This study aimed to research the trajectory of leisure activity and the health status of older adults and analyze the effects of leisure activity on the health status of older adults. Based on the longitudinal data of CLHLS (2008–2018), the latent growth curve model (LGCM) was used; we found that the leisure activities (LA), activities of daily living (ADL) ability, instrumental activities of daily living (IADL) ability, and cognitive ability (COG) of older adults show a nonlinear downward trend over time. Furthermore, the panel binary regression analysis is used to find that leisure activities have significant inhibitory effects on ADL disorder, IADL disorder, and cognitive impairment in the older population. In addition, by using latent profile analysis (LPA), the older population is classified into three groups according to the homogeneity of the older adults’ choice of leisure activities, namely the types of relaxation, entertainment, and intellectual-learning, respectively. Based on the classification results, the analysis of one-way ANOVA shows that the rates of ADL disorder, IADL disorder, and cognitive impairment of older adults with different types are significantly different. Moreover, the inhibitory effect of leisure activities on the rate of ADL disorder, IADL disorder, and cognitive impairment of older adults is more significant in the middle-aged and high-aged groups. Therefore, older adults should be encouraged to increase leisure activities, especially those who are middle-aged and high-aged.

Enhancing the pooling level of medical insurance is an inevitable requirement to strengthen the mutual assistance capability of funds and achieving national health. In China, with the continuous expansion of the migrant population seeking medical treatment in other regions, the role of provincial-pooling of basic medical insurance is becoming increasingly prominent. While there is limited research on the impact and mechanism of provincial-pooling of basic medical insurance on the health of migrant population. Therefore, this study aims to explore the impact of provincial-pooling of basic medical insurance on the health performance of migrant population and analyze the mediating role of social integration. Using data of three waves (2014, 2016 and 2018) of the China Labor force Dynamics Survey, this study focuses on a sample of migrant population enrolled in Urban and Rural Resident Basic Medical Insurance and employs the estimation methods of time-varying difference-in-difference and mediating effect model. The results of time-varying difference-in-difference show that provincial-pooling of basic medical insurance improves the health performance of migrant population by 9.6% (p < 0.05), and the event study method and placebo test all indicate that the research results are robust. The mediating effect analysis demonstrates that the provincial-pooling of basic medical insurance enhances health performance by fostering the subjective and objective social integration, and neighbourhood assistance, social equity, life happiness and trust in the majority are specific intermediary channels. The results of heterogeneity analysis indicates that provincial-pooling of basic medical insurance is more effective in improving the health performance of high-income (β = −0.090; P < 0.05), new-generation (β = −0.116; P < 0.1) and highly-educated (β = 0.130; p < 0.05) migrant population. Our results call for accelerating the promotion of provincial-pooling of basic medical insurance to improve health performance of migrant population.

Background The aging population poses a huge challenge to the health care system and puts great burden on the financial operation, and has become a common problem faced by countries around the world. Will the implementation of the universal three-child policy enhance the sustainability of medical insurance funds? How to effectively relieve the financial burden? Method This study analyzes the sustainability of the medical insurance fund and the financial burden under different fertility levels of the universal three-child policy by constructing a dynamic population projection model and an actuarial model of medical insurance. Results Compared with the current fertility policy (fertility rate 1.3), under the adjusted fertility policy (fertility rate 1.4-3.0), the occurrence of the current deficit and accumulated deficit of the medical insurance fund will be gradually postponed, and the fiscal subsidies burden will be significantly alleviated. Conclusions The universal three-child policy is conducive to improving the sustainability of the medical insurance fund and reducing the financial pressure, and the effect is more obvious at higher fertility levels. Considering the time-lag of the fertility policy, medical cost control and outpatient co-payment policies should be promoted simultaneously to improve the efficiency of fund utilization and the modernization of medical insurance governance by adjusting the stock.