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Background  Health behaviours (physical activity, maintenance of a healthy diet and not smoking) are known to be beneficial to the health and well-being of chronically ill people. With China’s ageing population and increased prevalence of people with chronic diseases, the improvement of unhealthy behaviours in this population has become crucial. Although recent studies have highlighted the importance of social participation for health and quality of life (QoL) among older people, no study to date has included social participation along with more traditional health behaviours. Therefore, this study aimed to identify associations of multiple health behaviours (social participation, physical activity, maintenance of a healthy diet and not smoking) with health and QoL outcomes (including cognitive and physical function) among chronically ill older adults in China.    Methods  For this nationally representative cross-sectional study, wave 1 data from the World Health Organization’s Study on global AGEing and adult health (China) were examined. In total, 6629 community-dwelling older adults (mean age, 64.9 years) with at least one chronic disease were included. Multivariate linear regression analyses were used to evaluate associations of health behaviours with health and QoL outcomes while controlling for background characteristics.    Results  Greater social participation was associated with better QoL [β = 0.127, standard error (SE) = 0.002,  p  < 0.001], cognitive function (β = 0.154, SE = 0.033,  p  < 0.001) and physical function (β = − 0.102, SE = 0.008,  p  < 0.001). Physical activity was associated with better QoL (β = 0.091, SE = 0.015,  p  < 0.001) and physical function (β = − 0.155, SE = 0.062,  p  < 0.001). Sufficient fruit and vegetable consumption was associated with better QoL (β = 0.087, SE = 0.015,  p  < 0.001).    Conclusions  Our findings suggest that social participation is an important health behaviour for quality of life and cognitive function among chronically ill older people in China. Health promotion programmes should expand their focus to include social participation as a health behaviour, in addition to physical activity, maintenance of a healthy diet and not smoking.

Social participation is an important health behaviour for health and quality of life among chronically ill older Chinese people