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Background: Studies have shown a close association between home and community-based healthcare services (HCBHS) utilization and depressive symptoms in older adults. However, no studies have explored the underlying mechanism of this relationship in rural China. This study was designed to evaluate the roles of instrumental activities of daily living (IADL) and marital status in the association between HCBHS utilization and depressive symptoms in Chinese rural older adults. Methods: Data were obtained from the 2018 China Health and Retirement Longitudinal Study, and 5,981 rural respondents (≥ 60 years old) were included. Depression scores were calculated using the ten-item Center for Epidemiological Studies Depression Scale. Moderated mediation analysis was carried out applying Hayes' PROCESS macro (Model 7). Results: HCBHS utilization had a direct and negative effect on depressive symptoms. Furthermore, marital status moderated the association between HCBHS utilization and IADL, which belonged to the indirect influence of the first half on the association between HCBHS utilization and depressive symptoms. HCBHS utilization was associated with IADL in single but not in married respondents. Conclusion: The results demonstrated that marital status moderated the indirect relationship between HCBHS utilization and depressive symptoms, with HCBHS utilization being negatively associated with IADL among single but not married respondents. The government should focus on rural older adults, especially those who are single and have poor IADL function, and improve the provision of HCBHS to alleviate depressive symptoms. [ABSTRACT FROM AUTHOR]

The concept of mixed land use encompasses both land-use diversity and land-use compatibility. However, the negative effects of unreasonable land mixing on the living environment must be considered. In an empirical study of 18 villages in Hebei Province, China, an analytical framework was constructed to investigate the influence of mixed land use in rural settlements on the quality of living environment. The results are as follows: (1) The index of living environment for villages with high and low levels of mixed land use was 0.0194 and 0.0143 in 2010, and 0.0433 and 0.0337 in 2020, respectively. The growth index of living environment for villages with high and low growth rates of mixed land use was 217.16% and 112.07% from 2010 to 2020. (2) Spearman correlation analysis showed a significant positive correlation between the levels (growth rates) of mixed land use and living environment. Additionally, Mann-Whitney U analysis showed that mixed land use can improve the quality of living environment. (3) The land-use diversity had a significant influence on the economy, infrastructure, and governance indicators of living environment. Land-use compatibility had a significant influence on the service indicator. This study indicates that improving the internal structure of rural settlements to optimize its mixed land use is an effective way to promote the comprehensive improvement of living environment. • The mixed use of rural residential areas measured by indicators of land use diversity and compatibility. • Spearman correlation analysis and Mann–Whitney U analysis were used to explore the relationship between the mixed use of rural residential areas and the quality of human settlements. • The land use diversity of rural residential areas has a significant effect on the economic and governance components of human settlements, and the land use compatibility has a significant effect on the environmental component. [ABSTRACT FROM AUTHOR]

Home- and community-based services (HCBS) are optimal ways to deal with disability problems among older adults. This study aims to analyze urban-rural disparities in the relationship between HCBS utilization and levels of disability among Chinese older adults with disabilities, so as to meet the long-term care needs of them. In applying the Andersen Behavioral Model, bivariate analysis and multivariate regression models were employed using data from 843 older adults with disabilities from the 2018 China Longitudinal Aging Social Survey (CLASS). After adjusting covariates, disability levels among Chinese older adults with disabilities were significantly correlated with HCBS utilization in urban areas but not in rural areas. The urban-rural disparities may be due to the low utilization of HCBS in rural areas (only 11.2%) among older adults with disabilities compared with their urban counterparts (22.7%)., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.