| BackgroudChina’s growing population and aging population structure have led to a substantial changes in the number of elderly Chinese over the last couple of decades. At the same time, China’s massive urbanization, sustainable industrialization, rapid economic development, and family structure simplification and downsizing have caused dramatic changes in the social environment and social relations in China. These specific factors commonly resulted in an increasing series of serious problems from older Chinese. In particular, with little social security and few pensions to ease burden in life, China’s ’only-child’ policy has made a young couple to support as many as four older parents, which led to acute stress for the aged.The continued deterioration of aged health had made all the family and individual suffer from heavy pressure, which causes rapidly increasing of the burden on disease and economic aspect. Social capital, as an important theoretical tool, has been used to explain the impact of the changes within the social environment and social relationship on health over the past decades within public health research.AimIn order to deeply understand the impact of social factors on health for the aged, this study would make construction of health-related social capital model from the perspective of social capital theory. This research selected Zhejiang Province as the sample, focus on investigateing health status for Chinese elderly (urban elderly, rural elderly and migration elderly) and its social influence factors, and lastly verified health-related social capital model. Finally it would provide related suggestions in order to promote the health of aged Chinese and formulate relevant health policy and social intervention.MethodsThe qualitative and quantitative methods were used in this research, which adopted embedded design framwork (quantitative-qualitative). A two-stage stratified cluster sampling method was applied. According to economic level, geographical distribution and population flow, it selected3cities in Zhejiang province as survey samples. A total of4087respondents were enrolled in the survey and accepted a face-to-face interview. In quantitative data analysis, factor analysis were used firstly on social capital, social support scale; Then t-test and variance analysis were used to assess the association linking health (self-rated health, depression) and social capital, social support, and key sociodemographic variables, while Spearman correlation analysis was applied to evaluate the relationship between health and social capital and social support; Furthermore regression analysis were performed to explore the impact of social capital and social support on health; At the same time, the interaction of social capital and social support was examined in model; In condition, this research focus on the change of structural social capital about migration elderly before and after migration, and the effects on health; Path analysis (structural equation modeling) was used in this study for further understanding of the effect of social capital, social support on health (direct and indirect effect); Finally two health related social capital model was compared (different health results). In qualitative data analysis, the theme analysis method was used to analyze the status of health and social capital, social support of the elderly, explain the formation reason, and understand the experience and problems of relevant government departments during the process.ResultsThe results of quantitative analysis found that:1) There was a statistical significance in health (self-rated health and depression) among different respondents of residence status, gender, age, marital status, education, family income;2) There were statistical significance in social capital, social support among different esidence status, but the specific dimensions varied;3) Regression analysis result showed that reciprocity, social network were positively related with self-rated health, trust and social participation were negative correlation with depression;4) Trust, reciprocity, social network, and social participation were positively related with social support;5) Social support was positively associated with self-rated health, and negatively with depression;6) Regression analysis result showed that household, age, marriage, education respectively were related with health (self-rated health, depression), gender was associated with self-rated health, family income was associated with depression;7) Path analysis result showed that social support, reciprocity, social network have direct effects on self-rated health; trust, social participation, social support have direct effects on geriatric depression; trust, reciprocity, social network, social participation have direct effects on social support; social participation has direct effect on social network; trust has direct effect on reciprocity;8) For migration elderly, sustained social network was negatively related with depression; reduced social participation was positively correlated with depression, negatively correlated with self-rated health; sustained social participation was positive related with self-rated health.The results of qualitative analysis showed:1. The overall health staus for elderly declined;2. Not only social capital staus for elderly, but also social network and social relations further were decreasing;3. When dealing with the problems for elderly, the type and degree of social support was limited, for which the demand in elderly were different;4. Government departments have taken some measures for problems of society aging and population migration, but relevant resource and method were not enough to solve problems.ConclusionThis study provides new evidence that social capital effectively mediates health directly and indirectly. Social support would partially mediate the relationships between social capital and health. When performing social interventions on health in Chinese elderly, the different effects of social capital by path should be considered. |
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