ArticleFrontiers in public health2026
High medical costs and resource shortages constrain rural happiness more than physical access in rural China.
Article in Frontiers in 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
Introduction: Access to healthcare services is closely associated with people's subjective well-being (SWB). Although a growing body of research has examined this relationship in rural contexts, variations across different rural regions in China remain underexplored. Methods: This study investigates the association between multidimensional healthcare accessibility-specifically affordability, availability, and geographic accessibility-and the SWB of 589 rural residents from two distinct counties representing economically developed (Kunshan, Jiangsu) and less-developed (Yudu, Jiangxi) regions. Results: Affordability and resource availability are significantly associated with rural residents' happiness, whereas geographic distance is no longer a primary constraint. Significant regional heterogeneity exists in mediation pathways: in the less-developed region, availability acts as a psychological safety net linked to reduced anxiety; in the developed region, affordability constraints are linked to reduced happiness through physical health capital depreciation. Discussion: Public health governance should transition from universal spatial expansion toward precision-driven interventions focusing on medical expenditure and service quality to better support the happiness of diverse rural populations.
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