Inequalities in the Access to Health Services Among Older Migrants: Evidence From the China Migrant Dynamic Monitoring Survey

Objectives: To identify differences in healthcare use between older migrant workers (OMWs) and older migrants (OMs) and explore associated factors and paths of healthcare use. Methods: The data came from the 2015 China Migrant Dynamic Monitoring Survey (CMDMS). CMDMS used a multi-stage stratified probability proportionate to size method as the sampling technique and conducted a desk review. The samples include OMWs, OMs for caring offspring (N = 4,439), and OMs for receiving care from family (N = 4,184). We built logistic regression and path analysis models to analyze the data. Results: Social health insurance (SHI) in current place of residence is associated with less expenditure among all subgroups. OMWs and OMs for receiving care from family with SHI in current place of residence are more likely to use healthcare. Conclusion: OMWs are particularly vulnerable in healthcare use and socioeconomic status. Having SHI registered in current place of residence helps decrease expenditure among OMs. We urge policymakers to consider a united health financing scheme across OMWs and other urban employees and streamline policies for migrants to enroll in SHI in current place of residence.</p

Can long-term care insurance reduce catastrophic health and long-term care expenditures among older adults? A quasi-experimental study in China

Older adults with cognitive and/or physical limitations often face excessive health and long-term care (LTC) costs, which significantly affect their living standards. However, current measures of catastrophic health expenditure primarily focus on healthcare costs, overlooking the substantial burden of LTC costs. Our study is among the first to introduce the concept of catastrophic health and long-term care expenditures (CHLTCE) to comprehensively capture the economic burden of health and LTC costs associated with functional limitations. Drawing data from 2011, 2013, 2015, and 2018 waves of China Health and Retirement Longitudinal Study, we employed a staggered difference-in-differences approach to assess the impact of long-term care insurance (LTCI) on alleviating CHLTCE. We found that after accounting for LTC costs, both total health and LTC expenditures and CHLTCE risk significantly increased compared to when only healthcare costs were considered. Furthermore, LTCI coverage significantly reduced CHLTCE risks among older adults with cognitive and/or physical limitations. This effect was more pronounced among those with severe cognitive impairments and those with physical limitations and chronic diseases. In addition, its effectiveness in reducing CHLTCE risks for individuals with complex care needs was observed only at the high threshold, but not at lower thresholds. Our findings offer empirical contributions by incorporating both health and LTC costs into catastrophic expenditures analysis. We recommend that policymakers refine LTCI eligibility criteria and implement tiered coverage options based on various levels and dimensions of cognitive and physical function—beyond activities of daily living—to offer targeted protection for individuals with complex care needs.</p

Social support, cognition, and mental health among older people in China:A longitudinal life course study

Research suggests that stronger social support systems across life stages facilitate continuous learning and emotional well-being, contributing to better cognition and mental health. However, evidence on the cumulative effect of social support over the life course remains scarce, and even less is known about the impact of broader neighborhood-level social support on individuals’ cognition—a crucial dimension in many countries, where neighborhoods serve as key support units for individuals. Using data from 2014, 2015, 2018, and 2020 waves of the China Health and Retirement Longitudinal Study, we employed mediation analysis to explore how individual and neighborhood social support accumulated across life stages are associated with cognition and depression at older ages. Our findings indicate that receiving individual support in youth was associated with a 0.5-point improvement in later-life cognitive scores, although no direct association was observed with depression. In addition, a one-point increase in the neighborhood support score was associated with a 1.2-point improvement in cognitive scores and 0.5 fewer depressive symptoms at older ages. These associations persist among individuals who were socioeconomically disadvantaged in their youth. Furthermore, both individual and neighborhood support in youth exert indirect effects on later-life cognition and depression by helping individuals maintain social support as they age. Our findings contribute theoretical insights into the importance of social support across life stages and highlight the stronger role of neighborhood support in shaping cognition and depression. Strengthening neighborhood social support and fostering lifelong supportive environments may help mitigate disadvantages in earlier life stages and reduce health disparities

Slipping Through the Gap: Exploring the Influence of Social Health Insurance on Access to Healthcare for Older Migrant Workers

