Longitudinal associations between neighborhood built environment and self-rated health accounting for social capital

With the advancement of the “Healthy China 2030 Initiative”, increasing attention has been paid to health outcomes in China amid rapid urbanization and population ageing. Among various factors, Built Environment (BE) and Social Capital (SC) play important roles in shaping individuals’ Self-Rated Health (SRH). However, prior studies mainly relied on cross-sectional design, with limited attention to age and urban-rural differences in these associations. We aimed to examine the longitudinal associations between BE and SRH accounting for SC, and to investigate heterogeneity in the associations by age and urbanicity. Data came from the 2010 and 2014 waves of the China Family Panel Studies (CFPS), including 15,570 respondents in the final analytical sample. Participants reported better SRH in neighborhoods characterized by more appealing environment, stronger social relationships and higher levels of social trust. Further, we observed distinct differences among age groups: Enhanced neighborhood aesthetics was more strongly related to better SRH for those aged 45 and above. Individuals under 60 with higher social trust reported better SRH. In addition, enhanced neighborhood aesthetics had a stronger association with improved SRH in urban areas, whereas strengthening social relationships and social trust played a more significant role in shaping positive SRH among rural residents. Overall, our findings suggest that improving neighborhood aesthetics and enhancing social relationships and social trust may contribute to better self-rated health. Further, our findings could inform policymakers that intervention strategies need to be tailored to meet the specific needs of different age groups and those across urban and rural areas.