{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:06:14Z","timestamp":1790139974926,"version":"4.0.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study examines how household age structure is associated with health-related expenditure in China, distinguishing broad medical and healthcare expenditure from narrower health\/fitness expenditure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using nationally representative China Household Finance Survey data from 2015, 2017, 2019, and 2021, we estimate associations between old-age and child dependency ratios and two expenditure outcomes and examine potential mechanisms through precautionary saving and household disposable income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Old-age dependency is positively and relatively consistently associated with both broad medical and healthcare expenditure and narrow health\/fitness expenditure. The association for child dependency is less stable across outcomes and specifications, but the mediation results are consistent with the possibility that household income constraints are relevant for discretionary health\/fitness expenditure. Robustness, heterogeneity, and supplementary instrumental-variable analyses support an associational interpretation rather than a strong causal claim.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Demographic structure is linked not only to the level of household health-related expenditure but also to its composition. Distinguishing old-age and child dependency helps clarify how demographic transition may shape household capacity for preventive and discretionary health investment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1815361","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:44:06Z","timestamp":1790138646000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Demographic structure, consumption composition, and household health investment: evidence from sports and fitness expenditure"],"prefix":"10.3389","volume":"14","author":[{"given":"Ziyue","family":"Wang","sequence":"first","affiliation":[{"name":"School of Physical Education and Sport Science, Fujian Normal University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"Bai","sequence":"additional","affiliation":[{"name":"Advanced Institute of Finance, Henan University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"q1000","DOI":"10.1136\/bmj.q1000","article-title":"China\u2019s declining fertility rate","volume":"385","author":"Li","year":"2024","journal-title":"BMJ"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1186\/s12913-025-13072-2","article-title":"The impact of ageing, socio-economic differences and the evolution of morbidity on future health expenditure\u2014a dynamic microsimulation","volume":"25","author":"Horvath","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"114322","DOI":"10.1016\/j.socscimed.2021.114322","article-title":"Decomposition of inequalities in out-of-pocket health expenditure burden in Saudi Arabia","volume":"286","author":"Al-Hanawi","year":"2021","journal-title":"Soc Sci Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e0312349","DOI":"10.1371\/journal.pone.0312349","article-title":"The role of health shocks after age 70 on housing and wealth profiles","volume":"20","author":"Aydilek","year":"2025","journal-title":"PLoS One"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"102759","DOI":"10.1016\/j.jhealeco.2023.102759","article-title":"Public long-term care insurance and consumption of elderly households: evidence from China","volume":"90","author":"Liu","year":"2023","journal-title":"J Health Econ"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1086\/651674","article-title":"Why do the elderly save? 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