ArticleBMC public health2026
Unmet needs for community-based healthcare services and blood pressure among Chinese older adults: A nationwide longitudinal cohort study.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundChina's rapidly aging population necessitates community-based healthcare services to meet the diverse needs of older adults. Unlike previous studies focusing on chronic disease management, this study investigated the association between unmet needs for community-based home visit and health education services designed for all older adults and their blood pressure outcomes.
methodsWe analyzed data from the Chinese Longitudinal Healthy Longevity Survey (2005-2018), including 10,200 participants aged ≥ 65 years. Unmet needs were defined as the discrepancy between perceived need and service availability. Blood pressure outcomes included systolic (SBP), diastolic (DBP), pulse pressure (PP), and mean arterial pressure (MAP). We employed fixed-effects models with instrumental variables to examine the effects of unmet needs on blood pressure outcomes.
resultsUnmet needs for home visits were associated with higher SBP (1.33 mmHg; 95% confidence interval [CI]: 0.50 to 2.17) and PP (1.77 mmHg; 95% CI: 1.04 to 2.51). Unmet needs for health education were linked to increased SBP (1.83 mmHg; 95% CI: 1.00 to 2.67) and PP (2.16 mmHg; 95% CI: 1.44 to 2.89). When analyzed independently, controlling for the other service, unmet home visit needs were primarily associated with higher PP (1.20 mmHg), while unmet health education needs remained significantly associated with both higher SBP (1.56 mmHg) and PP (1.76 mmHg). No significant independent associations were observed for DBP or MAP. Combined analysis revealed that older adults with unmet needs for both services experienced greater increases in SBP (2.81 mmHg) and PP (3.11 mmHg). Compared to individuals with both needs met, those with met home visit needs but unmet health education needs had the relatively higher increases in SBP (3.77 mmHg) and PP (3.38 mmHg). Notably, individuals reporting no perceived need for health education consistently exhibited elevated SBP and PP compared to those with met needs. These patterns were observed in both initially hypertensive and non-hypertensive subgroups, underscoring the potential preventive role of these services.
conclusionsUnmet needs for community-based healthcare services designed for all older adults, not just those with chronic conditions, are significantly associated with adverse blood pressure outcomes among older Chinese adults.
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