中国卫生事业管理2026，Vol.43Issue(8)：857-863,7.
社区环境对老年人衰弱的影响:健康不平等的中介作用和社会参与的调节作用
The Impact of Community Environment on Frailty among Older Adults from The Mediating Role of Health Inequal-ity and the Moderating Role of Social Participation
摘要
Abstract
Objective To investigate the impact of community environment on frailty among older adults,and examine the me-diating role of health inequality and the moderating role of social participation in the relationship between community environment and frailty.Methods Data were derived from the 2011 community survey and the 2018 individual follow-up survey of the China Health and Retirement Longitudinal Study(CHARLS).A total of 7,483 participants were included in the study.Information on community environment,frailty,health inequality,social participation,and demographic characteristics was collected.The PROCESS macro for SPSS was used to test the mediating effect of health inequality and the moderating effect of social participa-tion,and a simple slope plot was constructed.Results Community environment negatively predicted frailty among older adults(β=-0.298,P＜0.001).Health inequality partially mediated the relationship between community environment and frailty,with a mediating effect of-0.0803,accounting for 26.95％of the total effect(-0.298).Social participation moderated the pathway through which health inequality influenced frailty(β=-0.6178,P＜0.001),specifically moderating the second half of the me-diating pathway.Simple slope analysis revealed that in the low social participation group,health inequality had a stronger positive-ly predictive effect on frailty(β=9.1072,P＜0.001),while in the high social participation group,this predictive effect was weaker(β=7.2537,P＜0.001).Conclusion Community environment and health inequality are significant factors influencing frailty in older adults.Health inequality mediates the relationship between community environment and frailty,and social partici-pation moderates the second half of this mediating pathway.High social participation can attenuate the negative impact of health inequality on frailty.It is recommended to prioritize the improvement of communities with poor basic conditions,focus on the trav-el safety and convenience of public activity space,identify the vulnerable elderly group,establish social platforms for older adults,and encourage the participation of the elderly population.关键词
社区环境/衰弱/健康不平等/社会参与/中介作用/调节作用Key words
community environment/frailty/health inequality/social participation/mediating role/moderating role分类
医药卫生引用本文复制引用
符皓源,杨芳..社区环境对老年人衰弱的影响:健康不平等的中介作用和社会参与的调节作用[J].中国卫生事业管理,2026,43(8):857-863,7.基金项目
国家自然科学基金面上项目"医院-社区-家庭联动心血管病健康管理模式研究"(71874157) （71874157）
浙江省基础公益研究计划项目"主动式心血管病健康管理机制与综合干预技术开发"(LTGY23H270005) （LTGY23H270005）
杭州市哲学社会科学规划课题"基于移动医疗的阿尔茨海默症照顾者心理健康管理模式构建与成效评估"(M25YD121) （M25YD121）
浙江中医药大学2024年度省哲学社会科学重点培育研究基地自设课题"基于内在能力的老年人"数智中医"健康管理模式创新与实践"(2024JDYB09) （2024JDYB09）
