The purpose of this study was to associate the anti-inflammatory dietary diversity and depressive symptoms among a nationwide sample of Chinese older adults. We used data from the 2018 wave of Chinese longitudinal healthy longevity survey (CLHLS). We assessed depressive symptoms using the 10 items of the center for epidemiologic studies depression scale (CES-D-10). Based on the dietary diversity index (DDI) generated by previous studies, we construct two novel indicators: the protein-enriched dietary diversity index diet (PEDDI) and the anti-inflammatory dietary diversity index diet (AIDDI). We used multivariate logistic models to evaluate the associations of DDI, PEDDI, and AIDDI with depressive symptoms, statistically adjusted for a range of potential confounders. A total of 12,192 participants (mean age 83.6 years) were included in the analysis. We found that participants with a higher score of DDI (OR = 0.91, 95% CI: 0.89–0.92) and PEDDI (OR = 0.91, 95% CI: 0.88–0.93) showed lower odds of having depressive symptoms, while the association between AIDDI and depressive symptoms was more marked (OR = 0.80, 95% CI: 0.78–0.83). The associations remained in subgroup analyses and sensitivity analyses. The results indicate that intaking diversified diet, particularly anti-inflammatory foods, may be associated with a lower risk of depressive symptoms. The findings of this study, if confirmed as causal, provide evidence that an intervention of adopting an anti-inflammatory diversified diet may reduce the burden of depression among older adults.

In recent years, Chinese household financial debt has been growing rapidly due to the expansion of mortgage lending. This study aims to examine the impact mechanism of Chinese household financial debt on physical health. Using the 2010–2018 China Household Tracking Survey (CFPS) panel data, we developed fixed effects models to explore the effect of household financial debt on individuals’ psychical health, and we also used an instrumental variable to address endogeneity. The findings suggest that there is a negative effect of household financial debt on physical health and these findings still hold after a series of robustness tests. In addition, household financial debt can affect individuals’ physical health through mediating variables, such as healthcare behaviors and mental health, and the effects are more significant for those who are middle-aged, married, and with low-income levels. The findings of this paper are important for developing countries to clarify the relationship between household financial debt and population health, and to develop appropriate health intervention policies for highly indebted households.

Fragmented health insurance systems create barriers to universal health coverage (UHC) and reinforce social inequalities in urban development. To address these challenges, China implemented an urban-rural medical insurance integration policy, aiming to unify fragmented schemes and equalize access to healthcare. Using data from the China Labor-force Dynamic Survey and policy implementation records across 337 prefecture-level cities, this study applies a staggered difference-in-differences (DID) design to estimate the causal effects of integration. The results show that the reform significantly increased universal health insurance coverage (UHI) in Chinese cities, raising coverage by about 5.6%. Mechanism analysis indicates that higher reimbursement rates and lower out-of-pocket expenditures enhanced individuals' incentives to enroll. Heterogeneity analysis further reveals stronger effects among disadvantaged groups, such as those with lower education levels and older adults, while no crowding-out effect on commercial insurance is observed. The findings suggest that integrating fragmented health insurance systems can advance universal coverage and promote the equalization of public services, thereby contributing to more inclusive and sustainable cities.