Abstract
As populations age, a paradox persists: despite growing emphasis on “active aging,” geriatric depression remains widespread. This study explores how symbolic positioning across community, policy, and family domains is associated with depressive symptoms among older adults in China. Drawing on positioning theory and symbolic interactionism, we introduce soulful nurturing—a symbolic-affective process through which older adults interpret care, participation, and recognition as emotionally sustaining or wounding. Using data from the 2018 China Longitudinal Aging Social Survey, we employ two-stage least squares (2SLS) regression to account for potential endogeneity in community participation. Results suggest that participation in community co-governance tends to be associated with fewer depressive symptoms, particularly when senior welfare policies are present. Among individuals reporting familial neglect or abuse, however, this association weakens, indicating that symbolic coherence across social domains may matter. These findings imply that participation alone may not be sufficient to promote emotional well-being; rather, its potential benefits appear conditional on the symbolic legitimacy of older adults’ roles and the integrity of their relational environments. We propose that late-life depression may reflect not only social isolation, but also symbolic misalignment. Policy implications include designing eldercare frameworks that integrate material support with symbolic recognition.
Plain Language Summary
As people grow older, staying socially active is often seen as a way to improve emotional well-being. Many governments encourage older adults to join community activities to stay engaged and reduce depression. But does this always work? This study looks at older adults in China to understand when community involvement actually improves mental health. Using national survey data from over 4,600 people aged 60 and above, the researchers found that community participation only helped reduce depression if two conditions were met: First, the local government provided senior-specific support, such as transportation benefits or access to services. Second, the older adult felt supported and respected by their family. If either condition was missing—especially in cases of family neglect or emotional mistreatment—community activities had no protective effect. In fact, some older adults reported that participation felt meaningless or even emotionally harmful when their efforts were not recognized by others. This study shows that being active in the community is not enough on its own. What really matters is whether older adults feel seen, respected, and supported—both by government policies and by close family. Programs for older adults should therefore not only promote participation, but also strengthen emotional support and public recognition to truly improve mental health in later life.
Keywords
Introduction
As global population aging accelerates, governments are increasingly adopting policies that frame older adults as active contributors rather than passive dependents. Aging is no longer viewed solely as a phase of decline, but as a period of potential—marked by social productivity, civic engagement, and intergenerational reciprocity (Carr et al., 2023; X. Chen et al., 2022; Morrow-Howell & Gonzales, 2020). Older adults are now expected to play visible roles in family cohesion (Xie & Han, 2023), community building (Bandyopadhyay & Singh, 2023), and even economic sustainability (Reyes, 2023). This global trend toward “active aging” represents not only a policy response to demographic shifts but also a broader symbolic repositioning of later life (Blix & Ågotnes, 2023; Sánchez & Díaz, 2022).
Yet this narrative of empowerment is accompanied by a troubling empirical contradiction: geriatric depression remains widespread—and in many contexts, is rising. Estimates suggest that 10% to 15% of older adults globally experience significant depressive symptoms (Gambaro et al., 2022), with particularly high prevalence in societies undergoing rapid structural transformation (Dang et al., 2022; Tang et al., 2022). These trends challenge the assumption that greater participation is consistently associated with improved psychological outcomes. Instead, they point to a deeper question: under what symbolic and relational conditions does participation translate into emotional well-being?
This study addresses that question by shifting analytical focus from behavioral participation to symbolic positioning. We suggest that the emotional implications of community involvement and policy engagement depend on whether they are experienced as legitimate, emotionally resonant, and socially recognized (X. Chen et al., 2022; Morrow-Howell & Gonzales, 2020; Sánchez & Díaz, 2022). To conceptualize this dynamic, we introduce the term soulful nurturing—defined as the symbolic-affective process through which older adults interpret care, recognition, and participation as meaningful or wounding. Drawing on positioning theory (Davies & Harré, 1990) and symbolic interactionism (Blumer, 1986), we frame soulful nurturing as a relational infrastructure that shapes how older adults make sense of their roles within community, family, and policy domains.
In China, the paradox of active aging is especially pronounced. The country is experiencing one of the fastest demographic transitions globally, with projections estimating that 28% of the population will be aged 60 or above by 2040 (X. Chen et al., 2022). In response, Chinese policy has embraced a dual strategy of state withdrawal and community empowerment, encouraging older adults to participate in local governance, social mediation, and volunteerism (H. Chen & Adamek, 2017; Lu et al., 2024; Y. Zhang, 2023). However, these shifts occur amid fragile welfare guarantees, weakening kinship structures, and enduring cultural scripts that cast aging as both virtuous and vulnerable (L. Chen & Tian, 2023; Sin, 2012; Wang et al., 2022). In such a context, the emotional correlates of participation appear to vary depending on how older adults are positioned across multiple symbolic registers—public, institutional, and intimate.
Existing studies have shown that social support, family interaction, and formal services are important buffers against late-life depression (Newbould et al., 2022; Noone & Yang, 2022; Reynolds et al., 2022). Yet much of this research focuses on the presence or absence of care resources, overlooking how these resources are interpreted, contested, or internalized by older adults themselves. Emerging work in critical gerontology has begun to explore the symbolic and emotional texture of aging—how individuals experience inclusion, misrecognition, or moral injury through care relations and participatory expectations (Baruah, 2023; Mathews, 2024; Okun & Ayalon, 2023; Pinazo-Hernandis et al., 2023). However, few studies have empirically examined how symbolic misalignment across policy, community, and family domains contributes to depression, especially in transitional welfare states like China.
