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Abstract：
BACKGROUND: Population aging and internal migration have become the \"norm\" in China\'s population development. Influenced by both \"mobility\" and \"old age,\" internal elderly migrants (IEMs) face the second-level digital divide problems primarily characterized by digital technology usage gap, which can lead to adverse health outcomes. Understanding the impact of the digital divide on the health of IEMs can provide effective solutions to meet the health needs of this particular group and facilitate their better integration into a digital society. Therefore, this study aims at exploring the impact of the digital divide on the health of IEMs, and identifying priorities and recommendations for improving IEMs\' health by mitigating the adverse effects of the digital divide.
METHODS: In the 2017 China Migrant Dynamic Survey (CMDS), a cross‑sectional sample of 169,989 internal migrants in 32 provincial units across China was recruited by stratified probability proportionate to size sampling (PPS). We focus on IEMs and require interviewees to be 60 years and older. Therefore, we excluded samples younger than 60 years of age and retained only 6,478 valid samples. Subsequently, STATA 17.0 software was applied to analyze the data. Based on the research objective and Grossman\'s model of health demand, we empirically tested using ordered logit regression.
RESULTS: The digital divide does affect the health of IEMs in general and its negative effects tend to decrease significantly with age. In terms of groups, its impact showed noticeable group differences in residence arrangement, public health services and medical insurance coverage. Compared with IEMs who live alone or only live with their spouse, have not received public health service, and have not been covered by any medical insurance, the digital divide imposes a smaller adverse impact on the health of IEMs who live with at least one offspring, have received public health service, and have covered in at least one medical insurance. In terms of potential mechanisms, among the effects of digital divide on the health of IEMs, the mediating effect of urban integration is not significant, the social interaction has only a partial mediating effect, and the medical convenience has a significant mediating effect.
CONCLUSIONS: Our findings confirm the existence of the third-level digital divide among IEMs concerning health, that is, the digital divide has adverse health outcomes for this group, and underscore the important implications of reducing the negative impact of the digital divide in improving the health status of IEMs.
METHODS: In the 2017 China Migrant Dynamic Survey (CMDS), a cross‑sectional sample of 169,989 internal migrants in 32 provincial units across China was recruited by stratified probability proportionate to size sampling (PPS). We focus on IEMs and require interviewees to be 60 years and older. Therefore, we excluded samples younger than 60 years of age and retained only 6,478 valid samples. Subsequently, STATA 17.0 software was applied to analyze the data. Based on the research objective and Grossman\'s model of health demand, we empirically tested using ordered logit regression.
RESULTS: The digital divide does affect the health of IEMs in general and its negative effects tend to decrease significantly with age. In terms of groups, its impact showed noticeable group differences in residence arrangement, public health services and medical insurance coverage. Compared with IEMs who live alone or only live with their spouse, have not received public health service, and have not been covered by any medical insurance, the digital divide imposes a smaller adverse impact on the health of IEMs who live with at least one offspring, have received public health service, and have covered in at least one medical insurance. In terms of potential mechanisms, among the effects of digital divide on the health of IEMs, the mediating effect of urban integration is not significant, the social interaction has only a partial mediating effect, and the medical convenience has a significant mediating effect.
CONCLUSIONS: Our findings confirm the existence of the third-level digital divide among IEMs concerning health, that is, the digital divide has adverse health outcomes for this group, and underscore the important implications of reducing the negative impact of the digital divide in improving the health status of IEMs.
摘要：
背景：人口老龄化和内部迁移已成为中国人口发展的“常态”。受“流动性”和“老年”的影响，“内部老年移民(IEM)面临着以数字技术使用差距为主要特征的二级数字鸿沟问题，这可能导致不良的健康结果。了解数字鸿沟对IEM健康的影响可以提供有效的解决方案，以满足这一特定群体的健康需求，并促进他们更好地融入数字社会。因此,本研究旨在探讨数字鸿沟对IEM健康的影响，并确定通过减轻数字鸿沟的不利影响来改善IEM健康的优先事项和建议。
方法：在2017年中国移民动态调查(CMDS)中，通过与规模成比例的分层概率抽样（PPS），招募了来自中国32个省级单位的169,989名内部移民的横截面样本。我们专注于IEM，并要求受访者年龄在60岁以上。因此,我们排除了年龄小于60岁的样本,仅保留了6,478份有效样本.随后，采用STATA17.0软件对数据进行分析。基于研究目标和格罗斯曼健康需求模型,我们使用有序logit回归进行了实证检验。
结果：数字鸿沟确实总体上影响了IEM的健康，其负面影响随着年龄的增长而明显下降。在群体方面,它的影响显示了住宅安排中明显的群体差异，公共卫生服务和医疗保险。与单独生活或仅与配偶生活在一起的IEM相比，没有接受过公共卫生服务，并且没有任何医疗保险，数字鸿沟对至少与一个后代生活在一起的IEM的健康造成了较小的不利影响，接受过公共卫生服务，至少有一份医疗保险。在潜在机制方面，在数字鸿沟对IEM健康的影响中，城市一体化的中介效应并不显著,社会互动只有部分中介作用，医疗便利具有显著的中介效应。
结论：我们的发现证实了IEM之间在健康方面存在第三级数字鸿沟，也就是说,数字鸿沟对这一群体产生了不利的健康后果，并强调减少数字鸿沟的负面影响对改善IEM健康状况的重要意义。
方法：在2017年中国移民动态调查(CMDS)中，通过与规模成比例的分层概率抽样（PPS），招募了来自中国32个省级单位的169,989名内部移民的横截面样本。我们专注于IEM，并要求受访者年龄在60岁以上。因此,我们排除了年龄小于60岁的样本,仅保留了6,478份有效样本.随后，采用STATA17.0软件对数据进行分析。基于研究目标和格罗斯曼健康需求模型,我们使用有序logit回归进行了实证检验。
结果：数字鸿沟确实总体上影响了IEM的健康，其负面影响随着年龄的增长而明显下降。在群体方面,它的影响显示了住宅安排中明显的群体差异，公共卫生服务和医疗保险。与单独生活或仅与配偶生活在一起的IEM相比，没有接受过公共卫生服务，并且没有任何医疗保险，数字鸿沟对至少与一个后代生活在一起的IEM的健康造成了较小的不利影响，接受过公共卫生服务，至少有一份医疗保险。在潜在机制方面，在数字鸿沟对IEM健康的影响中，城市一体化的中介效应并不显著,社会互动只有部分中介作用，医疗便利具有显著的中介效应。
结论：我们的发现证实了IEM之间在健康方面存在第三级数字鸿沟，也就是说,数字鸿沟对这一群体产生了不利的健康后果，并强调减少数字鸿沟的负面影响对改善IEM健康状况的重要意义。
