农村家庭结构变迁下慢性病老人代际健康支持困境——以南通市为例

Dilemmas of Intergenerational Health Support for Elderly People with Chronic Diseases amid Changes in Rural Family Structure—A Case Study of Nantong City

摘要: 随着城镇化与生育政策调整，农村家庭结构呈现核心化、空巢化趋势，代际居住分离加剧。以南通市农村为例，慢性病老人群体因家庭养老功能弱化，面临照料缺口、医疗衔接不畅、心理疏离、健康管理协同不足及数字鸿沟等多重代际健康支持困境。基于福利多元主义与代际交换理论视角，结合农村实际提出“数字 + 代际”协同管理、社区嵌入式服务、政策激励等优化路径，为破解农村慢性病老人健康支持难题提供参考。

Abstract: Against the backdrop of urbanization and adjustments to fertility policies, rural family structures have tended toward nuclearization and empty-nesting, accompanied by increasingly separated intergenerational residences. Taking rural areas of Nantong City as the research setting, the elderly living with chronic diseases are confronted with multiple dilemmas in intergenerational health support arising from the declining capacity of family-based elderly care. These difficulties include insufficient care provision, disjointed medical services, psychological alienation, inadequate coordination in health management, and the digital divide. From the theoretical perspectives of welfare pluralism and intergenerational exchange, this study proposes optimized approaches tailored to rural realities, such as digital-enabled intergenerational collaborative management, community-embedded services, and policy incentives. The research offers references for addressing the challenges of health support for rural elderly patients with chronic diseases.