Social Networks and Private Medical Insurance Decisions among Chinese Elderly: Evidence from China Health and Retirement Longitudinal Study on the Roles of Strong and Weak Ties

With advances in medical technology and scientific knowledge, human life expectancy continues to rise, making the challenge of achieving health aging increasingly prominent. While private medical insurance serves as a vital supplement to public healthcare systems, the role of social networks in shaping insurance adoption among older adults remains critically underexplored, despite evidence that social connections influence health-related decision-making. The present research aims to explore the relationship between medical insurance purchase and both “weak ties” and “strong ties” among the elderly by using evidence from the China Health and Retirement Longitudinal Study (CHARLS). Drawing on the data, the relationship was checked via a logistic model which contained a variable representing strong ties and two variables standing for online weak ties and offline weak ties. Subsequently, the results indicate a U-shaped relationship between offline weak ties and insurance purchase, as well as a positive effect of online weak ties on insurance adoption at high usage levels. Importantly, these findings reveal a “threshold effect” in the information diffusion process within social networks. In contrast, strong ties showed no significant association, challenging existing theory predictions. These findings offer actionable insights: insurance companies can leverage social network thresholds for targeted marketing, and policymakers should integrate online/offline network dynamics into health security strategies for aging populations.