Smartphone use, health-promoting behaviours and self-rated health among middle-aged and elderly people in rural areas

Objective Accounting for the convergence of digitalization and ageing, our study focused on middle-aged and elderly people in rural areas. Moreover, the potential mechanisms by which smartphone use affects the self-rated health and heterogeneity among different groups were explored, and the mediating effects of health-promoting behaviours were explored, with the aim of providing relevant insights and recommendations for improving the health of rural middle-aged and elderly people and actively promoting healthy ageing in rural areas. Methods On the basis of data from the 2020 China Rural Revitalization Survey, we established a multiple linear regression model to assess the direct effects of smartphone use (including whether to use, difficulty of use, and duration of use) on the self-rated health of rural middle-aged and elderly people and examined the heterogeneity among the various groups in terms of sex, age, and education level. In addition, the three-step regression and bootstrap test methods were used to analyse the mediating effect of health-promoting behaviours on the relationship between smartphone use and self-rated health. Results Smartphone use among rural middle-aged and elderly people significantly and positively affected their health-promoting behaviours and self-rated health, and the findings were robust. The positive effects of smartphone use on self-rated health were heterogeneous among rural middle-aged and older adults of different ages, sexes, and education levels. Health-promoting behaviours exerted significant mediating effects, accounting for 91.91%, 95.27% and 90.91% of the total effects, respectively. Conclusion Smartphone use among rural middle-aged and elderly people notably affected the improvement in their self-rated health, and this positive effect differed according to sex, age and education level. The indirect path of encouraging rural middle-aged and elderly people to use smartphones, reducing the difficulty of smartphone use, and prolonging the duration of smartphone use for enhancing health-promoting behaviours could effectively improve their self-rated health.