The Relationship between Internet Use and Population Health: A Cross-Sectional Survey in China
Abstract
:1. Introduction
2. Literature Review
3. Data and Methods
3.1. Data Sources
3.2. Variable Design
3.2.1. Dependent Variables
3.2.2. Independent Variables
3.2.3. Mediating Variables
3.2.4. Control Variables
3.3. Statistical Analysis
4. Results
4.1. Basic Regression
4.2. Robustness Test
4.3. PSM to Eliminate Sample Selection Bias
4.4. Regression Results in Different Subgroups
4.5. Mediation Analysis
5. Discussion
5.1. Summary of the Finding
5.2. Policy Implication
5.3. Strengths
5.4. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Variable | VIF |
---|---|
Sex | 1.73 |
Age | 1.69 |
Marriage | 1.42 |
Education | 1.41 |
Political status | 1.25 |
Domicile | 1.24 |
Work attributes | 1.20 |
Medical insurance | 1.14 |
Exercise frequency | 1.07 |
Smoking | 1.03 |
Drinking | 1.02 |
Staying up late | 1.02 |
Appendix B
Variable | Subjective Health | Subjective Recent Health | ||
---|---|---|---|---|
95% Confidence Interval | 95% Confidence Interval | |||
Internet use | 0.011 | 0.104 | −0.046 | 0.075 |
Sex | 0.068 | 0.190 | 0.105 | 0.263 |
Age | −0.034 | −0.027 | −0.016 | −0.007 |
Marriage | −0.043 | 0.046 | −0.043 | 0.072 |
Education | −0.003 | 0.084 | 0.022 | 0.135 |
Political status | 0.092 | 0.399 | −0.196 | 0.202 |
Domicile | −0.086 | 0.031 | −0.059 | 0.093 |
Work attributes | −0.003 | 0.131 | 0.029 | 0.199 |
Medical insurance | −0.117 | 0.037 | −0.102 | 0.098 |
Exercise frequency | 0.009 | 0.026 | −0.012 | 0.011 |
Smoking | −0.010 | 0.118 | −0.114 | 0.055 |
Drinking | 0.008 | 0.151 | −0.001 | 0.187 |
Staying up late | −0.252 | −0.124 | −0.292 | −0.130 |
Appendix C
Variable | Model (1) | Model (2) | Model (3) | Model (4) | ||||
---|---|---|---|---|---|---|---|---|
95% Confidence Interval | 95% Confidence Interval | |||||||
Internet use | 0.015 | 0.175 | −0.078 | 0.127 | −0.070 | −0.010 | −0.052 | 0.026 |
Sex | 0.132 | 0.342 | 0.181 | 0.454 | 0.061 | 0.182 | 0.096 | 0.254 |
Age | −0.061 | −0.048 | −0.027 | −0.012 | −0.034 | −0.026 | −0.016 | −0.007 |
Marriage | −0.065 | 0.089 | −0.075 | 0.123 | −0.039 | 0.050 | −0.038 | 0.077 |
Education | −0.005 | 0.147 | 0.039 | 0.233 | −0.022 | 0.061 | 0.001 | 0.107 |
Political status | 0.153 | 0.678 | −0.331 | 0.358 | 0.087 | 0.394 | −0.201 | 0.197 |
Domicile | −0.148 | 0.054 | −0.100 | 0.159 | −0.094 | 0.023 | −0.069 | 0.082 |
Work attributes | −0.024 | 0.213 | 0.053 | 0.339 | −0.008 | 0.126 | 0.023 | 0.193 |
Medical insurance | −0.173 | 0.095 | −0.175 | 0.168 | −0.117 | 0.038 | −0.102 | 0.099 |
Exercise frequency | 0.015 | 0.046 | −0.020 | 0.019 | 0.008 | 0.025 | −0.013 | 0.010 |
Smoking | −0.013 | 0.210 | −0.198 | 0.094 | −0.008 | 0.121 | −0.111 | 0.057 |
Drinking | 0.019 | 0.269 | −0.001 | 0.325 | 0.009 | 0.151 | 0.001 | 0.188 |
Staying up late | −0.434 | −0.212 | −0.495 | −0.221 | −0.256 | −0.128 | −0.297 | −0.135 |
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Variables | Definition | N | Percentage (%) |
