A ritual way of ageing well: a qualitative study of a comprehensive, culturally grounded ritual-based health programme for older adults in urban China

Abstract

Introduction Rapid population ageing, urban migration, and the weakening of multigenerational households have left many older adults in Chinese cities facing intertwined physical decline, psychological distress, social loss, and a diminished sense of purpose. Conventional responses tend to be specialized and clinical and are often experienced by older Chinese adults as fragmented, unfamiliar, or stigmatizing. Collective ritual, defined as structured group practices using culturally familiar forms, such as greeting, blessing, mutual recognition, coordinated movement, communal singing, embrace, sharing, and role-taking to cultivate connection, emotion regulation, and meaning, is an ancient and culturally embedded practice that has always addressed body, mind, emotion, relationship, and spirit together. Methods This study examined how a comprehensive, culturally grounded ritual-based health programme, “Long and Prosperous Life” (Fushoubainian), supports ageing well in urban Beijing. Using a qualitative collective case-study design, we interviewed 21 participants: one programme designer, six frontline social workers, and fourteen middle-aged and older programme participants aged 48–77 years who joined the collective rituals for at least 6 months. Interviews were supplemented by informal follow-up contacts and field engagement after 6 years. We analysed transcripts using reflexive thematic analysis informed by the psychology of ritual and of ageing. Results Five interwoven dimensions of benefit were identified: the programme rebuilt belonging and interpersonal trust through a culturally resonant idiom of fictive kinship; it reworked beliefs about ageing, illness, and the self, fostering reappraisal, optimism, and perceived control; it awakened the body, with participants reporting improved mobility, sleep, energy, and health behaviours and better management of chronic disease; it regulated emotion through synchronised movement, communal song, laughter, and embrace; and it restored meaning through contribution, leadership, and, for some, a transcendent reorientation toward gratitude and non-attachment. Crucially, these were not five separate effects but facets of a single ritual practice that integrated physical from mental, individual from collective, and health from culture. Follow-up interview themes were also summarized and reported. Discussion We argue that community ritual should be understood not as a standard mental-health intervention but as a comprehensive, low-cost, culturally congruent way of ageing well, and we offer a transferable model for psychologists, gerontologists, and programme designers.