Date of Award

January 2024

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Yize Z. Zhao


Objective: This longitudinal study aims to delve into the complicated relationship between social convoy and the improvement of depressive symptomatology, while also investigating the potential mediating role of household registry status.Methods: The study utilized data from 2,511 participants from the China Health and Retirement Longitudinal Study (CHARLS), specifically from the 2015 survey (Wave 3) and the 2018 survey (Wave 4). The selected sample comprised Chinese adults aged 45 and older who exhibited depressive symptoms in 2015 and for whom comprehensive data on various social convoy components and sociodemographic variables were available. Logistic regression models were applied to assess the associations between characteristics of the social convoy and improvements in depressive symptoms. Additionally, these models were used to explore the potential interactions between urban-rural status and other variables in influencing depression outcomes. Results: Participants who demonstrated improvement in depression presented several key characteristics: they were predominantly male, had higher educational levels, and a larger proportion were classified as non-agricultural residents. Both univariate and multivariate analyses of the social convoy measures indicated strong positive correlations between emotional support, high levels of satisfaction with marriage, children, life, and community healthcare, and the improvement of depression status. Notably, elderly individuals residing in rural areas were more likely to show improvement in depression compared to their urban counterparts. Furthermore, the association between the number of household members and improvement in depression was more pronounced among individuals with non-agricultural household registry status. Conclusion: The findings from this study provide crucial insights into the complex interactions between household size, emotional support, life satisfaction, and household registry status in relation to depression improvement among middle-aged and older adults in China. These results highlight the significant roles that various components of the social convoy and the urban-rural divide play in influencing mental health outcomes among elderly individuals in China. This underscores the need for targeted mental health interventions that consider these dynamics to effectively address the needs of this population.


This is an Open Access Thesis.

Open Access

This Article is Open Access