ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 100 articles
The Impact of Chronic Diseases on Labor Participation Among Rural Elderly People in China
Provisionally accepted
- 1Shantou University, Shantou, China
- 2South China Agricultural University, Guangzhou, China
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Objective:To examine the impact of chronic diseases on labor participation among rural elderly in China and test the mediating role of the New Rural Cooperative Medical Scheme (NRCMS) in this relationship, thereby providing evidence for formulating policies to enhance the health and labor welfare of rural seniors. Methods:Data from 6,584 rural elderly individuals aged ≥60 years were obtained from the 2023 China Longitudinal Aging Social Survey (CLASS). Statistical analyses were conducted using Stata 17.0 software, including t-tests, chi-square tests, and binary logistic regression.Robustness checks were performed using inverse probability weighting regression and by altering the measurement of the independent variable. The mediating effect of the NRCMS was tested using a two-step regression approach. Results:The prevalence of chronic diseases among rural elderly was 76.6%, and the labor participation rate was 57.9%. After controlling for confounding factors, chronic diseases significantly reduced the risk of labor participation (OR=0.61, 95%CI: 0.53-0.70). Among specific conditions, cerebrovascular disease had the strongest negative impact(OR=0.59, 95%CI:0.49-0.71), followed by musculoskeletal disorders (OR=0.70, 95% CI: 0.61-0.81) and hypertension (OR=0.77, 95% CI: 0.68-0.87), with all results being statistically significant (p<0.001). Mediation analysis indicated that the NRCMS partially mediated the relationship between chronic diseases and labor 2 participation. This mediating effect showed heterogeneity across income levels and disease burden: it was significant only in the low-income group, and when the number of chronic diseases exceeded three, the proportion of the mediating effect increased to 41.9%. Conclusion:Chronic diseases constitute a major health risk factor that inhibits labor participation among the rural elderly. The NRCMS plays a significant mediating role in this process. Therefore, targeted measures are recommended, such as strengthening medical insurance coverage and chronic disease management for low-income individuals with multiple comorbidities. These measures would help mitigate the negative impact of health shocks on the labor capacity of the elderly and promote the rational utilization of rural elderly human resources.
Keywords: Rural elderly, chronic diseases, Labor participation, rural basic medicalinsurance, Mediating effect
Received: 31 Jul 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Meng and Li. 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: Tiancheng Li, lycmfc@163.com
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