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Cited by 7Health disparities and outcomesAging, Health, and DisabilityRetirement, Disability, and Employment

Social causation, social selection, and economic selection in the health outcomes of Chinese older adults and their gender disparities

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Zhang, Kangkang, Xu, Xinpeng, You, Hua·2023·SSM - Population Health
DOI 10.1016/j.ssmph.2023.101508PMC PMC10500472
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Abstract

Background: The economic selection hypothesis, which argues that the initial economic situation determines both subsequent health and economic conditions, has been drawn into the debate on causation-selection issues. This study aims to construct a path model with self-rated health and depression score of older adults as health outcomes to measure and compare the social causation forces of wealth accumulation, social selection forces of adulthood health, and economic selection forces of childhood economics, and to examine their gender disparities. Methods: Data was obtained from a sample of 19613 older adults aged 45 years or above from the 2014 life history survey and the 2015 routine follow-up survey of the China Health and Retirement Longitudinal Study. Structural equation modeling analysis was conducted employing the full information maximum likelihood estimation method. Results: The presence of social causation, social selection, and economic selection were all statistically supported. In self-rated health, social selection forces held the dominant position, while social causation forces were comparable to economic selection forces. In depression score, social selection still exhibited stronger forces than economic selection, but social causation had forces close to social selection and greater than economic selection. The forces of the three hypotheses in self-rated health did not significantly change with gender, but social causation exerted mightier forces than economic selection within the male group, unlike the female group. The forces of economic selection in depression score were greater in females than males and no significant differences were observed among the forces of the three hypotheses in the female group. Conclusions: Social causation, social selection, and economic selection operate simultaneously on the self-rated health and depression score of older adults. However, the force magnitudes of the three hypotheses and/or their rankings differ by health outcomes and gender.

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  • These perspectives collectively explain causation through mechanisms like social selection, social causation, and life course perspectives.

    “These perspectives collectively explain causation through mechanisms like social selection (a selective force that occurs when individuals change their own social behaviors in response to signals from conspecifics, thereby influencing others’ fitness [21]), social causation (the idea that an individual’s social environment and circumstances can influence their health and well-being [22]), and life”

    From Then, Now, Next: Unpacking the Shifting Trajectory of Social Determinants of Health (2025) · cites this paper as [22]

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Authors
Zhang, K., Xu, X., & You, H.
Affiliations
Nanjing Medical University (CN)
Corresponding author
  • Xu, Xinpeng
  • You, Hua
ORCID
Venue
SSM - Population Health
Publisher
Elsevier BV
Published
2023-12
Volume
24
Pages
101508
ISSN
2352-8273 (ISSN-L)
DOI
10.1016/j.ssmph.2023.101508
PMC
PMC10500472
OpenAlex
W4386572452
Cited by
7
References
2
Citations by year
2026: 3 · 2025: 3 · 2024: 1
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
Locations
  • SSM - Population Health (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Natural Science Foundation of China (72074122)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Demography › Retirement, Disability, and Employment
Keywords
social causation, social selection, economic selection, health outcomes, older adults, gender disparities, self-rated health, depression, childhood socioeconomic status, wealth accumulation, China Health and Retirement Longitudinal Study

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