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Published in: BMC Public Health 1/2020

Open Access 01-12-2020 | Research article

Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data

Authors: Mengyun Luo, Ding Ding, Adrian Bauman, Joel Negin, Philayrath Phongsavan

Published in: BMC Public Health | Issue 1/2020

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Abstract

Background

Social engagement forms the basis of social relationships by providing a sense of belonging, social identity, and fulfillment. Previous research demonstrates that social engagement was associated with positive health behaviors among older adults. However, the results have been different across health-related behaviors, and mostly based on data from high-income countries. For example, studies from the US and UK showed that social engagement was protective against smoking, while others found social engagement encouraged more smoking in many Asian cultures. In this study, we aim to examine the association between social engagement and a range of health-related behaviors and subjective well-being among older adults in six low- to middle-income countries.

Methods

Data from the WHO Study on Global Ageing and Adult Health (SAGE Wave 1) were used. A total of 33,338 individuals aged 50 and older in China, Russia, India, Ghana, South Africa, and Mexico were included. Social engagement, tobacco use, alcohol consumption, fruit and vegetable intake, physical activity, sedentary behavior, sleep duration, depression symptoms, self-rated health status, and quality of life were assessed using established self-reported measures. Multiple logistic regression models were used to examine the relationship between social engagement and nine outcome variables, adjusting for socio-demographic characteristics.

Results

Lower levels of social engagement were positively related to physical inactivity, prolonged sitting time, unhealthy sleep duration, perceived depression, poor self-rated health, and low quality of life. However, the associations between social engagement and tobacco use, excessive drinking, and insufficient fruit and vegetable intake were mixed across countries.

