The relationship between socioeconomic factors, social participation, behaviours, and healthy ageing: an analysis of longitudinal data

Abstract

To investigate the longitudinal associations between social participation, socioeconomic factors, health behaviours and Healthy Ageing (HA) among older Americans over a ten-year period. Retrospective secondary analysis using data from three waves of the Health and Retirement Study, corresponding with years (2006, 2010, 2016), a longitudinal survey of older American adults. The analysis included demographic factors (gender, age, race, marital status), and socioeconomic factors (education, total wealth and poverty-income ratio) in 2006, health behaviours (smoking, physical activity), and Body Mass Index in 2010, social participation in 2006 and HA (measured in 2010 and 2016). Healthy ageing was an aggregate variable including freedom from disability, freedom from cognitive impairment, and high physical functioning. Social participation was a dichotomous variable derived from work status, perceived neighbourhood safety, and engagement in volunteer work. Structural equation modelling (SEM) was employed to examine direct and indirect associations between these factors and HA at final follow-up. A total of 9,748 participants with complete data in the three waves were included. The mean age at baseline was 68 years. Social participation in 2006 was significantly associated with HA in 2016 (estimate: 0.09, 95% CI: 0.08, 0.11). Physical activity showed a strong positive association with HA in 2016 (estimate: 0.31, 95% CI: 0.29, 0.33). Furthermore, HA in 2010 was also a strong exposure associated with HA in 2016 (estimate: 0.46; 95% CI: 0.45–0.47). Social participation was significantly associated with HA, alongside established health behaviours such as physical activity. These findings underscore the importance of social participation as a key factor associated with HA and support the integration of social participation into public health strategies for older adults.