Need-Conditioned Uncertainty and Perceived Non-Provision of Community Services: Social Participation and Functional Status Among Older Adults in Urban China

Older adults who need community services may remain uncertain whether those services are locally provided or judge that they are not. Research on perceived unmet need often combines these positions. Using a cross-sectional survey of 929 adults aged 60 or older in urban Jiangsu, China, we paired reported need with perceived provision across 20 services and distinguished awareness gaps, perceived non-provision, and comparison uncertainty for services not reported as needed. Fractional logit models examined associations with social participation and functional status. Greater social participation was associated with fewer awareness gaps, concentrated among adults with ADL disability (-8.75 percentage points per SD). A weaker, less stable association with perceived non-provision appeared among functionally independent adults, and no counterpart appeared for comparison uncertainty. Unresolved uncertainty and negative provision judgments may call for different responses, and outreach may be especially relevant for older adults with ADL disability.