The association between smart elderly care and subjective well-being among older adults in China: the mediating roles of health status and social activities

Under the initiative of China’s “Internet+” strategy, smart elderly care reflects the government’s capacity to bridge the digital divide and provide inclusive care services for older adults. Though studies have identified positive associations between smart elderly care and health outcomes, empirical research examining its impact on older adults’ subjective well-being remains limited.

This study utilizes data from the 2021 Chinese Longitudinal Healthy Longevity Survey (CLHLS, N = 8,950), which includes multifaceted information on individuals aged 65 and above, covering their personal characteristics, health status, family information, and community elderly care services. A logit model is employed to investigate the association between smart elderly care and SWB. The mediating effects are tested using the bootstrap resampling method. To address endogeneity concerns, instrumental variable (IV) approaches including IV-Probit and 2SLS are applied as robustness checks.

The results reveal a positive correlation between smart elderly care and older adults’ subjective well-being (β = 0.101, p < 0.01). This association is partially mediated by both health status (proportion mediated: 38.47%) and social activities (proportion mediated: 2.65%). Heterogeneity analyses show that this positive association holds consistently across both rural and urban older adults, and is more pronounced among those with lower digital literacy.

This study challenges the prevailing assumption that the “digital divide inevitably isolates the older adults from participating in a digitized society.” By integrating digital technologies into older adults care services, we demonstrate that smart elderly care is positively associated with bridging technological barriers and addressing the unmet needs of aging populations. These findings further propose a synergistic mechanism—policy innovation, technological adaptation, and service optimization, to build an inclusive older adults care ecosystem, offering evidence-based insights for policymakers in aging societies to balance equity and efficiency in digital transformation.