This study makes three key contributions to address this gap. First, it introduces soulful nurturing as a mid-level theoretical construct that captures how symbolic alignment across relational domains produces or disrupts emotional well-being. Second, it applies positioning theory to interpret not only the behavioral act of participation, but its affective legitimacy—demonstrating how community roles are associated with either affirmation or distress depending on the extent of institutional and familial reinforcement (Bourdieu, 1979; Ji et al., 2022). Third, it tests these mechanisms empirically using nationally representative data from the 2018 China Longitudinal Aging Social Survey (CLASS), employing a two-stage least squares (2SLS) strategy to better estimate the association between civic participation and depressive symptoms, accounting for potential endogeneity.
The remainder of the article proceeds as follows. Theoretical framework and literature review present our theoretical framework and elaborates on the three symbolic domains—community co-governance, policy recognition, and family care—through which positioning operates. Methods outline the data and analytic approach. Findings and discussion present the empirical findings and discuss their implications for aging policy. We conclude by calling for a reorientation of active aging frameworks—from behavioral activation to symbolic coherence, from participation quantity to relational legitimacy.
Theoretical Framework and Literature Review
Theoretical Framework: Positioning, Symbolic Meaning, and Soulful Nurturing
This study draws on two interrelated theoretical traditions—positioning theory and symbolic interactionism—to conceptualize the symbolic-affective infrastructure through which older adults relate social participation and emotional well-being in later life. Rather than assuming that mental health outcomes are directly caused by care provision or participation, we suggest that such outcomes may be associated with how these roles are symbolically framed, morally interpreted, and emotionally inhabited. The experience of “being cared for” or “participating” is not a fixed good but emerges through socially embedded interpretations.
Positioning theory (Davies & Harré, 1990) provides a discursive-relational lens for understanding how individuals are repeatedly “invited into” or “assigned” particular roles—such as caregiver, contributor, dependent, or burden—within institutional and interpersonal narratives. These roles may carry not only behavioral expectations but also normative and emotional connotations (Davies, 2023). For older adults, participation in community governance or informal care work is often associated with civic virtue in public discourse, but it may also be experienced as a burden or a source of emotional strain (Anderson et al., 2022; Okun & Ayalon, 2023). The potential link between such role positioning and emotional outcomes underscores the significance of symbolic legibility in shaping older adults’ self-understanding.
Symbolic interactionism (Blumer, 1986) further emphasizes the interpretive processes through which individuals assign meaning to social roles and interactions. From this perspective, aging is not merely a biological process but a semiotic one, where identity is constructed through ongoing evaluations of moral fit, relational response, and symbolic clarity (Gubrium & Holstein, 2000). For example, being asked to volunteer or included in decision-making may be interpreted by older adults as gestures of respect, whereas being excluded or reluctantly cared for might signal marginality. These interpretations can shape emotional responses, potentially linking symbolic affirmation with psychological well-being (Bar-Tur, 2023; Ren et al., 2022).
To capture this process, we introduce the concept of soulful nurturing—defined as the symbolic-affective process through which older adults interpret care, recognition, and participation as emotionally meaningful or emotionally depleting. Rather than assuming this concept as an internal disposition, we conceptualize soulful nurturing as a relationally situated outcome shaped by the alignment—or misalignment—of symbolic roles across family, community, and policy settings. When older adults perceive their participatory roles to be respected by both institutions and families, they may experience emotional coherence. Conversely, misalignment across these domains may be associated with narrative confusion, affective distress, or a sense of symbolic erasure.
Literature Review: Symbolic Positioning and the Mental Health of Older Adults
Community Co-Governance as a Site of Symbolic Reinforcement
Prior research has identified a consistent association between older adults’ social participation and improved psychological outcomes, including reduced depression and enhanced life satisfaction (Jongenelis et al., 2022; Pilkington et al., 2012; Raue et al., 2022). In China, community co-governance—referring to older adults’ engagement in neighborhood decision-making, dispute mediation, and mutual aid—has been promoted as a cornerstone of aging-in-place strategies (H. Chen & Adamek, 2017; Lu et al., 2024; Shea, 2017). However, much of this literature conceptualizes participation primarily as a behavioral input, without addressing its symbolic reception.
Positioning theory suggests that participation may serve as more than an activity—it can also operate as a symbolic indicator of societal value (Davies & Harré, 1990). Similarly, symbolic interactionism emphasizes that social gestures acquire emotional meaning through the responses they elicit. Without social acknowledgment, participatory acts may fail to affirm identity or reduce distress (Blumer, 1986; Gubrium & Holstein, 2000; Lytle & Levy, 2022). Indeed, participation that is ignored or deemed routine may not be perceived as validating, regardless of frequency (Yang et al., 2024).
From this perspective, community co-governance may be interpreted not merely as a behavioral act but as a symbolic positioning process. Older adults who perceive their contributions as visible and respected might experience greater emotional resilience, while those who perceive their roles as tokenistic or unrecognized may not derive the same benefit (Blix & Ågotnes, 2023; Wirth et al., 2023).
