Climate exposure, family doctor contracting, and rehabilitation needs among older adults with physical disabilities in Jilin Province, China
Abstract
BackgroundOlder adults with physical disabilities may face greater difficulty maintaining healthcare contact and expressing their service needs under conditions of climatic stress. In China, family doctor contracting may help sustain access to routine care and rehabilitation-related support, but evidence on its role in this context remains limited.MethodsThis study links a large provincial disability service dataset from Jilin in 2020 with county-level climate indicators to examine whether exposure to unusually hot and cold conditions is associated with current rehabilitation needs among older adults with physical disabilities and whether these associations differ by family doctor contract status. The analysis includes 194,418 respondents. The logistic regression models include standardized measures of relative heat and cold days, individual-level controls, and prefecture indicators, with clustered standard errors.ResultsHigher exposure to extreme heat and extreme cold was associated with a lower likelihood of reporting current rehabilitation needs among respondents without family doctor contracts. For a one-standard deviation (SD) increase in relative heat days (14.2 days) and relative cold days (10.8 days), the respective odds ratios were 0.872 (95% CI 0.792–0.960; p = 0.005) and 0.879 (95% CI 0.790–0.978; p = 0.018), corresponding to 12.8% and 12.1% lower odds of reporting current rehabilitation needs. This pattern was weaker among respondents with family doctor contracts: the interaction ratios of odds ratios were 1.131 (95% CI 1.003–1.276; p = 0.044) for heat and 1.122 (95% CI 0.992–1.269; p = 0.067) for cold.ConclusionThe findings suggest that climate conditions may shape the expression of rehabilitation needs. Whether family doctor contracting helps maintain service contact, monitoring, and referral pathways under adverse environmental conditions requires prospective evaluation. Strengthening continuous primary care linkages may therefore be relevant to climate adaptation strategies for older adults with physical disabilities, but these cross-sectional associations do not establish clinical protection.
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BibTeX
@article{guo2026climate,
title = {{Climate exposure, family doctor contracting, and rehabilitation needs among older adults with physical disabilities in Jilin Province, China}},
author = {Dongyang Guo and Dongyu Guo and Xiaofeng Wang and Bo Hu},
journal = {Frontiers in Public Health},
year = {2026},
month = nov,
doi = {10.3389/fpubh.2026.1975197},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1975197},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Climate exposure, family doctor contracting, and rehabilitation needs among older adults with physical disabilities in Jilin Province, China
AU - Dongyang Guo
AU - Dongyu Guo
AU - Xiaofeng Wang
AU - Bo Hu
PY - 2026
DA - 2026/11/05
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1975197
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1975197
AB - BackgroundOlder adults with physical disabilities may face greater difficulty maintaining healthcare contact and expressing their service needs under conditions of climatic stress. In China, family doctor contracting may help sustain access to routine care and rehabilitation-related support, but evidence on its role in this context remains limited.MethodsThis study links a large provincial disability service dataset from Jilin in 2020 with county-level climate indicators to examine whether exposure to unusually hot and cold conditions is associated with current rehabilitation needs among older adults with physical disabilities and whether these associations differ by family doctor contract status. The analysis includes 194,418 respondents. The logistic regression models include standardized measures of relative heat and cold days, individual-level controls, and prefecture indicators, with clustered standard errors.ResultsHigher exposure to extreme heat and extreme cold was associated with a lower likelihood of reporting current rehabilitation needs among respondents without family doctor contracts. For a one-standard deviation (SD) increase in relative heat days (14.2 days) and relative cold days (10.8 days), the respective odds ratios were 0.872 (95% CI 0.792–0.960; p = 0.005) and 0.879 (95% CI 0.790–0.978; p = 0.018), corresponding to 12.8% and 12.1% lower odds of reporting current rehabilitation needs. This pattern was weaker among respondents with family doctor contracts: the interaction ratios of odds ratios were 1.131 (95% CI 1.003–1.276; p = 0.044) for heat and 1.122 (95% CI 0.992–1.269; p = 0.067) for cold.ConclusionThe findings suggest that climate conditions may shape the expression of rehabilitation needs. Whether family doctor contracting helps maintain service contact, monitoring, and referral pathways under adverse environmental conditions requires prospective evaluation. Strengthening continuous primary care linkages may therefore be relevant to climate adaptation strategies for older adults with physical disabilities, but these cross-sectional associations do not establish clinical protection.
SN - 2296-2565
ER -