Assessing the Impact of Internet Skills on Depressive Symptoms Among Chinese Middle-Aged and Older Adults: Cross-Sectional Instrumental Variables Analysis

Abstract

Abstract Background The potential benefits of IT for the well-being of older adults have been widely anticipated. However, findings regarding the impact of internet use on depressive symptoms are inconsistent. As a result of IT’s exponential growth, internet skills have supplanted internet access as the source of the digital divide. Objective This study evaluates the effect of internet skills on depressive symptoms through an instrumental variables (IV) approach. Methods Data from the China Health and Retirement Longitudinal Study’s wave 4 (2018) were used. This included 16,949 community residents aged 45 years and older. To overcome the endogeneity issue, we used an IV approach. Results Our results reveal the emergence of a second-level digital divide, the disparity in internet skills, among Chinese middle-aged and older adults. Liner regression suggests that a 1% increase in internet skills is associated with a 0.037% decrease in depressive symptoms (β=−.037, SE 0.009), which underestimates the causal effect. As expected, internet skills are an endogenous variable (F test P value <.001). IV regressions indicate that a 1% increase in internet skills reduces 1.135% (SE 0.471) to 1.741% (SE 0.297) of depressive symptoms. These 2 IV are neither weak (F–1=16.7 and 28.5; both >10) nor endogenous (Wu-Hausman test P value of .10; >.05 or >.01). Conclusions Better mental health is predicted through improved and higher internet skills. Consequently, residents and policy makers in China should focus on bridging the digital divide in internet skills among middle-aged and older adults.