Faith, Culture, and Inequality: Healthcare Access Among Elderly Han Buddhist Monks in China
Keywords:
Aged Han Buddhist Monks, Healthcare Access, Religious Determinants, Socioeconomic Disparities, Monastic Communities in ChinaAbstract
Elderly Han Buddhist priests continue to be overlooked, even though China's elderly population is expanding and presents substantial obstacles to equitable healthcare access. Previous research has not sufficiently examined how religious teachings, cultural practices, and socio-economic constraints interact to shape disparities in healthcare access within monastic communities. The objective of this investigation is to examine the impact of religious, cultural, and economic factors on the healthcare disparities and access of elderly Han Buddhist clergy in China. Using a mixed approach including a quantitative survey this study found that high levels of religiosity significantly hindered access to biomedical treatment, while internal cultural support within the monastic community enhanced access to healthcare. Access to medical services was also considerably enhanced by socio-economic factors, including urban location and education level. The theoretical discourse on faith-based health behavior and social capital in healthcare is enriched by these findings, which illustrate that the ideological component of structural exclusion of religious communities is not solely economic in nature. This research offers multidimensional policy implications, including inclusive health insurance schemes, training health workers sensitive to spiritual values, and empowering monastery-based health cadres. To develop sustainable healthcare solutions that align with the religious and cultural values of elder monastic communities, a collaborative, cross-sector approach is required, involving government, NGOs, and religious institutions.
References
1. Maura, J., & Weisman de Mamani, A. (2017). Mental health disparities, treatment
engagement, and attrition among racial/ethnic minorities with severe mental illness: A
review. Journal of clinical psychology in medical settings, 24(3), 187-210.
2. Cook, B. L., Hou, S. S. Y., Lee-Tauler, S. Y., Progovac, A. M., Samson, F., & Sanchez, M.
J. (2019). A review of mental health and mental health care disparities research: 2011-
2014. Medical care research and Review, 76(6), 683-710.
3. Gordon, T., Booysen, F., & Mbonigaba, J. (2020). Socio-economic inequalities in the
multiple dimensions of access to healthcare: the case of South Africa. BMC Public
Health, 20(1), 289.
4. McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socio-economic status and
access to healthcare: interrelated drivers for healthy aging. Frontiers in public health, 8,
231.
5. Pan, S. W., Wang, Z., Wang, W., & Dong, Z. (2021). Religious affiliation and healthcare
(non) utilization in China: a nationally representative study. SN Social Sciences, 1(11),
273.
6. Gu, S., Sokolovskiy, K., Evreeva, O., & Ivleva, S. (2024). Religious beliefs shaping health
care and transforming health concepts: The case of Shanghai. Journal of religion and
health, 63(6), 4376-4396.
7. Zeng, Y., Wan, Y., Yuan, Z., & Fang, Y. (2021). Healthcare-seeking behavior among
Chinese older adults: patterns and predictive factors. International Journal of
Environmental Research and Public Health, 18(6), 2969.
8. Li, C., Chen, Z., & Khan, M. M. (2021). Bypassing primary care facilities: health-seeking
behavior of middle-aged and older adults in China. BMC Health Services
Research, 21(1), 895.
9. Miao, J., & Wu, X. (2016). Urbanization, socio-economic status and health disparity in
China. Health & place, 42, 87-95.
10. Chen, Y., Zhao, Y., & Wang, Z. (2020). The effect of religious belief on Chinese elderly
health. BMC Public Health, 20(1), 627.
11. Chen, Y., Zhao, L., & Xie, B. (2023). Living arrangements and subjective well-being of
elderly Chinese Tibetan people: the mediating role of religion. Journal of religion and
health, 62(5), 3158-3174.
12. Zhang, J., Li, D., & Gao, J. (2021). Health disparities between the rural and urban
elderly in China: a cross-sectional study. International journal of environmental
research and public health, 18(15), 8056.
13. Singh, A. (2025). Embracing Differences and Imparting Commonalities: Negotiating
Normativity and Peace through Buddhist Ideals. Journal of Social Innovation and
Knowledge, 2(1), 54-76. https://doi.org/10.1163/29502683-bja00016
14. Bahall, M. (2017). Prevalence, patterns, and perceived value of complementary and
alternative medicine among cancer patients: a cross-sectional, descriptive study. BMC
complementary and alternative medicine, 17(1), 345.
