Religious life, monastic support, and healthcare inequity among aged Han Buddhist monks in China: an explanatory...

This study examines the determinants of healthcare access inequity among aged Han Buddhist monks in China by focusing on the interaction between religious life, monastic support, and socioeconomic background. Using an explanatory mixed-methods design, the study first collected quantitative data from 170 respondents, including 70 aged Han Buddhist monks, 50 monastery administrators, and 50 health policy stakeholders. Multiple linear regression was used to examine the effects of religious factors, monastic/cultural support, and socioeconomic background on healthcare access. The quantitative results showed that religious factors negatively predicted healthcare access (β = -0.319, p = 0.001), whereas monastic/cultural support was the strongest positive predictor (β = 0.427, p < 0.001), followed by socioeconomic background (β = 0.131, p = 0.017). The model explained 50.7% of the variance in healthcare access. The qualitative phase, based on interviews with 20 participants, was then used to explain the mechanisms behind these statistical patterns. The findings show that preferences for Traditional Chinese Medicine, meditation, spiritual practices, and caution toward invasive procedures may delay engagement with biomedical care. Conversely, support from fellow monks, monastery administrators, donors, Buddhist associations, and government actors can expand access, particularly for monks without stable income or family-based support. Barriers were most pronounced in rural and independent monasteries, where transportation, insurance, internal health facilities, and policy integration remained limited. The study concludes that healthcare inequity among aged Han Buddhist monks cannot be reduced to economic or geographic disadvantage alone; rather, it is produced through the interaction of religious values, monastic support structures, and modern healthcare systems. Healthcare interventions for this population should therefore be monastery-based, culturally sensitive to Buddhist values, and integrated with public health policy.