---|---|---|---|
Dependent variable | |||
Self-rated health | Unhealthy = 1 | 502 | 6.04 |
General = 2 | 746 | 9.20 | |
Healthier = 3 | 3942 | 47.46 | |
Relatively healthy = 4 | 1729 | 20.82 | |
Very healthy = 5 | 1369 | 16.48 | |
Chronic conditions | Unhealthy = 0 | 1988 | 23.93 |
Healthy = 1 | 6318 | 76.07 | |
Independent variable | |||
Internet use | No = 0 | 4863 | 58.55 |
Yes = 1 | 3443 | 41.45 | |
Internet social frequency | Very frequently = 1 | 6836 | 82.30 |
Frequently = 2 | 878 | 10.57 | |
Less = 3 | 142 | 1.71 | |
Never = 4 | 450 | 5.42 | |
Personal characteristics | |||
Sex | Female = 0 | 3979 | 47.91 |
Male = 1 | 4327 | 52.09 | |
Age | Unit: Years | 8306 | - |
Marital status | Unmarried = 1 | 1768 | 21.29 |
Married = 2 | 6250 | 75.25 | |
Cohabitation = 3 | 41 | 0.49 | |
Divorced = 4 | 217 | 2.61 | |
Widowed = 5 | 30 | 0.36 | |
Education | Primary school and below = 1 | 1446 | 17.41 |
Middle school = 2 | 4674 | 56.27 | |
College = 3 | 2139 | 25.75 | |
Postgraduate = 4 | 47 | 0.57 | |
Political status | Non-party members = 0 | 8109 | 97.63 |
Party member = 1 | 197 | 2.37 | |
Domicile | Agricultural = 1 | 6177 | 74.37 |
Non-agricultural = 2 | 2127 | 25.61 | |
Work attributes | Agricultural work = 1 | 1431 | 17.23 |
Non-agricultural work = 2 | 6875 | 82.77 | |
Medical insurance | No = 0 | 851 | 10.25 |
Yes = 1 | 7455 | 89.75 | |
Lifestyle | |||
Smoking | No = 0 | 5640 | 67.90 |
Yes = 1 | 2666 | 32.10 | |
Drinking | No = 0 | 7153 | 86.12 |
Yes = 1 | 1153 | 13.88 | |
Staying up late | No = 0 | 6931 | 83.45 |
Yes = 1 | 1375 | 16.55 | |
Mediating variables | |||
Health behavior | Poor= 0 | 3757 | 45.23 |
Good = 1 | 4549 | 54.77 |
Contents | Methods |
---|---|
Basic regression | Order probit/Probit |
Robustness test | Ologit/Order probit/Probit |
Net relationship between Internet use and health | Propensity Score Matching (PSM) |
Regression results in different subgroups | Order probit/probit |
Mediation analysis | Stepwise regression |
Variable | Model (1) | Model (2) | Model (3) | Model (4) |
---|---|---|---|---|
Self-Rated Health | Self-Rated Health | Chronic Conditions | Chronic Conditions | |
Independent variable | ||||
Internet use | 0.058 ** (0.024) | 0.078 *** (0.028) | 0.088 ** (0.042) | 0.040 *** (0.050) |
Personal characteristics | ||||
Sex | 0.129 *** (0.031) | −0.008 * (0.055) | ||
Age | −0.030 *** (0.002) | −0.027 *** (0.003) | ||
Marriage | 0.002 (0.023) | 0.004 (0.040) | ||
Education | 0.040 * (0.022) | 0.022 (0.038) | ||
Political status | 0.245 *** (0.078) | −0.013 (0.140) | ||
Domicile | −0.027 (0.030) | −0.015 * (0.009) | ||
Work attributes | 0.064 * (0.034) | 0.170 *** (0.056) | ||
Medical insurance | −0.040 (0.039) | −0.083 (0.076) | ||
Lifestyle | ||||
Exercise frequency | 0.017 *** (0.004) | −0.010 (0.007) | ||
Smoking | 0.054 * (0.033) | 0.107 * (0.059) | ||
Drinking | 0.079 ** (0.036) | 0.080 (0.065) | ||
Staying up late | −0.188 *** (0.033) | −0.128 *** (0.058) | ||
