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Background Widowhood and solitary residence weaken companionship, monitoring, and immediate household care for older adults. In China, rapid population aging and declining family co-residence have increased the number of widowed solitary elders, yet it remains unclear whether different types of social support are differentially associated with well-being in this high-risk subgroup. This study examines the heterogeneous associations between multiple support indicators and life satisfaction among Chinese widowed solitary elders aged 60 and above. Methods Data from a nationally representative survey of Chinese older adults were analyzed for 1,007 widowed solitary elders using descriptive statistics, logistic regression, and multiple sensitivity tests. Results Overall, 38.7% of widowed solitary older adults reported high life satisfaction, indicating generally low subjective well-being within this vulnerable subgroup. ADL/IADL functional impairment was consistently negatively associated with life satisfaction. ADL/IADL assistance receipt was positively linked to high life satisfaction in the primary model (OR = 1.373, 95% CI [1.009, 1.870]), though this association was specification-sensitive. In the supplementary depressive symptom model, medical service utilization was significantly associated with reduced odds of low depressive symptoms (OR = 0.641, 95% CI [0.470, 0.874]), implying that medical service utilization mainly reflects unmet health demands and psychological vulnerability instead of effective welfare gains. It is worth noting that social participation exhibited no stable association with life satisfaction across model specifications. Institutional income security exerted a consistent protective effect, whereas the well-being benefits of cash transfers from adult children lacked stability across sensitivity analyses. Conclusion These findings indicate that different forms of social support carry heterogeneous welfare implications for widowed solitary elders. The results support targeted gerontological practice that converts service availability into concrete daily help, uses medical utilization as a risk signal for follow-up, and coordinates formal security and family support as complementary rather than interchangeable resources.
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Li et al. (2026) studied this question.
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