Proactive Health: A Culture-Centered Study on the Differential Health Practices of Older Adults in Elderly Care Institutions in China

Against the backdrop of population aging and changing family structures in China, research on older adults' agentic health practices remains relatively limited. This study employs participant observation and in-depth interviews, drawing on the culture-centered approach, to examine the differential health practices reflected in the health narratives of elderly residents in care institutions. The findings suggest that, in the face of health issues, older adults demonstrate proactive forms of health practice, and that their health promotion and health maintenance behaviors are embedded in existing health resources and cultural networks. Structural disparities generate both development-oriented and survival-oriented health logics among older adults, while different patterns of social interaction also shape differentiated mental health outcomes: some older adults gain positive psychological experiences through the active cultivation of social relationships. At the same time, Mianzi culture and disease stigma constitute culturally structured barriers, prompting some older adults to adopt different self-protective strategies for mental health.