Policy Recognition as Institutional Positioning
Institutional support structures, such as welfare benefits targeted at older adults, may shape how participatory roles are interpreted. Prior studies suggest that a disconnect between demands for civic engagement and the absence of policy support may lead to symbolic overextension or emotional fatigue (Hubbard et al., 2003; Wen et al., 2022; S. Zhang, 2023). In China, access to senior welfare benefits—such as free transportation or health service prioritization—varies significantly by locality (Hutchins & Hazlehurst, 2006; Kühner & Chou, 2025), leading to disparities in perceived entitlement and dignity.
From a symbolic positioning perspective, welfare benefits may serve as more than functional supports; they may function as moral signifiers of social worth. When older adults receive such recognition, it may reinforce their sense of institutional legitimacy (Baruah, 2023; Charmaz & Belgrave, 2013). Conversely, the absence of recognition may be interpreted as marginalization, diminishing the emotional salience of civic participation (Gullette, 2019; Huang & Fang, 2016; Stevens et al., 2013).
Although theorists have noted this dynamic, empirical research has rarely explored whether institutional recognition moderates the relationship between participation and emotional outcomes. This study addresses that gap.
Family Neglect as Symbolic Fracture
In addition to public and institutional recognition, the family plays a critical role in positioning older adults emotionally and symbolically. Numerous studies have found that family support is associated with reduced risk of depression and higher life satisfaction among older adults (MacRae, 2002; Norris et al., 2013; Özer & Tanriverdi, 2023). In East Asian contexts, such support is often culturally linked to filial piety norms, where caregiving reflects not just instrumental help but moral alignment (Lo, 2020; Ren et al., 2022).
However, neglect or abuse by family members may signify a symbolic rupture—a disqualification of the older adult’s worth within kinship hierarchies. Research suggests that such experiences are not only materially harmful but emotionally disorienting (Ekoh et al., 2022; Mysyuk et al., 2016). Drawing on Bourdieu’s (1979) theory of symbolic violence, we argue that senior mistreatment functions not merely as interpersonal harm, but as relational disqualification—a denial of dignity that disrupts the coherence of the self. This symbolic fracture becomes especially consequential when it clashes with public visibility: the older adult who is respected in public but dismissed at home faces deep emotional dissonance (Amornkitvikai et al., 2023).
We introduce the notion of symbolic dissonance to capture this mismatch. This state occurs when roles in different social domains contradict each other, undermining emotional coherence and social identity. To our knowledge, few quantitative studies have tested whether family-based mistreatment moderates the relationship between participation and mental health.
By centering symbolic positioning across community, policy, and family domains, this study advances a multidimensional model of emotional well-being in older adulthood. We theorize soulful nurturing as the emergent effect of symbolic alignment—the convergence of public recognition, institutional affirmation, and private respect. When these domains reinforce one another, older adults experience narrative coherence, emotional stability, and dignity. When they diverge, symbolic dissonance arises, increasing vulnerability to depression and withdrawal.
This framework reframes the problem of late-life mental health not as one of participation level or support quantity, but as one of relational consistency. As Figure 1 illustrates, we view the emotional outcomes of aging as shaped not only by structural inclusion, but by the moral and symbolic infrastructures that render social roles livable, legible, and legitimate.
Conceptual framework.
Methods
Data and Sample
This study draws on data from the 2018 wave of the China Longitudinal Aging Social Survey (CLASS), a nationally representative dataset that documents the socioeconomic, health, and caregiving conditions of Chinese adults aged 60 and above. The CLASS survey was conducted by the National Survey Research Center at Renmin University of China using a multistage, stratified, probability-proportional-to-size (PPS) sampling method across 28 provinces. Data were collected through face-to-face interviews administered by trained enumerators, with field supervision and post-survey consistency checks ensuring data quality. The CLASS dataset has been widely used in gerontological and public policy research in China (Liu et al., 2020).
The original sample consists of 16,537 participants. For this study, analysis is limited to individuals with complete information on all core variables, including depressive symptoms, community co-governance participation, family treatment, exposure to local senior welfare policy, and covariates. After applying listwise deletion, the final analytic sample includes 4,621 participants.
While listwise deletion reduces sample size, it avoids introducing assumptions inherent in imputation and ensures consistency across models involving instrumental variables and interaction terms. This is particularly important for stratified analyses and for preserving the interpretive integrity of moderation effects. Listwise deletion remains an appropriate method when missingness is unlikely to be systematically related to the outcome variable (Newman, 2014). To assess potential selection bias, we compared key demographic characteristics (age, sex, education, and residence) between retained and excluded cases. No statistically significant differences were found, suggesting the analytic sample remains demographically representative of the original cohort.
Although multiple imputation is often recommended for addressing missing data, it is less suited for models involving two-stage least squares (2SLS) estimation or subgroup moderation, where assumptions about data structure must be tightly maintained. Given our theoretical emphasis on symbolic alignment across institutional and interpersonal domains, we prioritize full-case analysis to support analytical transparency.
All procedures involving human subjects in the original CLASS study were approved by the host institution’s institutional review board and conducted in accordance with the Declaration of Helsinki and Chinese legal requirements. Verbal informed consent was obtained from all participants, with interviewers documenting consent status and noting any refusal. No personally identifying information was collected. As this study conducts secondary analysis of de-identified public data, additional ethical review was not required. The societal value of this research—especially in informing eldercare policy and mental health interventions grounded in symbolic alignment—was considered to outweigh any minimal risks associated with data use.
