Elderly welfare programs and depressive symptoms in China: cross-sectional evidence from CHARLS 2020

There is limited evidence in China regarding the relationship between welfare programs and the depressive symptoms of the older adults. This study aims to explore the relationships between three different welfare programs and the depressive symptoms of older adults and to compare the potential pathways through which family support and social participation may operate. This study utilized data from the 2020 China Health and Retirement Longitudinal Study (CHARLS), including 7773 Chinese individuals aged 60 and above. The depressive symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D10). Welfare programs were measured through dummy variables indicating individual participation in these programs. The relationship was examined using multiple regression linear models. Mediation analysis was employed to test the mediating roles of family support and social participation. The old age allowance was negatively correlated with the depressive symptoms of older adults (r=-0.859, 95% CI [-1.346, -0.371], P < 0.01), mediated by economic support that older adults provide to their adult children. Further investigation revealed that this negative correlation was more evident among older women, agricultural older adults. A negative relationship between the one-child family allowance and older adults’ depressive symptoms(r=-0.696, 95%CI [-1.228, -0.165], P < 0.05) was associated with one child’s visitation and life care. This association was significant among agricultural, married/cohabiting older adults. The subsistence allowance was positively associated with the depressive symptoms of older adults, due to the mediation of economic support to children and children’s visitation (r = 1.737, 95%CI [1.192, 2.282], P < 0.01). The elderly welfare programs were strongly linked to depressive symptoms among older adults, with different welfare programs exhibiting varying degrees of association with these symptoms. Different dimensions of family support played a mediating role, while social participation did not exhibit a mediating effect. Rural and older women’s depressive symptoms were more significantly associated with the welfare programs.