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Using micro panel data from the China Family Panel Studies (CFPS) for 2018 to 2022, this study examines the impact of healthcare financial stress on subjective well-being and its underlying mechanisms. Two-way fixed-effects models are employed, controlling for individual and time fixed effects and a wide set of demographic and household characteristics. We estimate the association between healthcare financial stress and happiness scores and use mediation analysis to assess the roles of self-rated health status and freely disposable household income in transmitting this effect. The results indicate that, after controlling for individual and time fixed effects as well as a range of demographic and household characteristics, healthcare financial stress is significantly negatively associated with subjective well-being. Mediation analysis shows that healthcare financial stress worsens self-rated health and compresses disposable income, thereby amplifying its adverse effect on well-being. Heterogeneity analysis further reveals that low-income groups, rural residents, and individuals with limited social security coverage bear a disproportionately larger negative impact, suggesting that healthcare financial stress constitutes an important constraint on advancing common prosperity. Accordingly, this study recommends advancing a \u201cquasi-free\u201d reform of basic healthcare, accompanied by optimizing the financing and expenditure structure and strengthening health insurance payment and oversight, to alleviate healthcare financial stress, enhance well-being, and improve the healthcare security system.<\/jats:p>","DOI":"10.1177\/00469580261440165","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T07:35:30Z","timestamp":1776065730000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Healthcare Financial Stress on Residents\u2019 Subjective Well-Being: Health Status and Household Disposable Income as Mediators"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0497-0629","authenticated-orcid":false,"given":"Juanjuan","family":"Su","sequence":"first","affiliation":[{"name":"Yangzhou University, Jiangsu Province, China"},{"name":"Henan Institute of Economics and Trade, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9067-4011","authenticated-orcid":false,"given":"Gai","family":"Liu","sequence":"additional","affiliation":[{"name":"Yangzhou University, Jiangsu Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanglin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Henan Institute of Economics and Trade, Zhengzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"issue":"05","key":"e_1_3_4_2_2","first-page":"39","article-title":"The influence of educational inequality on residents\u2019 subjective well-being: an empirical study based on China family panel studies (CFPS) data","volume":"40","author":"Li J","year":"2024","unstructured":"Li J, Ren Y. 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