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Community human settlement and self-rated health among older adults

The mediating role of sleep quality

Bibliographic Data

ID22084841
AuthorsChen Li (0000-0001-6150-8594, Shanghai University of Engineering Science), C G Li (0009-0005-8747-4608, Shanghai University of Engineering Science), Chen Zhuo (UNSW Sydney, corresponding author)
Year2026
Volume14
Pages1820032-1820032
Publication date2026-03-23
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2026.1820032
PMID41948017
OpenAlexW7140101292
LanguageEN
References cited21

Introduction: Against the backdrop of rapid population aging, the community human settlement, as a crucial social environmental factor influencing the health levels of older adults, has increasingly become a focal point in public health research. Methods: Based on survey data from 2,113 older adults in Shanghai, China, this study employed the entropy method to construct a multi-dimensional community human settlement evaluation system encompassing the physical environment, social environment, and service accessibility. Multiple regression, instrumental variable methods, and mediation effect models were utilized to systematically analyze the pathways of influence and mechanisms of the community human settlement on the self-rated health of older adults. Results: The quality of the community human settlement was significantly positively correlated with the self-rated health levels of older adults, with community convenience and neighborhood support playing particularly prominent roles. Sleep quality exerted a significant mediating effect in this relationship, explaining 46% of the total effect. Among different groups, older adults with low income, those not married, and those with higher education levels were more sensitive to changes in the community human settlement, exhibiting stronger heterogeneity in health responses. Discussion: From the perspectives of ecological systems theory and the social determinants of health, this study reveals the psycho-physiological mechanism through which the community environment influences the health of older adults via sleep quality. It identifies environmentally sensitive high-risk groups, providing a theoretical basis and practical pathways for precise interventions in the construction of age-friendly communities

Community health · Empirical research · Mediation · Population · Psychological intervention · Public health · Social determinants of health · Health disparities and outcomes · Migration, Aging, and Tourism Studies · Urban Transport and Accessibility

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