased parental PWB by 0.18 points. Negative well-being fell significantly by 0.63 points if co-residence was with an adult daughter. Our findings imply that support from adult children significantly improved parental PWB, especially for the elderly in rural China. Public policies that facilitate the strengthening of cohabitation may help improve the well-being for older Chinese residents. Our study makes two main contributions to the international literature: first, we strengthened the causal inferences regarding the effects of co-residence with adult children on parental well-being through the use of a longitudinal study design; and second, we introduced a difference-in-differences propensity score matching (PSM-DID) approach to address potential selection bias that has previously been ignored in the literature.

This study aimed to examine the association between health insurance, city of residence, and outpatient visits among older adults living alone in China. A sample of 3173 individuals was derived from “Survey on Older Adults Aged 70 and Above Living Alone in Urban China” in five different cities. Logistic regression models indicated that older adults living alone who had urban employee basic medical insurance, urban resident basic medical insurance, and public medical insurance were more likely to have outpatient visits than those without any health insurance. After controlling the number of chronic diseases, only those with public medical insurance were more likely to have outpatient visits than uninsured older adults. Additionally, older adults who resided in Shanghai and Guangzhou were more likely to have outpatient visits than those in Chengdu, whereas older adults who were in Dalian and Hohhot were less likely to have outpatient visits. To improve the equity of outpatient visits among older adults living alone in China, policy efforts should be made to reduce fragmentation of different health insurance plans, expand the health insurance coverage for older adults, provide programs that consider the needs of this special group of older adults, and reduce the inequality in health resources and health insurance policies across cities.

Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.