For a detailed description of the methodology, please refer to the supplementary material.
Measures
Dependent Variable: Depression (Symbolic-Affective Outcome)
The primary outcome variable is depressive symptomatology, conceptualized as the symbolic-affective consequence of older adults’ positioning within family, community, and institutional contexts. It is constructed from 11 items in the CLASS 2018 mental health module, which assess self-reported frequencies of depressive symptoms experienced in the past week—such as sadness, loneliness, helplessness, insomnia, loss of appetite, and social detachment. Each item is scored on a 3-point Likert scale (1 = never, 2 = sometimes, 3 = often), with positively framed items (e.g., “I feel good,”“Life is enjoyable”) reverse-coded for directional consistency. An additive index is created by summing all items, with higher scores indicating greater depressive burden.
The scale demonstrates acceptable internal consistency (Cronbach’s α = .715) and construct validity (KMO = 0.836). It has been widely validated in Chinese aging research (Dang et al., 2022; Liu et al., 2020) and aligns with our theoretical focus on affective breakdown resulting from symbolic misalignment across relational domains.
Independent Variable: Community Co-Governance Participation (Public Symbolic Positioning)
To operationalize public symbolic positioning, we construct a 7-item index based on CLASS questions regarding older adults’ frequency of participation in community governance activities, including neighborhood patrols, dispute mediation, senior-child mutual assistance, environmental sanitation, intergenerational education, and formal volunteering. Each activity is scored on a 5-point ordinal scale (0 = never, 4 = almost daily), and the items are summed to produce a composite measure of civic engagement intensity.
This scale reflects the degree to which older adults are discursively and behaviorally positioned as contributors within community systems of aging governance (H. Chen & Adamek, 2017; Lu et al., 2024; Shea, 2017). It demonstrates excellent reliability (Cronbach’s α = .856) and strong construct validity (KMO = 0.909). In our framework, this variable serves as a behavioral proxy for symbolic participation and public role visibility.
Moderating Variable: Receipt of Local Senior Welfare Policy (Institutional Recognition)
To assess whether institutional environments symbolically affirm older adults’ participatory roles, we include a binary moderator indicating whether the participant reports having received at least one senior-targeted policy benefit (e.g., free public transport, discounted admission, service priority). The variable is coded 1 = yes and 0 = no.
This measure serves as an indicator of institutional ratification, allowing us to test whether the affective benefits of participation are conditioned by policy signals of entitlement and recognition (Beard & Williamson, 2011; Kühner & Chou, 2025). It captures the role of the state not merely as a service provider, but as a symbolic validator of older adults’ civic identities.
Heterogeneity Variable: Family Neglect and Abuse (Private Symbolic Fracture)
To examine private symbolic dissonance, we construct a binary variable indicating whether the participant experienced any form of neglect or abuse by family members in the past year. Seven CLASS items are used to assess incidents of emotional abandonment, financial exploitation, refusal of care, verbal abuse, food or housing deprivation, and mobility restriction. Each is coded as 0 = no and 1 = yes; any positive response results in a value of 1 on the composite binary indicator.
This measure captures symbolic fracture in the domestic sphere, where relational invalidation may erode the affective gains of public engagement. Prior research has linked such contradictions to the disintegration of identity and increased psychological vulnerability (Amornkitvikai et al., 2023; Ekoh et al., 2022; Özer & Tanriverdi, 2023).
Instrumental Variable: Traditional Confucian Value (Exogenous Civic Disposition)
To address potential endogeneity in community participation, we use endorsement of traditional filial values as an instrumental variable. Specifically, we draw on a CLASS item that asks whether participants agree with the statement: “Children should support their parents in old age.” Responses are reverse-coded so that higher values reflect weaker endorsement of filial obligation. This variable is intended to capture variation in civic disposition rooted in Confucian moral frameworks (Lo, 2020; Sin, 2012).
This instrument satisfies the relevance condition for two-stage least squares (2SLS): it is significantly associated with community participation in the first-stage regression (F = 10.302), exceeding the conventional F > 10 threshold for instrument strength (Stock & Yogo, 2005). The exclusion restriction is also supported: once actual family treatment, community participation, and welfare recognition are controlled for, filial belief is unlikely to have a direct effect on depression. In East Asian sociocultural contexts, traditional values shape behavior through institutional mediation rather than acting as direct emotional determinants (Chong et al., 2013; Ren et al., 2022). Thus, the instrument provides exogenous variation in public engagement while remaining conditionally independent of unobserved correlates of depression.
Covariates (Adjustment for Confounding)
To reduce omitted variable bias, we adjust for a robust set of control variables based on prior gerontological research (Ji et al., 2022; Jongenelis et al., 2022; Y. Zhang, 2023). These include: Age (continuous); Sex (0 = female, 1 = male); Education (ordinal scale from 1 = no education to 7 = college or above); Marital status (1 = married, 0 = not married); Urban Hukou type (1 = urban; 0 = rural); ADL independence (1 = independent, 0 = dependent); Self-rated health (reverse-coded 5-point scale); Hospitalization in last 2 years (count); Life satisfaction (reverse-coded 5-point scale); Work frequency (ordinal: 1 = daily to 5 = not working); Childhood access to medical care (1 = yes, 0 = no).
These covariates account for structural determinants of health, life-course disadvantage, and psychosocial status that may confound relationships between symbolic positioning and depression.
