Zhang, Xiaodong, Zhang, Yanan, Guo, Bin, Chen, Gong, Zhang, Rui, Jing, Qi, Khan, Hafiz T.A. ORCID: https://orcid.org/0000-0002-1817-3730 and Zhang, Lei (2024) The impact of physical activity on household out-of-pocket medical expenditure among adults aged 45 and over in urban China: The mediating role of spousal health behaviour. Population Health, 25 (101643). ISSN 2352-8273

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Abstract

Background: Increasing medical expenditure is viewed as one of the critical challenges in the context of population
ageing. Physical activity (PA), as a primary prevention strategy for promoting health, is considered as an
effective way to curb the excessive growth in medical expenditure. This study aimed to analyze the association
between PA and the household out-of-pocket medical expenditure (HOPME) among Chinese urban adults aged
45 and over, and to explore the mediating role of spousal health behaviour.

Methods: This study analyzed a nationally longitudinal survey: 2014–2018 China Family Panel Studies (CFPS).
Fixed effects regression model was applied to estimate the association between PA and annual HOPME. Sobel
model was utilized to test the mediating effect.
Results: (1) PA was negatively associated with the annual HOPME among urban resident aged 45 and over in
China. Exercising 1–5 times per week and maintaining the duration of each exercise session at 31–60 min were
effective in reducing annual HOPME. (2) Spousal PA played a significant mediating role in the relationship
between respondent’s PA and annual HOPME. (3) The negative association between the respondent’s PA and
HOPME were found among women and those aged between 45 and 65, so was the mediating effect of spouse’s
PA.
Conclusion: Individual PA not only directly reduces HOPME but also indirectly contributes to this reduction by
enhancing the PA levels of their spouses. To capitalize on these benefits, more actions should be taken to increase
the availability of PA facilities, enhance the public awareness of PA’s benefits, and encourage residents to
consistently engage in regular PA.

Item Type:	Article
Identifier:	10.1016/j.ssmph.2024.101643
Additional Information:	Gold OA - Read and Publish
Keywords:	Physical activity; Medical expenditure; Spousal physical activity; China
Subjects:	Medicine and health
Depositing User:	Hafiz T.A. Khan
Date Deposited:	06 Mar 2024 10:10
Last Modified:	19 Dec 2024 15:21
URI:	https://repository.uwl.ac.uk/id/eprint/11243

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