Public Long‐Term Care Insurance and Loneliness Among Older Adults: Evidence From the China Health and Retirement Longitudinal Study

AIM: Loneliness is widespread among older adults and is associated with serious health consequences. This study investigates whether the implementation of public long-term care insurance alleviates loneliness among the older population. METHODS: China initiated its public long-term care insurance pilot program in 2012, with subsequent expansions in 2016 and 2020. Exploiting this quasi-natural experiment framework and using panel data from the 2011-2018 China Health and Retirement Longitudinal Study, this study employed the difference-in-differences approach to examine the pilot program's effects on loneliness among older adults. The analytic sample comprised 28 829 individual-year observations from 9458 community-dwelling individuals aged 60 and above. RESULTS: The results indicated that the introduction of public long-term care insurance significantly mitigated loneliness among older adults. Compared to older individuals who resided in non-pilot cities and were not affected by the pilot program, those living in pilot cities experienced a 5.7% decrease in the likelihood of reporting loneliness (95% confidence interval [CI], 1.2%-10.2%), or a 0.121-point reduction in the loneliness score on a scale of 0-3 (95% CI, 0.043-0.199). Heterogeneity analyses further revealed that the effects were more pronounced among more vulnerable individuals, and in pilot cities with more generous insurance policies. CONCLUSION: Public long-term care insurance effectively reduces loneliness among older adults. The findings highlight the potential for this public health program not only to address physical health needs but also to enhance psychosocial well-being in aging populations, offering valuable insights for other countries facing similar challenges.