Analytical Strategy
We employ a two-stage least squares (2SLS) regression framework to estimate the causal effect of community co-governance participation on depressive symptoms. This approach addresses potential endogeneity arising from reverse causality and unobserved confounding (e.g., psychological traits influencing both depression and participation). In the first stage, community participation is instrumented using a reverse-coded measure of Confucian filial belief, which influences civic orientation but, conditional on covariates, is theoretically uncorrelated with depressive outcomes. The second stage regresses predicted values of participation on depressive symptoms. Instrument strength is confirmed by a first-stage F-statistic of 10.302. All models include robust standard errors, apply sampling weights, and control for a full set of demographic, health, and social variables. Analyses were conducted in Stata 16.0 (StataCorp, Texas, USA).
To assess whether the emotional effects of participation depend on institutional or relational context, we conduct subgroup estimations. First, we examine moderation by institutional recognition by estimating models separately for participants who did and did not receive local senior-specific welfare benefits. This tests whether participation generates psychological benefit only when publicly ratified. Second, we assess heterogeneity by familial positioning, comparing effects for those who did and did not report neglect or abuse. This allows us to examine whether private symbolic fracture disrupts the protective value of public engagement.
We further test robustness through two strategies. First, we adjust for childhood illness as a proxy for early-life adversity, mitigating potential omitted variable bias. Second, we restrict the sample to adults aged 75 and older, representing a “deep aging” subgroup per United Nations (2011) classification. Results across all specifications are consistent with our theoretical claim: participation reduces depressive symptoms only when embedded within symbolically coherent institutional and familial environments.
Results
Descriptive Patterns of Symbolic Positioning and Depression
Table 1 reports descriptive statistics for the core variables, offering a snapshot of how symbolic positioning unfolds among older adults in contemporary China. The average depression score is 18.22 (SD = 3.80, range: 11–33), reflecting a moderate but widespread level of emotional distress among community-dwelling seniors. This finding is notable given China’s policy emphasis on active aging, suggesting that discursive promotion of engagement has not translated into universal emotional security. Community co-governance participation scores are low overall, with a mean of 2.39 (SD = 4.25, range: 0–28), and a heavily right-skewed distribution—indicating that most participants participate rarely or not at all. This pattern suggests that while participation may be symbolically encouraged, its structural underdevelopment may be associated with the civic marginality experienced by many older adults.
Sample Characteristics.
Disparities in institutional and familial positioning reveal further fragmentation. While 74.5% of participants report having received at least one senior-targeted local benefit (e.g., subsidized transportation or health services), a substantial 25.5% report no such recognition. This uneven distribution likely reflects local policy discretion and highlights the non-universality of state-based symbolic affirmation. On the private side, 9.2% of participants report at least one experience of familial neglect or abuse within the past year. These incidents—ranging from financial exploitation to emotional abandonment—represent more than interpersonal breakdowns; they constitute symbolic failures, wherein the older adult is denied moral standing within kinship networks. The coexistence of public visibility and private dismissal reflects the symbolic dissonance many older adults confront, calling into question whether participation alone can offer psychological protection.
Demographically, the analytic sample mirrors key features of China’s aging population. The average age is 71.35 years, with women comprising 52.4% of the sample and urban residents accounting for 67.6%, reflecting the country’s urban-skewed distribution of eldercare resources. Most participants report independence in activities of daily living (92.1%) and moderate to high life satisfaction. Yet despite this functional capacity, public engagement remains low and uneven—suggesting a disconnect between older adults’ potential for participation and the recognition they receive. This asymmetry between individual readiness and symbolic inclusion reinforces the central premise of this study: that without alignment across public, institutional, and private domains, participation may lack the emotional efficacy to reduce psychological vulnerability. The descriptive findings thus establish a conceptual baseline for testing whether symbolic coherence is a necessary condition for the mental health benefits of civic engagement to materialize.
Community Co-Governance Participation and Depression
Tables 2 and 3 report the results of the two-stage least squares (2SLS) analysis examining the association between community co-governance participation and depressive symptoms. In the first stage (Table 2), endorsement of Confucian filial norms—reverse-coded to reflect weaker filial obligation—demonstrates sufficient predictive power for civic engagement, with an F-statistic of 10.302. This exceeds the conventional threshold of 10 for identifying weak instruments (Stock & Yogo, 2005), supporting the instrument’s relevance. Given that the measure reflects cultural orientation rather than emotional state, and that actual family dynamics are already included in the model, the exclusion restriction appears theoretically justified.
First-Stage Regression Statistics.
Note. Minimum eigenvalue statistic = 10.302 > 5.
Two-Stage Least Squares Instrumental Variable (2SLS) Regression Statistics.
p < .05. **p < .01. ***p < .001.
In the second-stage results (Table 3), predicted participation is significantly associated with reduced depression scores (β = −1.83, p = .003; 95% CI [−3.04, −0.62]), net of all covariates. This finding is consistent with Hypothesis 1, which posits that co-governance participation is associated with indicators of symbolic positioning—such as public visibility and perceived value—which in turn relate to emotional well-being in later life. The magnitude of the effect is also substantively meaningful: a 1.83-point reduction on an 11 to 33 scale represents a 10% decrease relative to the sample mean (18.22), suggesting that participation is correlated with lower depressive symptoms, particularly in contexts where symbolic support is present.
