Entertainment for Middle-Aged and Elderly Individuals and Inflammatory Responses

With the entertainmentof lifestyles and accelerated population ageing, the relationship between recreational activities and inflammation levels among middle-aged and elderly populations, alongside the moderating role of healthcare expenditure, has garnered significant academic attention. Existing research, however, lacks in-depth analysis of the underlying mechanisms linking these three factors. This study utilises panel data from the China Health and Retirement Longitudinal Study (CHARLS) 2011–2024, supplemented by social security records and various yearbook data. An entertainment index was constructed by modelling multiple leisure activities, while inflammation levels were measured using the C-reactive protein (CRP) index. Employing a bias-corrected dual machine learning (DML) model and a two-way fixed effects model, we examined the impact of the entertainment index on inflammation levels among middle-aged and elderly individuals, controlling for stable healthcare expenditure, and investigated its heterogeneity. Results indicate: (1) A significant positive causal relationship exists between the leisure index and inflammation levels among middle-aged and elderly individuals, with leisure activities increasing inflammation risk. This conclusion is robust across multiple methodological tests. (2) Heterogeneity exhibits distinct patterns: no significant gender-based differences were observed, with both male and female cohorts demonstrating a pronounced positive effect. Urban-rural disparities were pronounced, with the leisure index significantly influencing inflammation levels among urban middle-aged and elderly individuals, but showing no significant effect on rural cohorts. This study provides empirical support for optimising health management policies for middle-aged and elderly populations, guiding leisure activities, and rationally allocating healthcare resources.