Bidirectional relationship between digital inclusion and healthy ageing among Chinese older adults: a four-wave cross-lagged study

Abstract Population ageing and digital health have become important trend and challenge in today’s world development. And previous literature has concentrated on their causes and consequences. However, less is known about the bidirectional relationship between digital inclusion and healthy ageing among older adults, which is not conducive to governance of an ageing population and realization of digital health equity. Based on CHARLS database, this study empirically examines the bidirectional relationship between digital inclusion and healthy ageing using a four-wave cross-lagged model. The results show that digital inclusion significantly positively predicts healthy ageing (β = 0.049, p < 0.001; β = 0.037, p < 0.01; β = 0.086, p < 0.001). In addition, the role of healthy ageing in predicting digital inclusion is also emphasized (β = 0.057, p < 0.01; β = 0.048, p < 0.01; β = 0.043, p < 0.01). After controlling for covariates including sociodemographic characteristics, health-related behaviors and health outcomes, the bidirectional relationships are also significant ( p < 0.05). Multi-group analyses indicate that these cross-lagged effects were invariant across gender, marital status, residence and income groups ( p < 0.05), but varied significantly by education level ( p < 0.05). And sensitivity analyses further confirm the robustness of the findings. The present study provides substantial evidence and reference for the relationship between digital inclusion and healthy ageing in Chinese context and contributes to a deeper understanding of the solution to ageing population and digital divide.