Exploring Depression in Older Adults Amid Crises: A Moderated Mediation Analysis Through the Lens of Conservation of Resources Theory

Objectives: This study aims to investigate how emergency prevention expenditure, types of pension insurance and making ends meet affect depression levels of older adults in the context of public health emergencies. Method: Using cross-sectional analysis based on the 2020 China Health and Retirement Longitudinal Study data, we selected 12,964 respondents and constructed a moderated mediation model. We employed multiple linear regression method to assess the mediating effect of “making ends meet” and the moderating influence of urban GDP per capita. Additionally, we tested the U-shaped relationship between emergency prevention expenditures and depression levels. Results: Advanced type of pension insurance reduces depression levels (β = −.405, p < .001). Meanwhile, there exists a U-shaped relationship between emergency prevention expenditure and depression level. Easier access to making ends meet significantly decreases residents’ depression levels (β = −1.409, p < .001) and serves as a mediating variable between emergency prevention expenditures and pension insurance types’ influence on depression. The urban GDP per capita plays a moderating role in the latter part of the mediating effect (β = 1.022, p = .002). Conclusion: We call for greater economic security for the elderly in emergencies, while encouraging them to actively purchase protective equipment around the optimal expenditure amount on an individual basis.