More critically, this result challenges functionalist accounts that frame active aging as a linear input-output process—where more engagement automatically produces better outcomes. Instead, it supports a symbolic-affective interpretation: participation is more likely to be associated with reduced depressive symptoms when it is perceived as culturally legible, socially endorsed, and emotionally meaningful. In this framing, co-governance is not merely a task; it is a moral stage, a discursive performance of usefulness and visibility. For older adults navigating relational fragmentation, civic inclusion may offer compensatory affirmation. Yet, as subsequent sections demonstrate, this benefit is contingent rather than automatic—dependent on institutional ratification and private recognition. In this sense, affective well-being in later life is not solely the product of behavior, but of the symbolic infrastructure that gives behavior meaning.
Moderation by Institutional Recognition
To evaluate Hypothesis 2, we test whether the psychological benefits of community co-governance depend on institutional recognition—operationalized as self-reported receipt of senior-targeted local welfare benefits. From a symbolic positioning perspective, such benefits function not only as material support but as public signals of role legitimacy. Institutional ratification affirms that civic participation is valued, morally sanctioned, and socially meaningful. In the absence of such signals, participation may feel performative, burdensome, or invisible, diminishing its capacity to foster emotional well-being.
Table 4 presents results from stratified 2SLS models. Among participants who reported receiving at least one form of local senior benefit (Group 2), community participation shows a significant negative association with depression scores (β = −1.553, p = .006), mirroring patterns observed in the full-sample model. By contrast, among those who reported receiving no policy-based recognition (Group 1), the effect becomes statistically insignificant (β = −4.683, p = .445) despite being directionally negative. The wide confidence interval and loss of significance suggest that in the absence of symbolic affirmation from the state, civic engagement lacks emotional traction.
The Moderating Effect of the Local Senior Welfare Policy.
p < .05. **p < .01. ***p < .001.
This divergence supports the symbolic alignment argument: participation alone is insufficient unless it is anchored in a broader semiotic ecology that affirms older adults’ value. Institutional cues—such as free transportation, service priority, or public visibility—do more than facilitate activity; they legitimize presence. Without such cues, participation risks becoming a hollow gesture, unable to offset emotional vulnerability. These findings suggest that the association between co-governance and depression may be contingent on the presence of symbolic recognition by the state.
Heterogeneity by Family Neglect and Abuse
To test Hypothesis 3, we examine whether the emotional effects of community co-governance participation are moderated by private symbolic fracture—specifically, exposure to familial neglect or abuse. Building on positioning theory, we argue that the affective value of public participation is contingent on cross-domain symbolic alignment. When civic engagement is coupled with moral invalidation in the family—manifested as emotional abandonment, financial exploitation, or relational disregard—the stabilizing potential of public visibility is disrupted. In such cases, participation may become symbolically dissonant: a socially endorsed role externally contradicted by intimate misrecognition.
Table 5 presents results from stratified 2SLS models across three groups. Among participants who received local senior policy support and did not report familial neglect or abuse (Group 5, N = 3,261), community participation is significantly associated with lower depressive symptoms (β = −1.595, p = .009), consistent with prior models. However, for those who received the same institutional recognition but also reported familial mistreatment (Group 4, N = 180), the effect of participation becomes statistically insignificant (β = −1.049, p = .251). This breakdown shows the fragility of symbolic coherence: when public roles are privately disavowed, the psychological benefit of participation fails to materialize. Among those without institutional support (Group 3, N = 1,180), the effect remains non-significant, reinforcing that civic involvement requires multi-level affirmation to be affectively protective.
The Heterogeneity Test Statistics Integrating Neglect and Abuse From Family Members.
p < .05. **p < .01. ***p < .001.
These findings substantiate our theoretical claim that emotional integration in later life depends on symbolic consistency across institutional and familial spheres. Participation cannot be assumed to confer benefit in isolation—it gains affective power only when embedded in a coherent matrix of public validation and private dignity. The observed pattern—where public participation is associated with fewer depressive symptoms only in the absence of private symbolic harm—may reflect the presence of psychosocial tensions that coincide with weaker emotional associations of participation. This challenges policy approaches that isolate community programs from broader care infrastructures. Instead, it points toward a relational model of aging governance—one that recognizes the home not only as a site of care but as a symbolic field central to identity coherence. Addressing emotional harm in intimate settings may be an important contextual factor in understanding the emotional salience of public engagement.
Null Effects and Robustness Checks
Several subgroup analyses yielded statistically non-significant results, particularly in conditions marked by symbolic misalignment. For instance, among participants who reported no access to local senior welfare benefits (Table 4, Group 1), community co-governance participation showed no significant association with depressive symptoms (β = −4.683, p = .445). A similar pattern emerges among those who did receive institutional policy support but simultaneously reported familial neglect or abuse (Table 5, Group 4; β = −1.049, p = .251). These null effects are not empirical failures but conceptually consistent with our theoretical model. They highlight the affective incoherence that arises when public roles are unsupported by institutional affirmation or contradicted by private disregard. In such environments, participation may not function as empowerment; instead, it risks becoming a symbolic burden—a public gesture devoid of relational or moral resonance.