15. Dos Anjos, C. S., Borges, R. M. C., Chaves, A. C., de Souza Lima, A. C., Pereira, M. B.
M., Gasparoto, M. L., ... & Fuzita, W. H. (2020). Religion as a determining factor for
invasive care among physicians in end-of-life patients. Supportive Care in Cancer, 28(2),
525-529.
16. Chi, W. H. (2024). Ritual-based religious dissemination in Taiwan: The connection
between the religious and non-religious. Social Compass, 71(2), 251-271.
17. Nguyahambi, A. M., & Rugeiyamu, R. (2025). "It is not shrinking, NGOs need unlimited
freedom": Government Stance on the Perceived Shrinkage of Civic Space in
Tanzania. Journal of Social Innovation and Knowledge, 2(1), 77-
101. https://doi.org/10.1163/29502683-bja00013
18. Chien, S. Y., Chuang, M. C., & Chen, I. P. (2020). Why people do not attend health
screenings: factors that influence willingness to participate in health screenings for
chronic diseases. International journal of environmental research and public
health, 17(10), 3495.
19. Mhaka-Mutepfa, M., & Maundeni, T. (2019). The role of faith (spirituality/religion) in
resilience in sub-Saharan African children. The International Journal of Community
and Social Development, 1(3), 211-233.
20. Niu, G., & Zhao, G. (2018). Religion and trust in strangers among China's rural-urban
migrants. China Economic Review, 50, 265-272.
21. Qureshi, N. A., Khalil, A. A., & Alsanad, S. M. (2020). Spiritual and religious healing
practices: some reflections from the Saudi National Center for Complementary and
Alternative Medicine, Riyadh. Journal of religion and health, 59(2), 845-869.
22. Sarma, R. (2025). Traditional Health-Seeking Practices of the Mann Community in
Northeast India: An Exploratory Analysis from a Buddhist Perspective of Health and
Healing. Journal of Religion and Health, 1-15.
23. Nakash, O., Lambez, T., Cohen, M., & Nagar, M. (2019). Religiosity and barriers to
mental healthcare: A qualitative study among clients seeking community mental health
services. Mental Health, Religion & Culture, 22(5), 437-452.
24. Zhang, D., Kong, C., Zhang, M., & Kang, J. (2022). Religious belief-related factors
enhance the impact of soundscapes in Han Chinese Buddhist temples on mental
health. Frontiers in Psychology, 12, 774689.
25. Fang, M. L., Sixsmith, J., Sinclair, S., & Horst, G. (2016). A knowledge synthesis of
culturally-and spiritually-sensitive end-of-life care: findings from a scoping review. BMC
geriatrics, 16(1), 107.
26. Coombs, N. C., Campbell, D. G., & Caringi, J. (2022). A qualitative study of rural
healthcare providers' views of social, cultural, and programmatic barriers to healthcare
access. BMC Health Services Research, 22(1), 438.
27. Li, J., Shi, L., Liang, H., Ding, G., & Xu, L. (2018). Urban-rural disparities in health care
utilization among Chinese adults from 1993 to 2011. BMC Health Services
Research, 18(1), 102.
28. Shen, J., Fang, W., Zhu, Y., Ye, C., Zhu, Y., & Tao, Y. (2025). Utilization of preventative
health check-up services in China among middle-aged and older adult population:
evidence from China's 28 provinces. Frontiers in Public Health, 13, 1500018.
29. Tao, Z., & Cheng, Y. (2019). Modelling the spatial accessibility of the elderly to
healthcare services in Beijing, China. Environment and Planning B: Urban Analytics
and City Science, 46(6), 1132-1147.
30. Wu, X., & Gao, J. (2023). Active adaptation and passive dependence: A comparison of
protestant and Buddhist social services in contemporary China. Religions, 14(2), 246.
31. Zhongdi, L., Yunyu, H., Zhaoli, C., Yong, T., Jing, Y., Aiping, L., ... & Miao, J. (2017).
Application of Traditional Chinese Medicine in medical practice: a survey of community
residents in Beijing, China. Journal of Traditional Chinese Medicine, 37(2), 261-268.
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