Identifying the interactive pathways shaping health satisfaction among Chinese older adults with tourism...

As global aging accelerates, improving older adults' health satisfaction is a key policy and public health concern. While tourism has been associated with well-being, the pathways through which it is associated with health satisfaction remain unclear. It is not well understood whether social, environmental, and digital factors affect health satisfaction independently or interactively in the context of tourism participation. This study addresses this gap by examining the key determinants of health satisfaction among older adults engaging in tourism and assessing the independent and interactive effects of social relationships, environmental quality, and digital participation. This study uses data from 13,346 respondents in the China Health and Retirement Longitudinal Study (CHARLS). A data-driven approach combining machine learning and regression analysis was applied to identify key predictors of health satisfaction and examine their interaction effects in the context of tourism participation. The results show that health satisfaction among older adults is primarily associated with self-reported health, while social, environmental, and digital factors are also related to health satisfaction through interaction effects. In particular, social support, particularly marital relationships, is more strongly associated with health satisfaction among individuals with poorer health, whereas environmental factors including air quality and digital engagement are associated with variations in health satisfaction in a context-dependent manner. These findings suggest that health satisfaction is not explained by single factors, but is associated with the combined presence of tourism participation and multiple interacting conditions. The results indicate that health satisfaction in older adults engaging in tourism is shaped by multiple interacting factors rather than a single linear effect. Social relationships, environmental quality, and digital participation emerge as key determinants, each influencing well-being through distinct pathways. These findings highlight the complex and context-dependent nature of health satisfaction and highlight the importance of personalized interventions and policy strategies to enhance older adults' well-being through tourism-based social and environmental engagement.