Does the Improvement of Medical Insurance Equity Enhance the Mental Health of Elderly Residents in Rural Areas? Evidence From the Adjustment of Medical Insurance Policy in China

Background: Population aging is a global challenge. In rural China, elderly residents face urgent mental health issues due to limited healthcare and insufficient funding. The integration of urban and rural medical insurance policies by the Chinese government aimed to improve healthcare equity and provide health protection for this vulnerable group.

OBJECTIVES: This study investigated how enhanced medical insurance equity affects the mental health of elderly residents in rural China, offering insights into revising medical insurance systems amid global aging.

METHODS: In 2016, China implemented the consolidation of rural and urban medical insurance. From the perspective of naturalistic experiment, the paper utilized CHARLS panel data from 2015 and 2018 and constructed a DID regression model to assess the impact of enhanced medical insurance equity on the mental health of rural elderly residents.

RESULTS: The baseline regression analysis showed that enhanced medical insurance equity notably lowered CES-D scores among rural elderly residents (-1.060, p < 0.01). The effect was particularly strong for those with healthy behaviors (-1.236, p < 0.01). Regional disparities were also evident, with significant improvements in the east (-1.073, p < 0.05) and west (-1.662, p < 0.05), while in the central region it was statistically insignificant. The study found that increased medical reimbursements, resulting from equity enhancements, fostered better mental health among rural seniors.

CONCLUSIONS: Medical insurance equity notably enhanced the mental well-being of rural seniors, largely through higher reimbursement rates that acted as a mediator. The initiative not only bridged the healthcare disparity between urban and rural regions but also bolstered social health and welfare. A fair medical system can mitigate social inequities and health disparities, thus elevating life satisfaction and happiness. Furthermore, the paper exemplified a Chinese approach for healthy population aging and highlighted the efficacy of policy reforms in tackling healthcare inequities.