Frontiers in public health · 2026
Urban-rural disparities in education's mediating role between digital engagement and depression among Chinese older adults.
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Gong Guangwen, Li Haomiao, Wang Yuanhang, Chen Yingchun
Аннотация
BACKGROUND: Chinese older adults face dual challenges of digital exclusion and mental health burdens. This study examines whether educational attainment mediates the relationship between digital engagement and depression, and whether there is urban-rural heterogeneity in this mediating effect.
METHODS: Using nationally representative data from 3,206 adults aged ≥60, we conducted chi-square tests and used Hayes' PROCESS macro (Model 4 for mediation, Model 7 for moderated mediation), adjusting for covariates.
RESULTS: In total, 36.9% (n = 1,182 of 3,206) of Chinese older adults reported using the internet. Digital engagement was positively associated with education (β = 0.609, p < 0.001) and indirectly associated with lower depression through education (indirect β = 0.049, p < 0.001), accounting for 27.8% of the total effect. A direct association with lower depression remained (β = 0.078, p < 0.01). The education-mediated pathway showed significant urban-rural heterogeneity, being 29% stronger in urban areas (B = 0.102, 95% CI: 0.077-0.127) than rural areas (B = 0.079, 95% CI: 0.058-0.101; Index of Moderated Mediation = -0.023).
CONCLUSION: Digital engagement is associated with significant protection against depression among older Chinese adults, and the education-mediated pathway shows substantial urban-rural heterogeneity. To potentially realize the full mental health potential of digitalization, policymakers must implement synergistic strategies to reduce digital infrastructural inequities and address disparities in the translation of education into health benefits.
METHODS: Using nationally representative data from 3,206 adults aged ≥60, we conducted chi-square tests and used Hayes' PROCESS macro (Model 4 for mediation, Model 7 for moderated mediation), adjusting for covariates.
RESULTS: In total, 36.9% (n = 1,182 of 3,206) of Chinese older adults reported using the internet. Digital engagement was positively associated with education (β = 0.609, p < 0.001) and indirectly associated with lower depression through education (indirect β = 0.049, p < 0.001), accounting for 27.8% of the total effect. A direct association with lower depression remained (β = 0.078, p < 0.01). The education-mediated pathway showed significant urban-rural heterogeneity, being 29% stronger in urban areas (B = 0.102, 95% CI: 0.077-0.127) than rural areas (B = 0.079, 95% CI: 0.058-0.101; Index of Moderated Mediation = -0.023).
CONCLUSION: Digital engagement is associated with significant protection against depression among older Chinese adults, and the education-mediated pathway shows substantial urban-rural heterogeneity. To potentially realize the full mental health potential of digitalization, policymakers must implement synergistic strategies to reduce digital infrastructural inequities and address disparities in the translation of education into health benefits.