Association between Productive Engagement and Subjective Health Among Older Adults with Hearing and/or Vision Impairments

Background and Purpose: Older adults can make substantial economic and social contributions to society through productive engagement, such as paid work, caregiving, and volunteering. Whereas the positive association between positive ageing and perceived health status among older adults has been well documented in previous research, work and volunteering can pose barriers for those with poor health and disabilities. Subgroups of older adults with age-related hearing and/or vision impairments or dual sensory impairment (SI), however, lack access to various activities, and unequal access to participation can results in health disparities. Similar to volunteering, participation in a faith-based community provides supportive social connections and opportunities for altruism. Since preexisting studies also suggest that the benefits of religious involvement for health may be greater for members of minority groups, we added religious service attendance, which builds social capital in faith-based communities, as a variable.

 Methods: A sample of older adults who experience age-related SI in vision and/or hearing was drawn from the National Survey on Drug Use and Health (N = 2,164). In an effort to increase the study’s power to examine productive engagement among older adults with SI, we combined three years of data in the 2015–2017 period. Perceived health status was used as an outcome variable in multivariate logistic regression. Two aspects of productive engagement, employment status and regular religious service attendance were considered. Gender, race, marital status, educational attainment, poverty, urbanization, obesity, chronic disease, hospitalization, drinking, smoking, and difficulty with mobility were used as covariates. Multivariate logistic regression analyses were used to further examine differences in subjective health status among older adults with SI with regard to productive engagement after adjusting for a comprehensive list of control variables.

Results: Nearly one-half of SI respondents were male (53.4%), married (54.5%), and reported having at least one chronic disease (48.1%). A large majority of older adults with SI were high school graduates (78.2%), White (79.8%), non-poor (89.9%), and urban residents (79.7%). The majority (64.1%) of those with SI rated their health as good. As for PE, 14.1% of respondents reported being employed full or part time, and 38.03% attended religious services every other week (25+ per year). Employed older adults with SI were more likely to perceive their health status as good as compared to their unemployed counterparts (OR = 2.46, p < .05). Religious service attendees also perceived greater health (OR = 1.59, p < .05). Among the covariates, higher educational attainment, White race, having one chronic disease, hospitalization, smoking, drinking, and mobility challenges were related to health status.

Conclusions and Implications: The findings implied the need to identify late-life engagement through work and participation in a faith-based community as major clinical social work and public health issues. Given the barriers and disincentives to the productive engagement of older adults with SI, social workers should provide cultural competent programs that promote participation in labor force and faith-based communities. More empirical research on the impact of productive engagement on physical, mental, and cognitive health status among older adults with SI is warranted.