Implementing age-friendly policies in China: Assessing the impact on older adults’ self-rated health

Due to prolonged longevity and declining fertility rate, the global population is aging at an alarming speed, presenting tremendous pressure on social welfare and security system. In China, city governments have formulated numerous age-friendly policies to build a supportive environment for aging well. Despite that gerontological theory (e.g., ecological theory of aging and Anderson’s behavioral model) indicate that external physical and institutional environmental factors may influence older adults’ well-being, rigorous investigation of the impacts of China’s age-friendly urban policies on the elderly are quite limited. Most research has been restricted to developed countries and did not reach a consistent conclusion. Using text analysis of city policy documents and data from the China Health and Retirement Longitudinal Study (2011-2018), this study empirically tests whether the coverage of elderly care policy and preferential policy, two important age-friendly policies in Chinese cities, influences depressive symptoms, life satisfaction, and self-rated health for older adults aged 60 years and older. The results show that preferential policy was associated with the reduction in depressive symptoms and improvement in life satisfaction of older adults. Moreover, this study finds that the association between elderly care policy and older adults’ subjective well-being differs between rural and urban areas, but such heterogeneous effect is not significant for preferential policy. Findings suggest the potential benefits of expanding the coverage of preferential policy to both urban and rural areas and to include a broader range in daily life, such as housing, municipal services, and accessibility, to promote social inclusion and support aging well. Moreover, the elderly care policy should be fine-tuned to close the urban-rural gaps, and it should not only limit to providing necessary daily life and medical care but also aim to improve older adults’ mental health by providing them with psychological counseling and emotional interactions.