Social Ties and Depressive Symptoms Among Middle-Aged and Older Adults in China During Emergencies: The Moderating Role of Disaster Exposure.

Background: Public health emergencies disrupt daily life and impose a heavy burden on mental health. Middle-aged and older adults are particularly vulnerable to the shocks caused by such emergencies, which may substantially increase their risk of depressive symptoms. Although social ties are closely related to mental health, little is known about how different types of social ties are associated with mental health in emergency contexts. Moreover, these associations have rarely been examined alongside broader contextual shocks. This study explores how different social ties are associated with lower depressive symptoms and examines the role of indirect disaster exposure. Methods: Data were drawn from the 2020 wave of the China Health and Retirement Longitudinal Study (CHARLS) and matched with urban cumulative confirmed cases. Using data from 15,897 respondents, we employed linear regression and bootstrap resampling to test whether life satisfaction statistically accounts for some of the associations between social ties, household financial stability, and depressive symptoms. The model also examined whether the association between life satisfaction and depressive symptoms varied with indirect disaster exposure. Results: Broader social participation (b = -0.242, p < 0.01), more positive perceived changes in intergenerational relationships (b = -0.536, p < 0.05), and better household financial stability (b = -1.637, p < 0.01) were associated with fewer depressive symptoms. Life satisfaction statistically contributed to the link between weak ties, financial instability, and depressive symptoms (b = -2.136, p < 0.01). Indirect disaster exposure strengthened the negative association between life satisfaction and depressive symptoms (b = -0.134, p < 0.01). Conclusions: During public health emergencies, depressive symptoms among middle-aged and older adults are associated not only with social ties and household financial stability, but also with the broader context of city-level disaster exposure. Depression prevention strategies need to consider both individual psychological resources and contextual disaster exposure to identify vulnerable populations and reduce mental health risk.