ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1636724
This article is part of the Research TopicEnvironmental Challenges and Public Health Inequality: Climate Change Impacts and Adaptive BehaviorsView all 3 articles
Heat exposure and self-rated health in older Chinese adults: The mediating roles of chronic disease and intergenerational support, 2008–2018 CLHLS
Provisionally accepted
- Institute of Population Research, Hohai University, Nanjing, China
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Background Under the dual pressures of global warming and accelerated population aging, rising temperatures pose a particularly serious threat to the elderly. However, systematic evidence on the heat exposure-response pathway is still scarce. This study aims to explore the effects of heat exposure on self-rated health and its pathways in the elderly in China. We predicted that heat exposure would reduce the self-rated health of the elderly, and that chronic diseases and intergenerational support would mediate this effect. Methods We linked health data from 9,670 participants in the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2008-2018 waves) with meteorological records from the National Climatic Data Center (NCDC). Individual fixed-effects models were employed to disentangle acute versus cumulative thermal effects, while Bootstrap-mediated path analysis quantified the mediating mechanisms involving chronic disease proliferation and deterioration of intergenerational support. Results Heat exposure has a time effect on the health risk of the elderly, and long-term heat exposure (β = -0.156, P < 0.01; β = -0.003, P < 0.01) significantly reduces self-rated health through the cumulative effect of health disadvantages than short-term exposure (β = 0.004, P < 0.1; β = -0.001, P > 0.1). The increase in the number of chronic diseases (β = 0.260, P < 0.05) and the weakening of children's intergenerational support (β = -0.052, P < 0.01; β = -0.023, P < 0.01) constitute a mediating pathway at individual and household level separately. Conclusions We found that chronic diseases and intergenerational support from children mediated the effect of heat exposure on the deterioration of self-rated health in the elderly. Empirical evidence substantiates the necessity for a tiered intervention framework encompassing: individual-level chronic disease co-management protocols; household-driven initiatives to reinforce intergenerational support. This stratified approach alleviates bioclimatic risks through coordinated physiological adaptation and optimization of kinship network.
Keywords: Climate Change, Heat exposure, older adults, self-rated health, Mechanism paths
Received: 29 May 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Wang and Wang. 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: Huan Wang, Institute of Population Research, Hohai University, Nanjing, China
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