Population aging challenges global health systems. Drawing on China's intergenerational support tradition, this study examines multi-dimensional support effects on self-rated health (SRH) and urban-rural heterogeneity. Using 2021 survey data of 4,919 adults aged 65+ in Guangxi, multinomial logistic regression reveals non-linear patterns: high financial, instrumental, and emotional support significantly reduce health risks for older adults with poor SRH. For those with average SRH, moderate financial support improves health while high emotional support shows negative association, suggesting a "support paradox." Urban-rural analysis indicates urban elders benefit more from economic and instrumental support, whereas rural elders respond more positively to emotional support. Co-residence shows no significant moderating effect except a marginal positive interaction with low financial support in rural areas. Findings suggest emotional support constitutes a core health element, particularly in rural contexts. Policy implications include differentiated urban-rural strategies, optimizing co-residence arrangements, and leveraging digital channels to supplement support.
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