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The rapid digitalization of China’s healthcare system, a phenomenon that accelerated during the Covid-19 pandemic, had two negative consequences for a significant portion of elderly persons in China. The first is an unfortunate practical outcome: their exclusion from many health services such as online medical appointment platforms, e-prescription requests, obtaining e-referrals, and sharing electronic medical records. The second is an emotionally debilitating identity crisis as elderly persons’ former status as knowledgeable senior mentors was replaced with social perceptions of them as helpless and ignorant souls reliant on more youthful persons for guidance and assistance. This article adopts a grounded theory to explore the phenomenon from the perception of excluded elderly persons using participatory observation and in-depth interviews of 44 elderly clients of a rural hospital in the Shandong province in eastern China. The study shows that the current focus on direct practical aspects of digital exclusion may fail to capture the impact and ancillary consequences such as a painful loss of self-esteem by the digitally excluded. As the study illustrates, the practical aspects can all be overcome through intervention by those who aid the digitally excluded but this help may exacerbate the rarely considered ancillary harms of digital exclusion. Studies of digital exclusion will make more significant contributions to our understanding of the phenomenon if they look beyond the obvious direct consequences of digital exclusion to consider possible ancillary and flow-on effects.

Studies conducted in Western democratic countries with privately owned press presenting news from different ideological perspectives have found the phenomenon of news overload causes stress in media users (affective load) and this leads to news avoidance behavior. This study, conducting a structural equation modeling using AMOS 27, investigates the relationships between news overload, affective load, and consequent news avoidance behavior in China. The findings suggest, consistent with studies in Western democratic jurisdictions, that news overload and affective load influence users’ news avoidance behavior. However, in contrast to studies outside of China, this study found demographic variables of age, gender, education, and occupation had no statistically significant influence on avoidance behavior by Chinese social media news consumers. The results suggest that either social attributes and responses by media users in China are significantly different from those in Western countries or ideology plays an important role in avoidance behavior and the impact of ideology is different across different demographic groups in Western jurisdictions.

While the impact of fake news on viewers, particularly marginalized media users, has been a cause of growing concern, there has been little attention paid to the phenomenon of deliberately “manipulated” news published on social media by mainstream news publishers. Using qualitative content analysis and quantitative survey research, this study showed that consciously biased animated news videos released in the midst of the Umbrella Movement protests in Hong Kong impacted on both the attitudes of students and their participation in the protests. The findings raise concerns over potential use of the format by media owners to promote their preferred ideologies.