To assess the robustness of our findings and rule out alternative explanations, we implemented two complementary strategies. First, we introduced a dichotomous control for childhood adversity, based on access to healthcare during early life (1 = frequent childhood illness, 0 = not). This variable serves as a proxy for long-term socioeconomic disadvantage and latent health vulnerability that could confound both participation and mental health in later life. Including this variable helps isolate the symbolic mechanisms of interest from background life-course inequalities. After its inclusion, the core participation effects remained statistically stable and directionally consistent, suggesting that observed relationships are not merely driven by unmeasured adversity in early development.
Second, we restricted the analytic sample to participants aged 75 and older, in line with the United Nations’ (2011) definition of “deep aging” societies. This age-stratified analysis serves two purposes: it sharpens external relevance for aging policy in developed contexts and tests whether the symbolic logic of alignment holds under conditions of heightened vulnerability. Results from this subsample suggest that the negative association between participation and depressive symptoms is more likely to be observed when symbolic support is also reported—through both institutional recognition and familial respect. This pattern appears consistent with the symbolic-affective mechanisms theorized here, even among the oldest old, for whom public roles may be especially fragile and familial positioning especially consequential.
Therefore, the null effects and robustness checks substantiate our central claim: the emotional impact of civic participation is not universal. Rather, it is contingent—activated only when embedded within coherent symbolic ecologies that link public action to institutional legitimacy and private dignity. Absent that alignment, participation may no longer be associated with psychological benefits in the absence of coherent symbolic conditions. This reinforces the broader insight that symbolic consistency is not peripheral to aging well—it is a structural condition for emotional coherence in later life.
Discussion
From Active Participation to Symbolic Alignment
This study reconceptualizes active aging not as a linear behavioral process, but as a symbolic alignment across public, institutional, and familial fields. Drawing on symbolic interactionism (Blumer, 1986) and positioning theory (Davies, 2023; Davies & Harré, 1990), we argue that community participation only becomes emotionally protective when it is accompanied by institutional ratification and relational affirmation. Older adults are not merely performers of civic responsibility; they are symbolic actors, whose roles acquire meaning through the recognition embedded in policy, community, and kinship. Our findings suggest that the emotional correlates of civic engagement may depend on symbolic coherence—a framework that challenges narrow behavioral paradigms of active aging (Wirth et al., 2023).
This perspective complicates prevailing policy narratives that treat participation as universally beneficial. While older adults may join community patrols or assist neighbors, such acts may remain affectively hollow if not situated within a matrix of recognition. Our findings validate this concern: participation is negatively associated with depression primarily among those who report symbolic affirmation—by the state through welfare policies and by family through non-abusive, emotionally supportive interactions. Without such affirmation, participation becomes symbolic violence (Bourdieu, 1979)—a demand for performance without recognition, a contribution extracted without moral reciprocation.
Reframing Soulful Nurturing as a Relational Infrastructure
By introducing the concept of soulful nurturing, this study extends the lexicon of symbolic interactionism into the terrain of emotional aging. Soulful nurturing refers to the relational-symbolic infrastructure through which older adults experience care, contribution, and coherence. It is neither reducible to material support nor psychological disposition, but rather emerges through the alignment of positioning across institutional and private life (Bar-Tur, 2023; Charmaz & Belgrave, 2013). Like a shared symbolic idiom (Hutchins & Hazlehurst, 2006), it structures what kinds of roles feel meaningful and what kinds of mismatches lead to distress.
Our empirical results indicate that the association between participation and emotional well-being tends to be stronger in contexts where institutional recognition and familial support are reported. However, when it is mismatched—particularly in cases of family neglect—it becomes a site of symbolic dissonance. In such settings, older adults may experience a form of internalized contradiction: outwardly performing the role of the civic elder, while privately positioned as a burden or object of resentment. This disjuncture may erode the psychological integration of their social identity, leading to depressive symptoms even amidst public visibility.
Beyond the Contributor Model: Challenging the Active Aging Imperative
This study critiques the instrumentalist turn in active aging policy, especially in contexts of limited social protection. In many policy frameworks, older adults are cast as contributors first and citizens second (Erman & Yazar, 2023; Y. Zhang, 2023). This emphasis, while aimed at empowerment, may inadvertently reinforce a Darwinian model of aging—where the right to dignity and rest is conditional on continued productivity. In such regimes, participation is no longer an option but an obligation, and retirement becomes reframed as failure.
This finding echoes Mathews (2024) and Anderson et al. (2022), who warn that such policy designs can produce identity conflicts for older adults, especially those unable or unwilling to perform these idealized roles. The expectation of active contribution, when unbalanced by structural support, may exacerbate mental health issues such as depression (Ren et al., 2022), particularly for those already experiencing emotional neglect at home. Our data show that the association between participation and emotional well-being is weaker or non-significant when institutional or familial recognition is lacking. In such contexts, participation may be perceived as symbolic labor that lacks affective return.
The Dual Role of Public Policy: Gatekeeper and Facilitator
Our results highlight the ambiguous role of public policy in shaping the emotional landscape of aging. Policies that offer visible benefits—such as transportation discounts or prioritized healthcare access—not only reduce material hardship but also function as symbols of belonging and worth (Blix & Ågotnes, 2023; Kühner & Chou, 2025). These forms of institutional positioning help convert civic participation into emotional coherence. When absent, however, participation feels unrewarded and psychologically precarious.
