Digital Literacy and Self-Rated Health in China: Dual Pathways Through Information Accessibility and Mental Health

Background: Digital literacy is increasingly recognized as a key determinant of health, yet the mechanisms linking it to self-rated health in transitional economies like China remain underexplored. This study examines how digital literacy influences self-rated health, directly and indirectly through mental health, while exploring heterogeneity across age and gender groups. Methods: Using data from the 2023 Chinese General Social Survey (n=8,039 adults aged 18 and above), we constructed a multidimensional digital literacy index via entropy weighting and the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), integrating dimensions of digital access, usage, and entertainment. Structural equation modeling (SEM) and multi-group analyses were employed to test relationships, controlling for gender, age, and education. Model fit was assessed using RMSEA, CFI, and other indices; robustness was verified through alternative specifications, sensitivity checks, and outlier trimming. Results: Digital literacy had a significant positive effect on self-rated health (β=0.115, p<0.001), comprising a direct effect (β=0.076, p<0.001) and an indirect effect via mental health (β=0.039, p<0.001; mediation proportion=33.9%). Multi-group SEM revealed heterogeneity: effects were strongest in young and middle-aged females (β=0.141-0.143, p<0.001) and weaker in older adults (eg, β=0.050 for females >60, p<0.01). Mental health mediated more strongly in older groups (β=0.500, p<0.001). The model explained 38.5% of variance in self-rated health. Conclusion: Digital literacy positively influences self-rated health by enhancing resource access and mental well-being, with pronounced benefits for younger and female populations. Policymakers should prioritize age-appropriate digital literacy initiatives with psychological support to reduce disparities, aligning with China's "Healthy China 2030" and "Digital China" strategies.