Ashida Toyo, Fujiwara Takeo, Kondo Katsunori
Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
SSM Popul Health. 2022 Apr 4;18:101090. doi: 10.1016/j.ssmph.2022.101090. eCollection 2022 Jun.
Older people's social integration is important for their health and well-being. However, few studies have investigated the determinants of older adults' social integration through childhood socioeconomic status (SES). This study investigated the association between childhood SES and each aspect of social integration among Japanese older people. We used data from the Japan Gerontological Evaluation Study 2010, a self-reported survey of 23,320 functionally independent people aged 65 or older across Japan (response rate: 66.3%). Childhood SES was assessed based on respondents' subjective assessment of their SES at the age of 15. Social integration was identified as participation in community groups, social networks, being homebound, and being married. We used Poisson regression analysis with robust variance to investigate the association between childhood SES and each social integration measurement, adjusted for potential mediators; namely, adult sociodemographic characteristics, health status, health behavior (smoking), living status, and personality. Lower childhood SES had long-lasting impact on the social integration of this older Japanese cohort. In the fully adjusted model, older people with lower childhood SES were less likely to participate in community groups (Non-membership sports group or club, adjusted prevalence ratio [APR]: 1.03, 95% confidence interval [CI]: 1.00-1.06; (Non-membership hobby group, APR: 1.04; 95% CI: 1.00-1.09), almost never met friends (APR: 1.17, 95% CI: 1.11-1.24), had a smaller social network (APR: 1.13; 95% CI: 1.08-1.19), and were more likely to be homebound (APR: 1.24; 95% CI: 1.05-1.45) than those with high childhood SES. Lower childhood SES negatively affected social integration in older age. Mitigating childhood poverty might be important to increase social integration in later life, thereby improving health outcomes.
老年人的社会融入对其健康和幸福至关重要。然而,很少有研究通过童年社会经济地位(SES)来调查老年人社会融入的决定因素。本研究调查了日本老年人童年SES与社会融入各方面之间的关联。我们使用了2010年日本老年学评估研究的数据,这是一项对全日本23320名65岁及以上功能独立人群的自我报告调查(回复率:66.3%)。童年SES是根据受访者对其15岁时SES的主观评估来衡量的。社会融入被定义为参与社区团体、社交网络、居家不出以及婚姻状况。我们使用稳健方差的泊松回归分析来研究童年SES与每项社会融入指标之间的关联,并对潜在中介因素进行了调整;即成人社会人口学特征、健康状况、健康行为(吸烟)、生活状况和性格。童年SES较低对这一日本老年人群体的社会融入产生了长期影响。在完全调整模型中,童年SES较低的老年人参与社区团体的可能性较小(非会员体育团体或俱乐部,调整患病率比[APR]:1.03,95%置信区间[CI]:1.00 - 1.06;非会员兴趣小组,APR:1.04;95%CI:1.00 - 1.09),几乎从不与朋友见面(APR:1.17,95%CI:1.11 - 1.24),社交网络较小(APR:1.13;95%CI:1.08 - 1.19),并且比童年SES较高的人更有可能居家不出(APR:1.24;95%CI:1.05 - 1.45)。童年SES较低对老年时的社会融入产生负面影响。减轻童年贫困对于提高晚年的社会融入可能很重要,从而改善健康状况。