The Relationship between Depressive Symptoms of Older Adults and Support from Their Children in Rural China: A Conditional Process Analysis

Background and purpose

In rural China, support from children is the most important and traditional way of social support for older adults. In previous studies, rural older adults’ mental health problem is poorly understood and remains unsolved. The study aims to explore the mechanisms between support from children and depressive symptoms of older adults in rural China. The major research questions are as follows:

- Does the number of children have a direct influence on older adults’ depressive symptoms?

- Is the relationship between the number of children and older adults’ depressive symptoms mediated by financial support from children on older adults’ self-rated health?

- Does this mechanism depend on the co-residence situation between children and their older parents? 

Methods

This study used 2015 Harmonized China Health and Retirement Longitudinal Study (Harmonized CHARLS) in China. The sample is constrained to rural older parents, who are 65 years or older with at least one child (N=3418). The study applied a 10-item CES-D score as the dependent variable. The focal predictor is the number of children. Co-residence situation plays the role of moderator. Two mediators include the number of financial support from children and older adults’ self-rated health score. Age and gender are the two control variables. We applied a conditional process analysis model in this study. The PROCESS tool on the software of SPSS 23 was applied for data analysis.

Results

- The number of children has a significant and negative direct influence on older adults’ depressive symptoms (α = -0.24, p=0.02<0.05), controlling for other variables in the model.

- The negative relationship between the number of children and older adults’ depressive symptoms is significantly mediated by financial support from children on older adults’ self-rated health, no matter whether older parents live with their children or not (β_{non-residence}=-0.009, 95% CI= -0.0203 to -0.0030; β_residence=-0.0094, 95% CI= -0.0060 to 0.0065), controlling for age and gender.

- The index of the moderated mediation is an inference about whether the mechanism is moderated by the co-residence situation. This index is not statistically significant in this study (γ= -0.04, 95% CI= -0.0060 to 0.0065).

Conclusions and Implications

First, the number of children has a direct effect on older parents' depressive symptoms. The more children, the less depressive symptoms. Second, the relationship between the number of children and older adults’ depressive symptoms is mediated by financial support from children on older adults’ self-rated health. By giving parents greater hope they will not be in poverty, they will have better physical and mental health. Finally, we cannot say that this mechanism depends on the co-residence situation.

This study provides implications for policies and practices to improve rural older adults’ psychological well-being. With demographic changes facing China and children moving to urban areas while elders remain in rural homes, this study provides an understanding of the mental health consequences.