Urban-rural differences in the longitudinal reciprocal relationship between assets and health among Chinese older...

Socioeconomic resources are a major determinant of health in later life, yet the longitudinal relationship between assets and health, especially across urban-rural contexts, remains underexplored.

We utilized four waves of data (2011-2018) from the China Health and Retirement Longitudinal Study (CHARLS), comprising 4632 participants aged 60 and above. Household net worth was used to measure assets, while health was assessed through depressive symptoms and chronic diseases. Autoregressive cross-lagged panel models (ARCL) were applied to examine the bidirectional associations between assets and health over time, and multi-group analyses (MGA) were conducted to examine urban-rural differences.

We found no significant bidirectional relationship between assets and chronic diseases. In contrast, assets and depressive symptoms showed a significant reciprocal association, with depressive symptoms having a stronger negative effect on assets (β = -0.087 to -0.149, p < 0.001) than assets had on depressive symptoms (β = -0.040 to -0.060, p < 0.001). The critical ratio for difference in the multi-group analysis indicated that the negative impact of depressive symptoms on assets was significantly stronger in the rural group than in the urban group (CRD = 3.087, p < 0.001).

Assets and depressive symptoms are reciprocally associated in later life, with stronger adverse effects in rural areas. Policies should integrate asset-building with health security to enhance the well-being of older adults, particularly in rural populations.