ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1581826
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 53 articles
Public Health Implications of the Send-Down Movement: Long-Term Effects on Cognitive Ability of Rural Elderly in China
Provisionally accepted
Guangchuan Zhao1,2
Chen Su3*- 1Institute of Social Security and School of Public Administration, Nanjing University of Finance and Economics, Nanjing, China
- 2School of Economics, Fudan University, Shanghai, Shanghai Municipality, China
- 3School of Public Administration, Nanjing University of Finance and Economics, Nanjing, China
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Objective: This study examines the long-term effects of the send-down movement on the cognitive ability of rural elderly in China, focusing on how early-life exposure to human capital interventions shapes late-life cognitive trajectories.Methods: Leveraging four waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011(CHARLS, -2018)), we employ a cohort difference-in-differences (cohort DID) design to compare cognitive outcomes between rural residents exposed to senddown youths (SDYs) during childhood and non-exposed cohorts. Mechanisms are analyzed through a multi-mediation framework integrating educational attainment, non-agricultural work, social engagement, and fertility behaviors.Results: The analysis demonstrates that exposure to SDYs significantly enhanced cognitive ability among rural elderly individuals, resulting in a 0.857-point increase in cognitive ability score, a 4.33 percentage-point reduction in cognitive decline, and a 6.76 percentage-point decrease in cognitive impairment incidence. Mechanism analysis reveals that exposure to SDYs primarily influenced late-life cognitive ability through four pathways: improving rural children's educational attainment, increasing their probability of obtaining non-agricultural work, enhancing social engagement, and reducing fertility rates.Conclusion: The send-down movement positively influenced the cognitive health of rural elderly populations, underscoring the enduring impact of childhood access to educational resources on cognitive ability throughout the life course. Policy initiatives integrating early-life education with adult opportunity structures could yield compounded cognitive dividends, particularly in resource-limited rural settings.
Keywords: cognitive ability, Public Health, Send-Down Youths, Education, China
Received: 11 Apr 2025; Accepted: 06 May 2025.
Copyright: © 2025 Zhao and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chen Su, School of Public Administration, Nanjing University of Finance and Economics, Nanjing, China
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