Observations | 8306 | 8306 | 8306 | 8306 |
Adj-R2 | 0.0003 | 0.0214 | 0.0010 | 0.0333 |
Variable | Y = 1 | Y = 2 | Y = 3 | Y = 4 | Y = 5 |
---|---|---|---|---|---|
Self-rated health | Very healthy | Relatively healthy | Healthier | General | Unhealthy |
Internet use | 0.188 *** (0.006) | 0.010 *** (0.003) | 0.109 *** (0.004) | −0.009 *** (0.003) | −0.009 *** (0.003) |
Variable | Model (1) | Model (2) | Model (3) | Model (4) |
---|---|---|---|---|
Self-Rated Health | Chronic Conditions | Self-Rated Health | Chronic Conditions | |
Independent variable | ||||
Internet use | 0.127 *** (0.048) | 0.092 *** (0.103) | ||
Frequency of using the Internet socially | −0.039 *** (0.031) | −0.028 *** (0.026) | ||
Personal characteristics | ||||
Sex | 0.237 *** (0.054) | −0.012 (0.110) | 0.121 *** (0.031) | −0.009 (0.054) |
Age | −0.055 *** (0.003) | −0.051 *** (0.006) | −0.030 *** (0.002) | −0.026 *** (0.003) |
Marriage | 0.012 (0.039) | −0.004 (0.081) | 0.005 (0.023) | 0.004 (0.040) |
Education | 0.071 * (0.039) | 0.050 (0.078) | 0.020 (0.021) | 0.007 (0.035) |
Political status | 0.416 *** (0.134) | −0.002 (0.287) | 0.240 *** (0.078) | −0.014 (0.140) |
Domicile | −0.047 (0.051) | −0.026 * (0.015) | −0.035 (0.030) | −0.016 * (0.009) |
Work attributes | 0.095 (0.061) | 0.334 *** (0.110) | 0.059 * (0.034) | 0.159 *** (0.056) |
Medical insurance | −0.039 (0.068) | −0.188 (0.159) | −0.040 (0.034) | −0.086 (0.076) |
Lifestyle | ||||
Exercise frequency | 0.031 *** (0.008) | −0.020 (0.014) | 0.017 *** (0.004) | −0.010 (0.007) |
Smoking | 0.098 * (0.057) | 0.217 * (0.119) | 0.056 * (0.033) | 0.109 * (0.059) |
Drinking | 0.144 *** (0.064) | 0.165 (0.135) | 0.080 ** (0.036) | 0.078 (0.065) |
Staying up late | −0.323 *** (0.057) | −0.239 ** (0.118) | −0.192 *** (0.033) | −0.133 ** (0.058) |
Observations | 8306 | 8306 | 8306 | 8306 |
Adj-R2 | 0.0222 | 0.0325 | 0.0211 | 0.0334 |
Variable | Unmatched Matched | Mean | Bias (%) | Reduce Bias (%) | t-Test | ||
---|---|---|---|---|---|---|---|
Treated | Control | t | p > |t| | ||||
Sex | U | 0.565 | 0.490 | 15.0 | 74.3 | 6.72 | 0.000 |
M | 0.564 | 0.545 | 3.9 | 1.60 | 0.109 | ||
Age | U | 30.394 | 33.737 | −44.7 | 90.8 | −19.72 | 0.000 |
M | 30.403 | 30.097 | 4.1 | 1.89 | 0.059 | ||
Marriage | U | 1.740 | 1.937 | −34.3 | 93.0 | −15.46 | 0.000 |
M | 1.742 | 1.756 | −2.4 | −1.00 | 0.318 | ||
Education | U | 2.470 | 1.829 | 108.8 | 99.2 | 48.98 | 0.000 |
M | 2.466 | 2.461 | 0.9 | 0.37 | 0.709 | ||
Political status | U | 0.038 | 0.136 | 15.5 | 99.2 | 7.24 | 0.000 |
M | 0.038 | 0.037 | 0.1 | 0.04 | 0.966 | ||
Domicile | U | 1.386 | 1.166 | 50.4 | 92.9 | 23.17 | 0.000 |
M | 1.383 | 1.368 | 3.6 | 1.34 | 0.182 | ||
Work attributes | U | 1.944 | 1.746 | 56.8 | 98.1 | 24.17 | 0.000 |
M | 1.944 | 1.940 | 1.1 | 0.66 | 0.507 | ||
Medical insurance | U | 0.892 | 0.902 | −3.1 | 77.2 | −1.41 | 0.158 |
M | 0.892 | 0.890 | 0.7 | 0.29 | 0.773 | ||
Exercise frequency | U | 2.167 | 1.732 | 16.5 | 97.6 | 7.38 | 0.000 |
