Education and Psychological Distress of Older Chinese: Exploring the Longitudinal Relationship and Its Subgroup Variations

Objective: The goal of this study is to examine whether and how education predicts distress for older Chinese and whether this association varies by age, gender, and rural/urban residence.

Method: The random-effect panel model and Heckman selection model were used to analyze four waves of data with a total sample size of 54,405 from the Chinese Longitudinal Healthy Longevity Survey.

Results: We found the following: (a) There is a persistent and negative association between education and distress among older Chinese; (b) education predicts lower levels of distress over time and this is particularly true for males, urban residents, and the young-old; and (c) the effect of education on distress is largely explained by physical health, economic conditions, and a three-dimensional framework of leisure-time activities.

Discussion: Our findings strengthen the external validity of the relationship between education and health and suggest the dynamic patterns on the subgroup variations within the association in China.