Migration and Depression among Chinese Grandparents: Moderated Mediation Model of Social Support and Social Health Insurance

Against the background of growing urbanization, Chinese grandparents increasingly migrate to cities to provide informal childcare. However, this upheaval may negatively impact their well-being. This study aimed to investigate the association of migration status with depressive symptoms among grandparent caregivers and test the indirect association of social support and moderation of social health insurance. Using multi-stage cluster random sampling, we recruited and surveyed 981 grandparent caregivers (mean age = 58.3 years; 71.6% female) from Eastern China. After controlling for covariates, migration status was positively associated with depressive symptoms. The indirect association via family social support (but not friend social support) was significant. Moreover, social health insurance coverage moderated the indirect association via family social support. Hence, the role of family social support appears to outweigh that of support from friends in protecting Chinese grandparent caregivers’ mental health; such protection is stronger among those without local social health insurance. We underscore the need for universal social health insurance coverage, regardless of individuals’ migration status, to protect grandparent caregivers’ mental health in China.