Social Infrastructures for Healthy Aging: The Intersection of Space, Activity, and Community Engagement in China’s Urban Neighborhoods

Population aging presents urgent challenges for global urban health, especially in China. This study examines how three types of neighborhood social infrastructures – public green spaces, gated green spaces, and neighborhood centers – affect health among older adults through physical and social activities and community engagement. Using survey data from Hangzhou, we estimated multilevel regression models. Results show that physical activity in public green spaces and social activities in both public green spaces and neighborhood centers were significantly associated with better health, while gated green spaces showed no independent effects. Higher community engagement was positively associated with health but did not moderate most activity–health relationships, except in neighborhood centers where diminishing returns were observed. Findings highlight that meaningful engagement, rather than access alone, underpins the health benefits of neighborhood environments and provide insights for developing age-friendly communities in rapidly urbanizing contexts.