Investigating the Relationship between COVID-19 Concerns and Self-Rated Physical Health of Older Adults in the US: The Mediating Role of Social Support

Background: The COVID-19 outbreak caused health and social crises to all, particularly among older adults, who experienced worsened physical health, reduced social connectedness, and COVID-19 concerns. However, there is insufficient evidence regarding this relationship among older adults in the United States. This study examined whether social support mediates the correlation between COVID-19 pandemic-related concerns and self-rated physical health among older adults in the United States.

Methods: This study used data from the National Social Life, Health, and Aging Project (NSHAP) COVID-19 sub-study conducted in 2019-20, which collected information on the experiences of older adults during the early stages of the pandemic using web, phone, and paper surveys. The study had a sample size of 2672 participants (response rate=58%). The participants aged 50-99 years (mean=67.71), 45.7% identified as male, while the majority, comprising 54.3%, identified as female. Self-rated physical health (SRPH) was rated on a scale of five-point system, with higher scores indicating better health. Concern for the pandemic was rated on a scale of ten-point system, with higher numbers indicating greater concern. Social support level was measured using a three-point scale: “Since the start of the COVID-19 pandemic, has anyone outside your household given you advice, encouragement, moral support, or emotional support?, Yes (1), No (have not needed support, 2), and No (have not been able to get or find support, 3)”. The control variables in this study were age, gender, race/ethnicity, and marital status. A mediation analysis was employed using PROCESS Procedure from SPSS Version 4.2, employing Model 4.

Results: Results showed that concern about COVID-19 significantly predicted lower perceived social support (b = -0.0397, p < .001) and worse SRPH (b = -0.0536, p < .001). The direct effect remained significant and negative (b = -0.0536, p < .001), indicating that even after accounting for perceived social support, concern about COVID-19 has a negative impact on self-rated physical health. The indirect effect through perceived social support is significant and negative (b = -0.0045, 95% CI [-0.0078, -0.0014], p = .006), suggesting that perceived social support partially mediates the relationship between concern about COVID-19 and SRPH. Among the covariates, only marital status showed a significant negative association with perceived social support (b = -0.0318, p < .001), suggesting that unmarried individuals perceive lower social support.

Implications: This study highlighted the pressing need for comprehensive support systems for older adults during pandemics, emphasizing the pivotal role of social support in maintaining their well-being. Marital status emerged as a significant factor affecting the perceived social support. Future studies could examine the results of conducting tailored interventions that enhance social support networks. Community and home-based services must be equipped to address the unique challenges faced by older adults, ensuring their psychological resilience and overall health in times of crisis.