Association of Internet Use and Health Service Utilization with Self-rated Health in Middle-aged and Older Adults: Findings from a Nationally Representative Longitudinal Survey

Overview

Journal Front Public Health

Specialty Public Health

Date 2024 Oct 18

PMID 39421818

Authors

Ximin Ma

Qi Hu

Jiahui He

Wenlong Wang

Kexin Chen

Hui Qiao

Affiliations

Soon will be listed here.

Abstract

Objective: This study aims to explore the relationship between internet use and self-rated health among middle-aged and older adults and further investigates the mediating role of health service utilization between internet use and self-rated health, providing a reference for more effectively utilizing the internet to improve the health status of middle-aged and older adults.

Method: We analyzed data from the 2018 and 2020 waves of the China Health and Retirement Longitudinal Study (CHARLS), this includes 10,011 in 2018 and 7,080 in 2020 over the age of 45. To explore the relationship between internet use and self-rated health, we employed propensity score matching (PSM) and instrumental variable regression analysis, accounting for a wide range of potential covariates. Additionally, the Sobel test was used to examine the mediating effect of health service utilization on this relationship.

Results: According to the fully adjusted propensity score matching and instrumental variable regression model, internet use significantly enhanced self-rated health among middle-aged and older adults (β = 0.348, < 0.01; β = 0.293, < 0.1). However, subgroup analyses revealed that this positive effect was not significant among middle-aged and older adults who were divorced (β = 0.190, > 0.05), lived in special zone (β = -1.379, > 0.05), and lacked medical insurance (β = 0.314, > 0.05). Furthermore, mediation analysis revealed that inpatient services (β = 0.0215, < 0.01) acted as a mediator in the relationship between internet use and self-rated health.

Conclusion: Internet use positively correlates with self-rated health among middle-aged and older adults. Additionally, the utilization of health services can significantly influence this relationship. These findings underscore the importance of developing targeted government strategies to promote internet access and create a supportive online environment, thereby enhancing the health outcomes of this demographic group.

References

Matusitz J, McCormick J . Sedentarism: the effects of Internet use on human obesity in the United States. Soc Work Public Health. 2012; 27(3):250-69. DOI: 10.1080/19371918.2011.542998. View

Xavier A, DOrsi E, Wardle J, Demakakos P, Smith S, Von Wagner C . Internet use and cancer-preventive behaviors in older adults: findings from a longitudinal cohort study. Cancer Epidemiol Biomarkers Prev. 2013; 22(11):2066-74. DOI: 10.1158/1055-9965.EPI-13-0542. View

Huohvanainen E, Strandberg A, Stenholm S, Pitkala K, Tilvis R, Strandberg T . Association of Self-Rated Health in Midlife With Mortality and Old Age Frailty: A 26-Year Follow-Up of Initially Healthy Men. J Gerontol A Biol Sci Med Sci. 2016; 71(7):923-8. DOI: 10.1093/gerona/glv311. View

Falk Erhag H, Ahlner F, Rydberg Sterner T, Skoog I, Bergstrom A . Internet use and self-rated health among Swedish 70-year-olds: a cross-sectional study. BMC Geriatr. 2019; 19(1):365. PMC: 6929471. DOI: 10.1186/s12877-019-1392-8. View

Lieber J, Clarke L, Timaeus I, Mallinson P, Kinra S . Changing family structures and self-rated health of India's older population (1995-96 to 2014). SSM Popul Health. 2020; 11:100572. PMC: 7160449. DOI: 10.1016/j.ssmph.2020.100572. View

Huang C, Hsieh H, Chiu H, Wang P, Lee M, Li C . Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study. Psychiatry Investig. 2017; 14(6):770-778. PMC: 5714718. DOI: 10.4306/pi.2017.14.6.770. View

Zhao Y, Hu Y, Smith J, Strauss J, Yang G . Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS). Int J Epidemiol. 2012; 43(1):61-8. PMC: 3937970. DOI: 10.1093/ije/dys203. View

Zhang J, Xu F, Zhou Y, Wu J, Li Y, Qing W . Association between frailty and meaning in life of older adults in nursing home: the mediating effect of psychological resilience. Front Psychol. 2024; 15:1365817. PMC: 11216323. DOI: 10.3389/fpsyg.2024.1365817. View

Leinonen R, Heikkinen E, Jylha M . Changes in health, functional performance and activity predict changes in self-rated health: a 10-year follow-up study in older people. Arch Gerontol Geriatr. 2004; 35(1):79-92. DOI: 10.1016/s0167-4943(02)00017-1. View

10.

Mougharbel F, Sampasa-Kanyinga H, Heidinger B, Corace K, Hamilton H, Goldfield G . Psychological and Demographic Determinants of Substance Use and Mental Health During the COVID-19 Pandemic. Front Public Health. 2021; 9:680028. PMC: 8270652. DOI: 10.3389/fpubh.2021.680028. View

11.

Li L, Ding H, Li Z . Does Internet Use Impact the Health Status of Middle-Aged and Older Populations? Evidence from China Health and Retirement Longitudinal Study (CHARLS). Int J Environ Res Public Health. 2022; 19(6). PMC: 8954843. DOI: 10.3390/ijerph19063619. View

12.

James N, Daniels H, Rahman R, McConkey C, Derry J, Young A . A study of information seeking by cancer patients and their carers. Clin Oncol (R Coll Radiol). 2007; 19(5):356-62. DOI: 10.1016/j.clon.2007.02.005. View

13.

Zhao J, Li W, Zhang Q . Do Scholars-Turned-Businessmen Impact Green Innovation?. Front Psychol. 2022; 13:920782. PMC: 9252513. DOI: 10.3389/fpsyg.2022.920782. View

14.

Lima-Costa M, Cesar C, Chor D, Proietti F . Self-rated health compared with objectively measured health status as a tool for mortality risk screening in older adults: 10-year follow-up of the Bambuí Cohort Study of Aging. Am J Epidemiol. 2011; 175(3):228-35. DOI: 10.1093/aje/kwr290. View

15.

Yang Y, Liu T, Jia Y . The impact of interaction with children on internet addiction in older adults: A moderated mediation model. Front Psychol. 2022; 13:989942. PMC: 9448416. DOI: 10.3389/fpsyg.2022.989942. View

16.

Caetano S, Silva C, Vettore M . Gender differences in the association of perceived social support and social network with self-rated health status among older adults: a population-based study in Brazil. BMC Geriatr. 2013; 13:122. PMC: 4225700. DOI: 10.1186/1471-2318-13-122. View

17.

Tang D, Jin Y, Zhang K, Wang D . Internet Use, Social Networks, and Loneliness Among the Older Population in China. Front Psychol. 2022; 13:895141. PMC: 9133735. DOI: 10.3389/fpsyg.2022.895141. View

18.

Choi N, DiNitto D . Internet use among older adults: association with health needs, psychological capital, and social capital. J Med Internet Res. 2013; 15(5):e97. PMC: 3668603. DOI: 10.2196/jmir.2333. View

19.

Gracia E, Herrero J . Internet use and self-rated health among older people: a national survey. J Med Internet Res. 2009; 11(4):e49. PMC: 2802559. DOI: 10.2196/jmir.1311. View

20.

Ang C, Ismail R, Kassim Z, Mohd Ghazali A, Reidpath D, Su T . Frequent Eating Out and 10-Year Cardiovascular Disease Risk: Evidence from a Community Observatory in Malaysia. Biomed Res Int. 2022; 2022:2748382. PMC: 8920648. DOI: 10.1155/2022/2748382. View