Understanding How Community Elder Care and Social Security Shape Health Frailty : A Chinese Longitudinal Perspective

Using five waves (2005-2018) of the China Longitudinal Healthy Longevity Survey, this study examines how community home-based elderly care services and social-security coverage jointly shape trajectories of multidimensional frailty. Latent growth and Croon-corrected structural equation models show that community services alone have no significant effect, whereas their integration with social security reduces both baseline frailty and its progression. Chain mediation reveals cross-domain pathways, particularly the social-psychological-physiological sequence. These findings highlight the role of community services as mechanisms translating institutional support into sustained health gains in later life.