The influence mechanism of rural physical environment on the mental health of older adults in Sichuan, China: A multi-level and multi-dimensional comparative study

In the context of the demand for rural revitalization in China, the health of rural older adults has garnered widespread societal attention. Although there is an association between the rural physical environment and the mental health of older adults, research on the underlying mechanisms remains limited. Based on survey data collected from 42 counties, 124 villages, and 1091 older adults in Sichuan Province, this study explores the internal mechanisms linking the rural physical environment to the mental health of older adults by using behavioral patterns as mediators, and it compares differences across gender and age groups. The results reveal that both rural greening landscapes and leisure facilities exert significant positive influences on the mental health of rural older adults. Greening landscapes primarily influence mental health directly, whereas leisure facilities influence mental health indirectly-mediated through increased walking and neighborhood interaction, alongside a negative mediating influence of mahjong. Group comparison analyses indicate that the direct influence of greening landscapes is more pronounced for vulnerable groups such as female and older aged, whereas leisure facilities are more influential for relatively stronger groups such as males and younger aged groups. Moreover, in the influence path of leisure facilities to the mental health of older adults, mahjong has a significant negative influence only on males and older aged groups, while the negative influence of farming is significant solely for younger aged group. These findings offer valuable theoretical guidance for tailoring intervention measures to different groups, thereby maximizing the health benefits of improvements in the rural physical environment and enhancing the mental health of rural older adults.