Objectives: Older migrant workers (OMWs) frequently confront barriers to accessing care, as their Social Health Insurance (SHI) coverage may not extend beyond their hometown. This study seeks to investigate whether Chinese OMWs can still derive benefits from SHI in accessing healthcare services, even when their SHI is not registered in the same location as their current residence.Methods: This study used data from 2015 China Migrants Dynamic Survey and focused on OMWs aged 60 years and older (N = 3,050). Logistic regression models were employed to investigate the factors influencing healthcare use.Results: Having SHI registered in current place of residence and interprovincial migration were significantly associated with increased likelihoods of doctor visits among OMWs. However, inpatient services use did not appear to be associated with the SHI registration place and migration range.Conclusion: Chinese OMWs derive fewer benefits from SHI in accessing healthcare services when their SHI is not registered in current residence. Governments in Low- and Middle-Income Countries should consider implementing targeted policies to provide adequate protection for OMWs and expand the coverage of direct reimbursement for cross-province healthcare services

Association of socioeconomic status with glycated haemoglobin level and risk factors for diabetic retinopathy: a cross-sectional study in Sichuan, western China

OBJECTIVE: Diabetes affects 1 in 10 adults in China. Diabetic retinopathy (DR) is a diabetes-related complication that, if untreated, impairs vision and causes blindness. Evidence on DR diagnosis and risk factors is limited. This study aimed to add evidence from socioeconomic factors. DESIGN: A cross-sectional survey of people with diabetes conducted in 2019 was analysed by using logistic regression to evaluate the association of socioeconomic factors with the glycated haemoglobin (HbA1c) level and DR. SETTING: Five counties/districts of western China (Sichuan) were included. PARTICIPANTS: Registered participants with diabetes aged from 18 to 75 years were selected, and at last 2179 participants were included in the analysis. RESULTS: In this cohort, 37.13% (adjusted value 36.52%), 19.78% (adjusted value 19.59%) and 17.37% of participants had HbA1c&lt;7.0%, DR (24.96% of those in the high-HbA1c group) and non-proliferative DR, respectively. Participants with higher social health insurance coverage (urban employee insurance (UEI)), higher income and urban residents tended to have glycaemic control (HbA1c) compared with their counterparts (OR: 1.48, 1.08 and 1.39, respectively). Participants with UEI or higher income had a lower risk of DR (OR: 0.71 and 0.88, respectively); higher education was associated with a 53%-69% decreased risk of DR. CONCLUSION: This study shows disparities in the effect of socioeconomic factors on glycaemic (HbA1c) management and DR diagnosis among people with diabetes in Sichuan. Lower socioeconomic (especially non-UEI) status conferred a higher risk of high HbA1c and DR. The insights from this study indicate the need for national programmes to implement community-level measures to facilitate access to better HbA1c management and early detection of DR in patients with lower socioeconomic status and diabetes. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry (ChiCTR1800014432).</p

The BabyView dataset: High-resolution egocentric videos of infants' and young children's everyday experiences

Human children far exceed modern machine learning algorithms in their sample efficiency, achieving high performance in key domains with much less data than current models. This ''data gap'' is a key challenge both for building intelligent artificial systems and for understanding human development. Egocentric video capturing children's experience -- their ''training data'' -- is a key ingredient for comparison of humans and models and for the development of algorithmic innovations to bridge this gap. Yet there are few such datasets available, and extant data are low-resolution, have limited metadata, and importantly, represent only a small set of children's experiences. Here, we provide the first release of the largest developmental egocentric video dataset to date -- the BabyView dataset -- recorded using a high-resolution camera with a large vertical field-of-view and gyroscope/accelerometer data. This 493 hour dataset includes egocentric videos from children spanning 6 months - 5 years of age in both longitudinal, at-home contexts and in a preschool environment. We provide gold-standard annotations for the evaluation of speech transcription, speaker diarization, and human pose estimation, and evaluate models in each of these domains. We train self-supervised language and vision models and evaluate their transfer to out-of-distribution tasks including syntactic structure learning, object recognition, depth estimation, and image segmentation. Although performance in each scales with dataset size, overall performance is relatively lower than when models are trained on curated datasets, especially in the visual domain. Our dataset stands as an open challenge for robust, humanlike AI systems: how can such systems achieve human-levels of success on the same scale and distribution of training data as humans?Comment: 9 pages, 2 figures, 4 tables and SI. Submitted to NeurIPS Datasets and Benchmark

