Association between internet use by middle-aged and older adults and the health of their family members: Nationally representative longitudinal survey in China.

Background: Although a number of studies have investigated the effects of internet use on the health status of middle-aged and older adults (MAOAs), there has been surprisingly little research exploring whether the use of internet among MAOAs has a positive association with the health of their family members. Objective: This study aims to explore the relationship between MAOAs' internet use and the health of their family members, including spouses, siblings, and children. Methods: The datasets were extracted from the China Health and Retirement Longitudinal Survey conducted in 2015 and 2018, comprising 15,946, 37,565, 31,057 individuals who were spouses, siblings and children of MAOAs, respectively. The binary logistic models combined with individual-, household-, community-, and time-level random intercepts were constructed to estimate the association between MAOAs' internet use and the health of their family members. A series of sensitivity analyses was conducted to assess the robustness of the study findings. Results: Internet use by MAOAs was associated with a rise in the odds of reporting to have a good health status by an average of 209.29%, 23.12% and 85.71% for their children, spouses, and siblings, respectively. The positive association of internet use by MAOAs and health were found to be most pronounced among children, especially those from less affluent backgrounds. While internet use contributed to improved health among female siblings, statistically significant positive association was only observed for male spouses. Conclusions: Effective strategies and action plans aimed at promoting internet use should account for the holistic impact of family engagement in addressing the health needs of both MAOAs and their family members in the era of rapid population ageing.