Exploring the state and drivers of community integration for older adults in China: insights from a social ecosystem perspective.

BACKGROUND: Community integration is vital for healthy aging by fostering social participation. This study aims to investigate the current status of and influencing factors on community integration among older adults in China, to fill the research gap in this area, and to provide empirical evidence for the development of healthy aging policies in China and other countries facing the challenges of aging. METHODS: A cross-sectional survey was conducted between May and October 2024 in Guizhou Province using a two-stage probability proportional to size sampling design. Data from 3,940 valid community-dwelling older adults aged ≥ 60 years were collected. Descriptive statistics, t-tests, and one-way ANOVA were used to examine differences in community integration scores, and hierarchical linear regression was applied to explore the effects of micro-, meso-, and macro-level factors within the social-ecosystem framework. RESULTS: The average community integration score was 17.98 (SD = 6.17). Univariate analyses identified 19 variables significantly associated with community integration. Hierarchical regression showed that micro-level factors (e.g., age, gender, personal income, health status, ADL) explained the largest proportion of variance (18.2%), while adding meso-level factors (e.g., marital status, number of children, living alone, community exercise facilities) increased the explained variance to 20.6%. The inclusion of macro-level contextual variables (e.g., social insurance coverage rate, proportion of residents with higher education) raised it slightly to 21.1%, indicating that interpersonal and community resources exert stronger effects than broader structural conditions. CONCLUSIONS: Community integration among older adults in China remains low and is shaped by multilevel factors. Targeted interventions should integrate individual support, family involvement, and community resources to enhance participation and promote the development of age-friendly and health-promoting communities.