Application of CRISPR–Cas in ageing and health equity

The recent advances in CRISPR-Cas technology have shown great potential in tackling age-related diseases and pathologies. However, older people from disadvantaged groups are less likely to have access to this technology compared to those from the more advantaged background. In particular, research shows that older people from certain minority groups may have concerns about participating in CRISPR-Cas-related research due to mistrust of this technology. This may lead to the underrepresentation of certain minority groups in the research, hence affecting the effectiveness of the CRISPR-Cas-related treatment. CRISPR-Cas may also have limited applications for the poor and those who live in less developed regions where this technology is either too expensive or not available. We urge governments to address the issue of equitable access to CRISPR-Cas technology by involving underrepresented groups in research, improving the ethical diversity in genomics databases, and reducing financial barriers to accessing the technology.</p

Mapping Maternal Health in the New Media Environment: A Scientometric Analysis

Background: The new media provides a convenient digital platform to access, use and exchange health information. As a special group of health care, maternal is still of international concern due to their high mortality rate. Improving maternal health as a Millennium Development Goal of the United Nations is an important quest for the health care system. Scientific research provides advice on how to improve maternal health through stringent reasoning and accurate data. However, the dramatic increase of publications, the diversity of themes, and the dispersion of researchers may reduce efficiency. Objective: This study aims to analyze the research progress on maternal health under the global new media environment, exploring the current research hotspots and research frontiers. Methods: A scientometric analysis was carried out by CiteSpace5.7.R1, searching in the core database of Web of Science for articles published in English from 1998 to 2021, and combined topic words such as new media, maternal, and health. In total, 3312 articles have been retrieved, of which 2270 studies have been included for further analysis. Top countries and institutions, potentially high-impact literature, research frontiers, and hotspots were analyzed in this study. Results: The number of publications grew rapidly after 2008, from 29 publications sharply increasing to 472 publications by 2020. Research centers concentrated in Latin America, such as the University of Toronto, the University of California. The work of Larsson M, Lagan BM, Tiedje L, and Helle C had a high potential impact. Most of the research subjects were maternal and newborn babies, and the research frontiers focused on health education and maternal psychological problems. Maternal mental health, maternal and infant nutrition, weight, production technology, and equipment were hotspots. Conclusion: The development of new media has brought a new era for maternal health, characterized by psychological qualities, healthy and reasonable physical conditions, and advanced technology.</jats:p

The Association of Midday Napping With Hypertension Among Chinese Adults Older Than 45 Years: Cross-sectional Study

BackgroundHypertension is one of the main public health issues around worldwide, and midday napping is a popular habit. The association between the two remains to be explored. ObjectiveThe goal of the research was to explore the association of midday napping with hypertension. MethodsThis study separately selected 11,439, 12,689, and 9464 Chinese respondents aged over 45 years from the China Health and Retirement Longitudinal Study 2011, 2015, and 2018 data sets. Binary logistic regression was used to explore the association of midday napping with hypertension, and the 3-step method was used to test the mediation effect of BMI. ResultsAmong all respondents, the prevalence rates of hypertension were 24.6% (2818/11439) in 2011, 21.1% (2683/12689) in 2015, and 22.1% (2092/9464) in 2018. Midday napping was positively correlated with hypertension. In 2011 and 2015, napping 60 to 90 minutes had the greatest odds ratios [OR] (OR2011 1.705, OR2015 1.494). In 2018, the biggest OR came from the group napping 30 to 60 minutes (OR 1.223), and ORs of different napping durations decreased from 2011 to 2018. In addition, BMI had a partial mediation effect in 2015 and 2018. ConclusionsMidday napping is a potential risk factor for hypertension with BMI acting as a mediator. To prevent hypertension, avoiding prolonged duration of midday napping and taking action to maintain a normal BMI level are recommended