M | 2.160 | 2.149 | 0.4 | 0.16 | 0.870 | ||
Smoking | U | 0.313 | 0.327 | −3.0 | 31.4 | −1.34 | 0.180 |
M | 0.314 | 0.323 | −2.0 | −0.85 | 0.395 | ||
Drinking | U | 0.130 | 0.145 | −4.6 | 97.5 | −2.06 | 0.040 |
M | 0.130 | 0.130 | 0.1 | 0.05 | 0.961 | ||
Staying up late | U | 0.217 | 0.129 | 23.5 | 87.4 | 10.74 | 0.000 |
M | 0.216 | 0.205 | 3.0 | 1.13 | 0.257 |
Self-Rated Health | Chronic Conditions | |||||||
---|---|---|---|---|---|---|---|---|
Treated | Control | ATT | SE | Treated | Control | ATT | SE | |
Unmatched | 2.642 | 2.698 | 0.056 | 0.023 | 0.237 | 0.241 | 0.004 | 0.010 |
Matched | ||||||||
(1) | 2.645 | 2.252 | 0.103 | 0.037 | 0.237 | 0.215 | 0.023 | 0.015 |
(2) | 2.646 | 2.550 | 0.097 | 0.034 | 0.237 | 0.216 | 0.022 | 0.014 |
(3) | 2.645 | 2.560 | 0.085 | 0.033 | 0.237 | 0.214 | 0.023 | 0.013 |
Variable | Work Attributes | Education | ||||||
---|---|---|---|---|---|---|---|---|
Agricultural | Non-Agricultural | High School and Below | University and Above | |||||
(1) | (2) | (1) | (2) | (1) | (2) | (1) | (2) | |
Internet use | 0.012 (0.087) | 0.052 (0.156) | 0.086 *** (0.029) | 0.055 ** (0.054) | 0.043 (0.032) | 0.015 (0.058) | 0.103 * (0.058) | 0.039 * (0.108) |
Control variables | Yes | Yes | Yes | Yes | Yes | Yes | Yes | Yes |
Observations | 1431 | 1431 | 6875 | 6875 | 6120 | 6120 | 2186 | 2186 |
Adj-R2 | 0.0219 | 0.0444 | 0.0206 | 0.0275 | 0.0216 | 0.0378 | 0.0249 | 0.0516 |
Self-Rated Health | Chronic Conditions | |||||
---|---|---|---|---|---|---|
Variables | Step One | Step Two | Step Three | Step One | Step Two | Step Three |
Internet use | 0.078 *** (0.028) | 0.139 *** (0.046) | 0.075 *** (0.276) | 0.040 *** (0.050) | 0.139 *** (0.046) | 0.038 *** (0.051) |
Control variables | Yes | Yes | Yes | Yes | Yes | Yes |
Health behavior | 0.115 *** (0.120) | 0.085 *** (0.094) | ||||
Observations | 8306 | 8306 | 8306 | 8306 | 8306 | 8306 |
Adj-R2 | 0.0214 | 0.0541 | 0.0255 | 0.0333 | 0.0541 | 0.0334 |
Variables | c | a | b | c’ | Mediation | Percentage (%) |
---|---|---|---|---|---|---|
Self-rated health | 0.078 | 0.139 | 0.115 | 0.075 | 0.0159 | 20.38 |
Chronic conditions | 0.040 | 0.139 | 0.085 | 0.038 | 0.0118 | 29.53 |
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Li, L.; Ding, H. The Relationship between Internet Use and Population Health: A Cross-Sectional Survey in China. Int. J. Environ. Res. Public Health 2022, 19, 1322. https://doi.org/10.3390/ijerph19031322
Li L, Ding H. The Relationship between Internet Use and Population Health: A Cross-Sectional Survey in China. International Journal of Environmental Research and Public Health. 2022; 19(3):1322. https://doi.org/10.3390/ijerph19031322
Chicago/Turabian StyleLi, Liqing, and Haifeng Ding. 2022. "The Relationship between Internet Use and Population Health: A Cross-Sectional Survey in China" International Journal of Environmental Research and Public Health 19, no. 3: 1322. https://doi.org/10.3390/ijerph19031322