Individual educational attainment, neighborhood-socioeconomic contexts, and self-rated health of middle-aged and elderly Chinese: Exploring the mediating role of social engagement

Analyzing the 2011-2013 China Health and Retirement Longitudinal Study with 14,507 respondents from 393 neighborhoods, and applying generalized linear mixed-effects model, this study examines how individual-level education and neighborhood-socioeconomic contexts affect health through social engagement. Findings reveal that measures of social engagement-social activity and productive activity-are significantly related to self-rated health and partially mediate the effects of individual-level education. Neighborhood-socioeconomic contexts have independent effects on self-rated health beyond individual socio-demographics, and social activity mediates the effects of neighborhood recreational facilities. This study is among the first to simultaneously explore the health effects of individual and neighborhood-level socioeconomic conditions.