Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Medical Sociology and Rehabilitation Science, Charitéplatz 1, 10117 Berlin, Germany.
Social Policy Groups, Hertie School, Friedrichstrasse 180, 10117 Berlin, Germany.
Int J Environ Res Public Health. 2022 Sep 19;19(18):11840. doi: 10.3390/ijerph191811840.
Family characteristics are associated with individuals' health and wellbeing. However, the link between family structure (e.g., operationalized via marital status) and health outcomes is ambiguous, and whether family climate mediates the relationship is unclear. This study uses the Biobehavioral Family Model (BBFM) to investigate the association of older adults' family structure with later health, the mediating role of family climate and mental health and how these links vary by socioeconomic status (SES). Using data from = 29,457 respondents aged over 50 in Waves 4, 5 and 6 (2011, 2013 and 2015) of the Survey of Health, Retirement and Ageing in Europe (SHARE), the BBFM was applied in a longitudinal mediation analysis of family structure and health, including both indicators of mental and physical health. Structural equation modeling was applied, and a multigroup analysis was performed to test the role of SES in a moderated mediation. Family climate and mental health mediated the relationship between family structure and subsequent physical health. Good levels of family climate were found to be consistently associated with improved mental and physical health. These relationships were significantly moderated by SES, showing that the association of family climate and health was weaker for those in low SES positions. Family climate and mental health should be considered as potential mechanisms linking family structure to later physical health outcomes across time; however, these associations are diminished for those with low SES.
家庭特征与个体的健康和幸福有关。然而，家庭结构（例如，通过婚姻状况来操作化）与健康结果之间的联系并不明确，家庭氛围是否在其中起中介作用也不清楚。本研究使用生物行为家庭模型（BBFM）来研究老年人的家庭结构与后期健康之间的关联，以及家庭氛围和心理健康在其中的中介作用，以及这些关联如何因社会经济地位（SES）而变化。利用来自欧洲健康、退休和老龄化调查（SHARE）第 4、5 和 6 波（2011 年、2013 年和 2015 年）中年龄在 50 岁以上的 29457 名受访者的数据，采用纵向中介分析方法，对家庭结构和健康进行了 BBFM 分析，包括心理健康和身体健康的指标。应用结构方程模型，并进行了多组分析，以检验 SES 在调节中介中的作用。家庭氛围和心理健康在家庭结构与随后的身体健康之间起中介作用。发现良好的家庭氛围与改善的心理健康和身体健康始终相关。这些关系受到 SES 的显著调节，表明家庭氛围和健康之间的关联对于 SES 较低的人群较弱。家庭氛围和心理健康应被视为将家庭结构与后期身体健康结果联系起来的潜在机制；然而，对于 SES 较低的人群，这些关联会减弱。
