Demographic structure, consumption composition, and household health investment: evidence from sports and fitness expenditure.

PURPOSE: This study examines how household age structure is associated with health-related expenditure in China, distinguishing broad medical and healthcare expenditure from narrower health/fitness expenditure.

METHODS

Using nationally representative China Household Finance Survey data from 2015, 2017, 2019, and 2021, we estimate associations between old-age and child dependency ratios and two expenditure outcomes and examine potential mechanisms through precautionary saving and household disposable income.

RESULTS

Old-age dependency is positively and relatively consistently associated with both broad medical and healthcare expenditure and narrow health/fitness expenditure. The association for child dependency is less stable across outcomes and specifications, but the mediation results are consistent with the possibility that household income constraints are relevant for discretionary health/fitness expenditure. Robustness, heterogeneity, and supplementary instrumental-variable analyses support an associational interpretation rather than a strong causal claim.

CONCLUSION

Demographic structure is linked not only to the level of household health-related expenditure but also to its composition. Distinguishing old-age and child dependency helps clarify how demographic transition may shape household capacity for preventive and discretionary health investment.