Better Health for the Rural Elderly? Exploring the Impact of Community-based Home Care Policy

The deteriorating physical and mental health of the rural elderly has become a common problem in developing countries and demands immediate attention. This article investigates the overall impact of China’s policy of community-based home care on rural elderly’s health, reveals the underlying mechanisms, and examines specific types of elderly care services. Based on the theoretical analysis of the mechanisms, we carried out an empirical analysis using the PSMDID method with data from the China Health and Retirement Longitudinal Study (CHARLS) for 2013, 2015, and 2018. We find that community-based home care not only reduces the scores of Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) among the rural elderly but lowers their scores of negative emotions and levels of depression, therefore enhancing their physical and mental health. These effects remain robust against sensitivity analyses, regression by year, and interferences of previous policies. Distinguishing different types of services, we find that daily care reduces individuals’ scores of ADL and negative emotions, and therefore enhances physical and mental health; while regular medical and recreational services lower ADL or IADL scores and thus improve physical health, their impact on mental health is not significant. This article concludes that community-based home care significantly improves the physical and mental health of rural elderly, and hence advises rural pension policy-making.