The health of migrant populations has become a critical public health concern amid China’s rapid urbanization, especially within the framework of the “Healthy China” initiative aimed at reducing health disparities. While existing research has extensively examined the challenges rural migrants face regarding employment, housing, and access to services, the specific role of public health services in shaping local identity remains underexplored. This study investigates how public health influences local identity among new-generation rural migrants and examines the mediating role of social integration in this relationship, addressing a significant gap in the migration and public health literature. Utilizing data from 56,014 new-generation rural migrants, this study employed ordinary least squares (OLS) and logistic regression models to assess the impact of three public health indicators—public health awareness, health records, and health education—on social integration and local identity. The Karlson-Holm-Breen (KHB) method was applied to evaluate mediation effects within a counterfactual framework, adjusting for demographic, socioeconomic, and migration-related variables. All three public health variables had statistically significant and positive effects on both social integration and local identity (p < 0.001). Public health awareness exhibited the strongest association with local identity, followed by health records and health education. KHB decomposition revealed that social integration mediated approximately 30% of the total effect of public health on local identity. Specifically, the mediating effect accounted for 30.22% for public health awareness, 33.12% for health records, and 29.43% for health education. Despite uniformly significant effects, the degree of mediation varied only slightly, indicating a stable and robust mediating role of social integration. Public health services are positively associated with the development of local identity among new-generation rural migrants, with social integration serving as a critical mediating mechanism. These findings underscore the potential of comprehensive public health strategies not only to meet the health needs of migrant populations but also to promote their social integration. This research provides empirical support for China’s “Healthy China” initiative and offers actionable insights for designing policies aimed at enhancing migrant inclusion through improved public health access and community-based interventions.

Objectives: In the rural regions of China, characterized by a pronounced aging demographic and limited resources, a substantial proportion of middle-aged and older adults engage in grandparenting roles. Yet, the literature lacks consistent evidence regarding the effects of grandparenting on the mental health of this cohort. Accordingly, this study aimed to explore the impact of grandparenting on the mental health of rural middle-aged and older adults, as well as the underlying mechanisms.Methods: This analysis encompassed 10,881 middle-aged and older adults, utilizing data from the 2018 Harmonized China Health and Retirement Longitudinal Study (CHARLS). The mental health of participants was assessed using the Center for Epidemiological Studies Depression-10 (CESD-10) scale, while support from children was categorized into financial and emotional types. The study employed logistic and OLS regression models to identify the mediating role of child support and utilized the Karlson-Holm-Breen (KHB) method for decomposing this mediating effect.Results: The findings demonstrated that grandparenting had a significant negative impact on depression among rural middle-aged and older adults. Furthermore, children’s support played a vital role in mediating this relationship, accounting for approximately one-third of the overall influence. Moreover, the decomposition analysis revealed that both emotional and economic support from adult children equally contributed to the declination of depression among rural middle-aged and older adults.Conclusion: Grandparenting significantly enhances mental well-being in rural middle-aged and older adults, with the support from adult children serving as a vital pathway for this positive impact. Both economic and emotional assistance from children hold equal importance in this dynamic. It underscores the necessity of fortifying the family support system to amplify the support provided by children, which in turn could significantly enhance the mental health of rural middle-aged and older adults.

Population ageing and weakening family support systems pose major public health challenges in China and worldwide. Long-term care insurance (LTCI) has emerged as a key policy response; however, evidence on its effectiveness in improving health outcomes among older adults with disabilities remains limited. This study examined whether, and through which pathways, LTCI affects health outcomes by reconfiguring support systems. Guided by a support system reconfiguration perspective, we conceptualised LTCI as a formal intervention that interacts with existing informal support networks. Using five waves (2011–2020) of the China Health and Retirement Longitudinal Study, we applied a difference-in-differences design to estimate the effects of LTCI on symptom burden, psychological burden, and a composite health outcome index among older adults with disabilities. We assessed robustness using parallel-trends tests, placebo tests, and propensity score matching. LTCI implementation was associated with significant reductions in symptom burden (β = −0.595, p < 0.01), psychological burden (β = −0.732, p < 0.05), and overall adverse health outcomes (β = −0.172, p < 0.01). Effects were strongest among non-cancer patients, individuals with medium socioeconomic status, and those living with children. No significant effects were observed among cancer patients or those with very high or very low socioeconomic status. Benefits emerged approximately one year after implementation and persisted over time. LTCI appears to improve health outcomes by reconfiguring—rather than replacing—existing support systems, with effectiveness depending on alignment with underlying care needs and available resources. The policy performs best when it complements family-based care and targets populations with moderate resources. These findings can inform the design of integrated long-term care policies that address heterogeneous needs in ageing societies while strengthening existing support networks.