Mediating Factors Explaining the Associations between Solid Fuel Use and Self-Rated Health among Chinese Adults 65 Years and Older: A Structural Equation Modeling Approach.

Exposure to indoor air pollution from cooking with solid fuel has been linked with the health of elderly people, although the pathway to their association is unclear. This study aimed to investigate the mediating effects between solid fuel use and self-rated health by using structural equation modeling (SEM) with the baseline data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). We conducted a cross-sectional survey among 7831 elderly people aged >65 years from the CLHLS. SEM was used to analyze the pathways underlying solid fuel use and self-rated health. We estimated indirect effects of sleep quality (β = −0.027, SE = 0.006), cognitive abilities (β = −0.006, SE = 0.002), depressive symptoms (β = −0.066, SE = 0.007), systolic blood pressure (β = 0.000, SE = 0.000), and BMI (β = −0.000, SE = 0.000) on the association between solid fuel and the self-rated health using path analysis. Depressive symptoms emerged as the strongest mediator in the relationship between solid fuel use and self-rated health in the elderly. Interventions targeting sleep quality, cognitive abilities, depressive symptoms, systolic blood pressure, and BMI could greatly reduce the negative effects of solid fuel use on the health of the elderly population.