Digital Inclusion Pathways for Older Chinese Adults in the Context of Active Aging: Secondary Analysis of 2023 China Longitudinal Aging Social Survey Data.

Digital inclusion was positively associated with social engagement in older Chinese adults.

• Standardized path coefficient β=.50 for the association between digital inclusion and social engagement
• Analysis based on 9918 adults aged 60 years or older from the 2023 China Longitudinal Aging Social Survey
• Digital inclusion was measured through digital access, device proficiency, and digital ability
• Social engagement captured social support, frequency of participation in community or voluntary activities, and nononline activities

Mental health showed the strongest association with self-rated health (SRH) among older adults.

• Standardized path coefficient β=.74 for the association between mental health and SRH
• Mental health included depressive symptoms, social adaptation, and life satisfaction
• Overall health status was assessed using 3 SRH indicators: current SRH, SRH relative to age peers, and SRH relative to last year
• Adding mental health to regression models produced a greater increase in model fit than adding digital inclusion alone

The direct path from social engagement to overall health status was nonsignificant, indicating participation influences health primarily through psychological pathways.

• P=.34 for the direct path from social engagement to overall health status
• Social engagement influenced overall health status through mental health as a mediator rather than directly
• Structural equation modeling was used to estimate direct and mediated effects
• Analyses were two-sided with α=.05

Older age, chronic disease, and functional limitations were associated with poorer overall health status.

• These associations were identified through multivariable hierarchical linear regressions and structural equation modeling
• Higher education and current employment were associated with better health status
• Sample comprised 9918 adults aged 60 years or older from nationally representative 2023 China Longitudinal Aging Social Survey data
• Analyses included descriptive statistics, multivariable hierarchical linear regressions, and structural equation modeling

Digital inclusion improved model fit for health status outcomes modestly in regression analyses, while adding mental health produced a greater increase.

• Digital inclusion's contribution to model fit for health outcomes was modest compared to mental health
• The indirect pathway from digital inclusion to health status was mediated sequentially through social engagement and then mental health
• Digital inclusion measures included digital access, device proficiency, and digital ability
• The study used a secondary analysis design of newly released 2023 wave data from the China Longitudinal Aging Social Survey

Digital inclusion promoted active aging indirectly by expanding social engagement and enhancing mental health, thereby improving overall health status.

• The pathway was specified as: digital inclusion → social engagement → mental health → overall health status
• Social engagement and mental health were specified as sequential mediators
• The study aimed to quantify both direct and indirect pathways through structural equation modeling
• Policy recommendations emphasized improving digital skills and capability rather than access alone, and expanding meaningful social engagement opportunities