Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Unit Social Epidemiology, Achterstrasse 30, D-28359, Bremen, Germany.
Health Sciences Bremen, University of Bremen, Bremen, Germany.
Int J Equity Health. 2018 Aug 16;17(1):121. doi: 10.1186/s12939-018-0840-y.
Psychosocial factors shape the health of older adults through complex inter-relating pathways. Besides socioeconomic factors, time use activities may explain gender inequality in self-reported health. This study investigated the role of work-related and social time use activities as determinants of health in old age. Specifically, we analysed whether the impact of stress in terms of time pressure on health mediated the relationship between work-related time use activities (i.e. housework and paid work) on self-reported health.
We applied structural equation models and a maximum-likelihood function to estimate the direct and indirect effects of psychosocial factors on health using pooled data from the Multinational Time Use Study on 11,168 men and 14,295 women aged 65+ from Italy, Spain, UK, France and the Netherlands.
The fit indices for the conceptual model indicated an acceptable fit for both men and women. The results showed that socioeconomic status (SES), demographic factors, stress and work-related time use activities after retirement had a significant direct influence on self-reported health among the elderly, but the magnitude of the effects varied by gender. Social activities had a positive impact on self-reported health but had no significant impact on stress among older men and women. The indirect standardized effects of work-related activities on self-reported health was statistically significant for housework (β = - 0.006; P < 0.001 among men and β = - 0.008; P < 0.001 among women) and paid work (β = 0.012; P < 0.01 among men and β = 0.000; P > 0.05 among women), which implied that the paths from paid work and housework on self-reported health via stress (mediator) was very weak because their indirect effects were close to zero.
Our findings suggest that although stress in terms of time pressure has a direct negative effect on health, it does not indirectly influence the positive effects of work-related time use activities on self-reported health among elderly men and women. The results support the time availability hypothesis that the elderly may not have the same time pressure as younger adults after retirement.
社会心理因素通过复杂的相互关联途径塑造老年人的健康。除了社会经济因素外，时间利用活动可能可以解释报告健康状况的性别不平等。本研究调查了与工作相关和社会时间利用活动作为老年健康决定因素的作用。具体来说，我们分析了时间压力方面的压力对健康的影响是否在与工作相关的时间利用活动（即家务和有偿工作）对自我报告的健康之间的关系中起中介作用。
我们应用结构方程模型和最大似然函数，使用来自意大利、西班牙、英国、法国和荷兰的 65 岁以上的 11168 名男性和 14295 名女性的多国时间使用研究的汇总数据，估计社会心理因素对健康的直接和间接影响。
概念模型的拟合指标表明，该模型对男性和女性都有较好的拟合度。结果表明，社会经济地位（SES）、人口统计学因素、压力和退休后的工作相关时间利用活动对老年人的自我报告健康有显著的直接影响，但影响的大小因性别而异。社会活动对自我报告的健康有积极影响，但对老年男女的压力没有显著影响。工作相关活动对自我报告的健康的间接标准化效应在统计学上具有显著意义，家务劳动（β=-0.006；P<0.001 男性和 β=-0.008；P<0.001 女性）和有偿工作（β=0.012；P<0.01 男性和 β=0.000；P>0.05 女性），这意味着从有偿工作和家务劳动到自我报告的健康的压力（中介）的路径非常微弱，因为它们的间接效应接近于零。
我们的研究结果表明，尽管时间压力方面的压力对健康有直接的负面影响，但它并没有通过工作相关时间利用活动对老年男女自我报告的健康产生间接的积极影响。研究结果支持时间可用性假说，即老年人退休后可能没有与年轻人相同的时间压力。
