ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1596215
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 67 articles
Investigating the association between social participation and all-cause mortality risk among Chinese Middle-Aged and Older Adults
Provisionally accepted
- 1School of Public Health, Southwest Medical University, Luzhou, China
- 2Department of General Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
- 3Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, China
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Objective: While the association between social participation and all-cause mortality has been investigated to some extent, the link remains inconclusive, especially in China. This study aimed to investigate the association between social participation and allcause mortality among middle-aged and elderly people in China.Methods: Using data from the China Health and Retirement Longitudinal Study, and altogether 15,883 participants were included. The Cox proportional hazards regression model was used to assess the relationship between social participation and all-cause mortality, and subgroup analyses were conducted by age (< 60 years, ≥ 60 years) and sex.Results: With a median follow-up of 9.01 years, 2,175 participants developed deaths. Results from multivariable Cox regression modeling showed participants who participated in social activities had an all-cause risk of death of 0.88 (HR = 0.88, 95% CI: 0.78, 0.99) compared with those who did not. Further analyses showed that compared with participants with no social participation, those with 1 item of social participation had an all-cause mortality risk of 0.93 (HR = 0.93, 95% CI: 0.81, 1.06), and those with ≥ 2 items were 0.77 (HR = 0.77, 95% CI: 0.64, 0.94). In addition, subgroup analyses showed no age (P interaction = 0.571) or sex (P interaction = 0.440) differences in the relationship between the both.Our results suggest social participation is an independent protective factor for all-cause death among middle-aged and elderly people in China. Active social participation helps to reduce the risk of death.
Keywords: Social Participation, All-cause mortality, Middle-aged and older adults, prospective cohort study, China Health and Retirement Longitudinal Study
Received: 19 Mar 2025; Accepted: 26 Jun 2025.
Copyright: © 2025 Xu, Gan, Zeng, Yan and Yang. 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: Chao Yang, School of Public Health, Southwest Medical University, Luzhou, China
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