Caught in cultural lag: exploring health anxiety of China’s first-generation modern older adults

Health anxiety among older adults has attracted growing attention globally as the ageing population increases. In previous studies, health anxiety has largely been understood as a biomedical and psychological concern. This study conceptualizes health anxiety as a culturally mediated experience, embedded in socially shared ideals of what it means to age “well,” remain valuable, and feel morally adequate in later life. From September 2022 to December 2023, the authors conducted life story interviews with 28 first-generation modern older adults in China who were socialized under collectivist moral frameworks yet have aged amid rapid modernization. These findings suggest a process in which participants initially seek to align themselves with dominant ideals of progress, autonomy, and successful ageing, but subsequently come to experience health anxiety when encountering bodily uncertainty, fragmented care arrangements, and weakening intergenerational and community support. Through this socialized shift, these external constraints and vulnerabilities are interpreted through moral expectations and internalized as personal inadequacies. By foregrounding these cultural dynamics, the study challenges individualistic accounts of health anxiety and demonstrates how contemporary norms and policy discourses of ageing escalate emotional distress in later life.