Preventive health management and elderly consumption: evidence from China

Health uncertainty can suppress elderly consumption through precautionary saving, yet the consumption effects of preventive health management remain underexplored. This paper examines China’s National Free Health Examination Programme, which provides free annual check-ups to adults aged 65 and above. Using five waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011–2020), we exploit staggered city-level programme adoption and apply the Callaway–Sant’Anna difference-in-differences estimator, using never-treated and not-yet-treated cities as controls under a conditional parallel-trends assumption. We find that the programme significantly increases elderly household non-health consumption, with results robust to alternative estimators that accommodate treatment-effect heterogeneity. Effects are larger among low-income, less-educated, and less-healthy individuals and are concentrated in discretionary spending, including tourism and cultural activities, while subsistence consumption remains unaffected. Mechanism analyses provide complementary evidence consistent with two potentially interrelated channels: improvements in functional health and the updating of subjective survival beliefs, accompanied by reductions in precautionary financial buffers. These findings highlight the potential of preventive public health programmes to stimulate elderly consumption and influence its composition.