Friday, January 13, 2012: 10:30 AM
Farragut Square (Grand Hyatt Washington)
* noted as presenting author
Background: Social support has been considered as an important determinant of health among older adults. Self-rated health (SRH) is one of the most commonly used measurements of health status. Social support, both received and given, has been shown to have direct impacts on SRH. However, the few studies that have investigated the relationship between social support and SRH in Chinese contexts were conducted predominantly in urban areas with a cross-sectional design, incapable of detecting individual changes over time and failed to reveal the dynamic relationship between instrumental support and SRH. Objectives: This paper aims to examine how changes in instrumental support, both received and provided, affect SRH over time in rural China. With the application of bivariate latent change score structural equation modeling, the current study is able to present the dynamic interplay between each dimension of instrumental support and SRH. Methods: Data used in this study came from the 2001, 2003, 2006 and 2009 waves of a longitudinal study entitled “The Well-being of Older People in Anhui Province”, collected jointly by the Schools of Gerontology and Social Work at the University of Southern California and the Population Research Institute of Xi'an Jiaotong University, China. Older adults aged 60 and above resided in the rural region of Chaohu, Anhui Province were randomly selected using stratified multi-stage sampling method. There initially were 1,696 respondents participated and 731of them were successfully followed up over 8-year period. SRH was assessed by a single question “how do you think about your health status?” on a 4-point scale and higher value means worse health. Respondents were asked to report frequencies of instrumental support received from and provided to 9 sources of people (e.g., siblings, sons, daughters, daughters-in-law, sons-in-law, grandchildren) on a 5-point scale (0= “none”, 1= “seldom”, 2= “several times per month”, 3= “at least once per week”, 4= “every day”). A summated score, with a range from 0 to 36, was calculated for each dimension of instrumental support, that is, household chore help received, personal care received, household chore help given, and personal care given, respectively. Four bivariate latent change score models for each dimension of instrumental support and SRH using MPlus 5.1 were conducted separately. Maximum likelihood estimation was used to deal with missing data. Results: Household chore help received was found to be the leading indicator of SRH over time (χ2/df=96.627/23, p=0.000; CFI=0.906; RMSEA=0.043) and similar pattern was also true for personal care received (χ2/df=65.859/23, p=0.000; CFI=0.940; RMSEA=0.033). Personal care provided to others turned out to be the leading indicator of SRH over time (χ2/df=60.498/23, p=0.000; CFI=0.951; RMSEA=0.031) and this pattern also held for household chore help provided to others (χ2/df=50.673/23, p=0.001; CFI=0.973; RMSEA=0.027). Conclusions and Implications: These findings suggest that coupling effects from instrumental support, both received and given, to SRH exist among the older adults in rural China. Interventions should focus on encouraging and maintaining instrumental support, both received and given, among older adults in order to improve health outcomes.
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