This dual role of policy—as both gatekeeper of legitimacy and facilitator of engagement—requires careful calibration. Overemphasis on “activating” older adults without equivalent investment in social care infrastructure may aggravate rather than alleviate geriatric depression. As our findings show, older adults embedded in families marked by neglect or abuse gain no emotional benefit from participation, even when institutional support exists. This suggests that public recognition alone cannot compensate for private symbolic fracture (Ekoh et al., 2022; Özer & Tanriverdi, 2023). Policies that ignore this dynamic risk compounding emotional harm while celebrating surface-level inclusion.
Familial Positioning and the Invisible Weight of Intimate Disregard
While much research on active aging focuses on public policy and civic engagement, our study highlights the emotional centrality of family positioning. Older adults who experience neglect, disrespect, or emotional abandonment face symbolic dissonance that undermines their public roles. In such cases, participation becomes not a protective buffer but a disorienting contradiction. The very act of being visible in the community is emotionally destabilized by being invisible at home.
This confirms insights by Baruah (2023), Quinn et al. (2023), and Pilkington et al. (2012), who emphasize that caregiving, when consistent and morally positioned, can serve as a bridge to community reengagement. Conversely, relational harm constitutes not just interpersonal trauma but a symbolic collapse—a misrecognition that disrupts the emotional ecology of aging. As positioning theory suggests, identity coherence requires consistency across fields (Davies, 2023). The failure of such consistency is not benign; it leads to internalized confusion, identity erosion, and psychological withdrawal.
Toward a Relational Ethics of Aging Policy
This study calls for a shift from behavioral activation to relational ethics in aging policy. The goal is not merely to increase participation rates or extend working years, but to synchronize symbolic infrastructures across community, policy, and household. The concept of active aging must be decoupled from moral obligation and re-anchored in symbolic legitimacy. Without this, participation can become coercive, even punitive—especially for those structurally excluded from recognition.
Policymakers face a dual imperative: to craft interventions that empower older adults to engage meaningfully, and to ensure that these roles are emotionally and relationally sustainable. This requires not only welfare expansion but also cultural shifts in how aging is narrated and recognized. As Yaghoobzadeh et al. (2023) and Sin (2012) remind us, aging is not just a biological process or labor category—it is a socially constructed positionality, shaped by narratives, norms, and structures. The future of aging policy lies not in more programs, but in more coherent symbolic environments that affirm older adults as whole persons—not merely contributors, but beings entitled to recognition, rest, and relational dignity.
Conclusions
This study investigated the conditional relationship between community co-governance participation and depressive symptoms among older adults in China, highlighting how this association is shaped by the presence or absence of symbolic recognition at both institutional and familial levels. Using nationally representative survey data and a two-stage least squares (2SLS) estimation strategy, we found that civic engagement is associated with lower levels of depression primarily among older adults who report local policy support and no experience of familial neglect. These findings raise questions about assumptions that community participation is intrinsically beneficial and reveal the need to analyze participation as a contextually situated, symbolically mediated process.
Several limitations should be acknowledged. First, the study is based on cross-sectional data, which restricts causal interpretation beyond short-term associations. Future research should explore longitudinal trajectories to assess how changes in symbolic positioning affect emotional outcomes over time. Second, while our binary measures of institutional and familial support capture key dynamics, they may overlook finer gradations of recognition or harm. Mixed-methods designs could enrich this understanding by capturing the subjective meaning-making processes that underlie symbolic affirmation or erosion. Third, while the Chinese case provides a theoretically generative context, comparative studies across welfare regimes are necessary to test the generalizability of our findings in diverse cultural and policy settings.
Looking ahead, future research might develop standardized measures of symbolic coherence in later life, explore how digital platforms mediate new forms of visibility and exclusion, or analyze how gender, migration history, and local political structures interact with symbolic positioning in shaping mental health outcomes. The broader challenge remains: to build societies where older adults’ roles are not only enacted, but recognized; not only useful, but meaningful.
Supplemental Material
sj-docx-1-sgo-10.1177_21582440261428914 – Supplemental material for Community Co-Governance, Welfare Policy, and Geriatric Depression in China: A Positioning Theory Approach
Supplemental material, sj-docx-1-sgo-10.1177_21582440261428914 for Community Co-Governance, Welfare Policy, and Geriatric Depression in China: A Positioning Theory Approach by Shuang He and Yujie Zhang in SAGE Open
Footnotes
Acknowledgements
The author would like to acknowledge the CLASS team for providing the data.
Ethical Considerations
All procedures involving human participants in the original CLASS study were approved by the Research Ethics Committee of Renmin University of China and conducted in accordance with the Declaration of Helsinki and relevant Chinese legal provisions. As this study involves only secondary analysis of anonymized data, no additional ethical review was required. The potential benefits of the research—namely, informing social policy to support older adults’ mental health—outweigh any minimal risk associated with the original data collection.
Consent to Participate
To minimize risk, no personally identifiable information was collected. Verbal informed consent was obtained from all participants after being informed of the study’s purpose, their right to withdraw, and the confidentiality of their responses. The consent process was documented by interviewers.
Author Contributions
The authors collaboratively and equally contributed to the study conceptualization, data acquisition, methodology development, data analysis, draft writing, and data interpretation.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Chongqing Municipal Social Science Planning Doctoral and Cultivation Project (Grant 2023BS080).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data Availability Statement
Supplemental Material
Supplemental material for this article is available online.
References
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