Social perceptions, age stereotypes, and health behaviours: an economic and public health perspective from China.

Favourable perceptions of ageing were strongly associated with higher levels of preventive care, physical activity, and social participation.

• Standardised coefficients for the association between positive social cognition of ageing and health behaviours ranged from approximately 0.46 to 0.55.
• The analysis used nationwide survey data from Chinese adults across multiple provinces.
• A multilevel analytical framework was applied, examining individual health behaviours within provincial social climates.
• Three health behaviour outcomes were examined: preventive care, physical activity, and social participation.

Approximately one quarter of the association between positive social cognition of ageing and health behaviour was mediated by an indirect pathway through lower endorsement of negative age stereotypes.

• Stronger social cognition corresponded to lower endorsement of negative stereotypes, which in turn was associated with healthier behaviour.
• About one quarter of the total association between positive perceptions of ageing and health behaviour was linked to this indirect pathway.
• This represents a mediation pathway running from social cognition through stereotype endorsement to behavioural engagement.

Age-related stereotypes displayed a consistent negative association with health behaviour.

• Standardised coefficients for the negative association between age-related stereotypes and health behaviour ranged from -0.36 to -0.41.
• This negative pattern was particularly pronounced in rural areas.
• The negative association was consistent across the three health behaviour outcomes examined.

Provincial discourse on ageing moderated the relationships between social cognition, stereotypes, and health behaviour.

• In provinces characterised by more supportive public discourse on ageing, the link between cognition and behaviour was stronger.
• In environments where stereotypes were more salient, their negative association with behaviour was amplified.
• These contextual effects were identified through the multilevel analytical framework that nested individuals within provincial social climates.

Urban residents showed a stronger alignment between positive views of ageing and behavioural engagement than rural residents, indicating an institutional gradient in healthy ageing.

• The urban-rural difference was described as an 'institutional gradient in healthy ageing.'
• The negative association of age-related stereotypes with health behaviour was particularly pronounced in rural areas.
• The authors interpret this pattern as reflecting differences in institutional environments between urban and rural settings.