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Livable City and Depressive Symptoms among Older Adults in China——Evidence from the China Health and Retirement Longitudinal Studies (CHARLS)

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Listed:
  • Feng, Zhixin
  • Chen, Hongyu
  • Xie, Jing

Abstract

As urbanization accelerates and China's population continues to age, the rising prevalence of depression among older adults highlights the urgent need to develop livable cities that address their specific needs. This study investigates how city-level livability relates to depressive symptoms among older adults, using data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), combined with indicators from the China City Statistical Yearbook and Google Earth Engine. Multilevel linear regression models were applied to assess five domains of livability: ecological environment, housing quality, social economy, health services, and community life. The results show that higher levels of housing quality, stronger socio-economic conditions, better health services, and more vibrant community life were associated with lower levels of depressive symptoms in univariate analyses. However, when all domains were considered simultaneously, only housing quality and community life remained significant. These two domains also moderated the effects of self-rated health, gender, and education on depression, with greater benefits observed among individuals with good health and higher education. Enhanced community life further reduced disparities across demographic groups. In contrast, the ecological environment showed no significant association. These findings emphasize the importance of domain-specific approaches to urban livability, integrating both physical and social environments. Policy efforts should prioritize housing improvements, such as barrier-free design, utility access, and digital connectivity, and community initiatives that promote social engagement and physical activity, including intergenerational programs and digital literacy training. By identifying pathways linking livability to mental health, this study offers guidance for creating inclusive and mentally supportive cities for China's aging population.

Suggested Citation

  • Feng, Zhixin & Chen, Hongyu & Xie, Jing, 2026. "Livable City and Depressive Symptoms among Older Adults in China——Evidence from the China Health and Retirement Longitudinal Studies (CHARLS)," Social Science & Medicine, Elsevier, vol. 389(C).
    • Handle: RePEc:eee:socmed:v:389:y:2026:i:c:s0277953625011402
    DOI: 10.1016/j.socscimed.2025.118809
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    References listed on IDEAS

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    1. Daniel Kim & Beth Ann Griffin & Mohammed Kabeto & José Escarce & Kenneth M Langa & Regina A Shih, 2016. "Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-14, June.
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    3. Zhuolin Pan & Ye Liu & Jamie R. Pearce & Chunyu Zheng, 2025. "Depression Among Older Adults in China: Effects of Urbanicity Across the Life Course," Annals of the American Association of Geographers, Taylor & Francis Journals, vol. 115(2), pages 363-379, February.
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