The impact of spouse health on social participation of older adults in China: Evidence from the CLHLS

Background: China is dealing with a serious aging issue. Social participation is essential for active aging. The health status of spouses is intertwined with the trajectory of the social function of the elderly. Objectives: This study examined the association between spouse health and social participation among older Chinese adults. The study also explored the mediating role of loneliness and anxiety between spousal health and social participation.Methods: The analytic sample included 6125 adults aged 60 years and above. Prospective data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). First, we described basic socio-demographic information about the sample. Secondly, Spearman's correlation analysis was used to determine whether cor-relations existed between spousal health, loneliness, anxiety, and social participation. Finally, mediation analysis was run using the SPSS macro PROCESS program.Results: Spousal health, loneliness, anxiety, and social participation were significantly correlated (P < 0.01). Spousal health could not only have a direct positive impact on social participation in older adults (beta = 0.239, 95 % CI: 0.120, 0.359), but also indirectly on social participation through three pathways: an independent medi-ating effect of loneliness (beta = 0.020, 95 % CI: 0.009, 0.034), an independent mediating effect of anxiety (beta = 0.018, 95%CI: 0.009, 0.032), and a chain mediating effect of loneliness and anxiety (beta = 0.004, 95%CI: 0.002, 0.007).Conclusion: This study suggests paying more attention to elderly couples and decreasing the negative conse-quences of changes in spousal health.