Impact of Smart Wearable Devices on Health and Health Inequality Among Older Adults: Evidence from China

<b>Background</b>: As China enters the digital era and actively promotes an active aging strategy, smart wearable devices have become increasingly prevalent among older adults; however, their impact on health inequality remains unclear. This study investigates the association between smart wearable devices and health, as well as health inequality, among Chinese older adults, and further examines the mediating roles of joy of living and social participation. <b>Methods</b>: Data were derived from two waves (2018 and 2020) of the China Longitudinal Aging Social Survey (CLASS), with a final sample of 7098 adults aged 60 and above. A two-way fixed-effects model, propensity score matching-difference-in-differences (PSM-DID) approach, and mediation analysis were employed. <b>Results</b>: Smart wearable devices were significantly positively associated with both health and health inequality among older adults in China. Mediation analysis revealed that joy of living and social participation played an intermediary role. <b>Conclusions</b>: This study provides preliminary evidence that smart wearable devices are associated with health and health inequality among Chinese older adults. Policy efforts should focus on developing more user-friendly devices, promoting digital literacy among older adults, and supporting disadvantaged groups. Furthermore, the mediating effects suggest that fostering joy of living and encouraging active social participation may serve as effective pathways to improve health.