Conclusion

This international study found high social engagement as a potential health-promoting factor in some low- to middle-income countries. Although the impacts of social engagement on tobacco and alcohol use and diet were complicated and culture-specific, interventions at both individual and community levels should encourage healthy lifestyles through positive social engagement.
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Literature
2.
go back to reference Litwin H. Physical activity, social network type, and depressive symptoms in late life: an analysis of data from the National Social Life, health and aging project. Aging Ment Health. 2012;16(5):608–16.PubMedPubMedCentralCrossRef Litwin H. Physical activity, social network type, and depressive symptoms in late life: an analysis of data from the National Social Life, health and aging project. Aging Ment Health. 2012;16(5):608–16.PubMedPubMedCentralCrossRef
3.
go back to reference Nelson LA, Noonan CJ, Goldberg J, Buchwald DS. Social engagement and physical and cognitive health among American Indian participants in the health and retirement study. J Cross Cult Gerontol 2013;28(4):453–3.PubMedPubMedCentralCrossRef Nelson LA, Noonan CJ, Goldberg J, Buchwald DS. Social engagement and physical and cognitive health among American Indian participants in the health and retirement study. J Cross Cult Gerontol 2013;28(4):453–3.PubMedPubMedCentralCrossRef
4.
go back to reference Aida J, Kondo K, Hirai H, Subramanian SV, Murata C, Kondo N, et al. Assessing the association between all-cause mortality and multiple aspects of individual social capital among the older Japanese. BMC Public Health. 2011;11:499.PubMedPubMedCentralCrossRef Aida J, Kondo K, Hirai H, Subramanian SV, Murata C, Kondo N, et al. Assessing the association between all-cause mortality and multiple aspects of individual social capital among the older Japanese. BMC Public Health. 2011;11:499.PubMedPubMedCentralCrossRef
5.
go back to reference Stamatakis E, Hamer M, Dunstan DW. Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol. 2011;57(3):292–9.PubMedCrossRef Stamatakis E, Hamer M, Dunstan DW. Screen-based entertainment time, all-cause mortality, and cardiovascular events: population-based study with ongoing mortality and hospital events follow-up. J Am Coll Cardiol. 2011;57(3):292–9.PubMedCrossRef
6.
go back to reference Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med. 2000;51(6):843–57.PubMedCrossRef Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci Med. 2000;51(6):843–57.PubMedCrossRef
7.
go back to reference Samuel LJ, Dennison Himmelfarb CR, Szklo M, Seeman TE, Echeverria SE, Diez Roux AV. Social engagement and chronic disease risk behaviors: the multi-ethnic study of atherosclerosis. Prev Med. 2015;71:61–6.PubMedCrossRef Samuel LJ, Dennison Himmelfarb CR, Szklo M, Seeman TE, Echeverria SE, Diez Roux AV. Social engagement and chronic disease risk behaviors: the multi-ethnic study of atherosclerosis. Prev Med. 2015;71:61–6.PubMedCrossRef
8.
go back to reference Kikuchi H, Inoue S, Fukushima N, Takamiya T, Odagiri Y, Ohya Y, et al. Social participation among older adults not engaged in full- or part-time work is associated with more physical activity and less sedentary time. Geriatr Gerontol Int. 2017;17(11):1921–7.PubMedCrossRef Kikuchi H, Inoue S, Fukushima N, Takamiya T, Odagiri Y, Ohya Y, et al. Social participation among older adults not engaged in full- or part-time work is associated with more physical activity and less sedentary time. Geriatr Gerontol Int. 2017;17(11):1921–7.PubMedCrossRef
9.
go back to reference Kawachi I, Berkman L. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, and Glymour MM, editors. Social Epidemiology. 2nd ed. London: Oxford University Press. 2014. p.174–190. Kawachi I, Berkman L. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, and Glymour MM, editors. Social Epidemiology. 2nd ed. London: Oxford University Press. 2014. p.174–190.
10.
go back to reference Van Holle V, McNaughton SA, Teychenne M, Timperio A, Van Dyck D, De Bourdeaudhuij I, et al. Social and physical environmental correlates of adults' weekend sitting time and moderating effects of retirement status and physical health. Int J Environ Res Public Health. 2014;11(9):9790–810.PubMedPubMedCentralCrossRef Van Holle V, McNaughton SA, Teychenne M, Timperio A, Van Dyck D, De Bourdeaudhuij I, et al. Social and physical environmental correlates of adults' weekend sitting time and moderating effects of retirement status and physical health. Int J Environ Res Public Health. 2014;11(9):9790–810.PubMedPubMedCentralCrossRef
11.
go back to reference Lindstrom M, Giordano GN. Changes in social capital and cigarette smoking behavior over time: a population-based panel study of temporal relationships. Nicotine Tob Res. 2016;18(11):2106–14.PubMedCrossRef Lindstrom M, Giordano GN. Changes in social capital and cigarette smoking behavior over time: a population-based panel study of temporal relationships. Nicotine Tob Res. 2016;18(11):2106–14.PubMedCrossRef
12.
go back to reference Sapag JC, Poblete FC, Eicher C, Aracena M, Caneo C, Vera G, et al. Tobacco smoking in urban neighborhoods: exploring social capital as a protective factor in Santiago. Chile Nicotine Tob Res. 2010;12(9):927–36.PubMedCrossRef Sapag JC, Poblete FC, Eicher C, Aracena M, Caneo C, Vera G, et al. Tobacco smoking in urban neighborhoods: exploring social capital as a protective factor in Santiago. Chile Nicotine Tob Res. 2010;12(9):927–36.PubMedCrossRef
13.
go back to reference Ding D, Hovell MF, Ji M, Hofstetter CR, Zheng P, Fu H, et al. Employment and social "determinants" of smoking in urbanizing China: a representative survey. Nicotine Tob Res. 2009;11(7):779–84.PubMedPubMedCentralCrossRef Ding D, Hovell MF, Ji M, Hofstetter CR, Zheng P, Fu H, et al. Employment and social "determinants" of smoking in urbanizing China: a representative survey. Nicotine Tob Res. 2009;11(7):779–84.PubMedPubMedCentralCrossRef
14.
go back to reference Dare J, Wilkinson C, Allsop S, Waters S, McHale S. Social engagement, setting and alcohol use among a sample of older Australians. Health Soc Care Community. 2014;22(5):524–32.PubMedCrossRef Dare J, Wilkinson C, Allsop S, Waters S, McHale S. Social engagement, setting and alcohol use among a sample of older Australians. Health Soc Care Community. 2014;22(5):524–32.PubMedCrossRef
15.
go back to reference Martinez P, Lien L, Landheim A, Kowal P, Clausen T. Quality of life and social engagement of alcohol abstainers and users among older adults in South Africa. BMC Public Health. 2014;14:316.PubMedPubMedCentralCrossRef Martinez P, Lien L, Landheim A, Kowal P, Clausen T. Quality of life and social engagement of alcohol abstainers and users among older adults in South Africa. BMC Public Health. 2014;14:316.PubMedPubMedCentralCrossRef
16.
go back to reference Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Lopez Ridaura R, et al. Data resource profile: the World Health Organization study on global AGEing and adult health (SAGE). Int J Epidemiol. 2012;41(6):1639–49.PubMedPubMedCentralCrossRef Kowal P, Chatterji S, Naidoo N, Biritwum R, Fan W, Lopez Ridaura R, et al. Data resource profile: the World Health Organization study on global AGEing and adult health (SAGE). Int J Epidemiol. 2012;41(6):1639–49.PubMedPubMedCentralCrossRef
17.
go back to reference World Health Organization. Diet, nutrition and the prevention of chronic diseases. Geneva: World Health Organization; 2003. World Health Organization. Diet, nutrition and the prevention of chronic diseases. Geneva: World Health Organization; 2003.
18.
go back to reference Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMedCrossRef Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health. 2009;6(6):790–804.PubMedCrossRef
19.
go back to reference World Health Organization. The STEPS instrument and support materials. Geneva: World Health Organization; 2014. World Health Organization. The STEPS instrument and support materials. Geneva: World Health Organization; 2014.
20.
go back to reference Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, et al. Daily sitting time and all-cause mortality: a meta-analysis. PLoS One. 2013;8(11):e80000.PubMedPubMedCentralCrossRef Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, et al. Daily sitting time and all-cause mortality: a meta-analysis. PLoS One. 2013;8(11):e80000.PubMedPubMedCentralCrossRef
21.
go back to reference Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.PubMedCrossRef Cappuccio FP, Cooper D, D'Elia L, Strazzullo P, Miller MA. Sleep duration predicts cardiovascular outcomes: a systematic review and meta-analysis of prospective studies. Eur Heart J. 2011;32(12):1484–92.PubMedCrossRef
22.
go back to reference Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–92.PubMedPubMedCentralCrossRef Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–92.PubMedPubMedCentralCrossRef
23.
go back to reference Anand A. Understanding depression among older adults in six low-middle income countries using WHO-SAGE survey. Behav Health. 2015;1(2):1–11. Anand A. Understanding depression among older adults in six low-middle income countries using WHO-SAGE survey. Behav Health. 2015;1(2):1–11.
24.
go back to reference da Rocha NS, Power MJ, Bushnell DM, Fleck MP. The EUROHIS-QOL 8-item index: comparative psychometric properties to its parent WHOQOL-BREF. Value Health. 2012;15(3):449–57.PubMedCrossRef da Rocha NS, Power MJ, Bushnell DM, Fleck MP. The EUROHIS-QOL 8-item index: comparative psychometric properties to its parent WHOQOL-BREF. Value Health. 2012;15(3):449–57.PubMedCrossRef
25.
go back to reference Yun EH, Kang YH, Lim MK, Oh JK, Son JM. The role of social support and social networks in smoking behavior among middle and older aged people in rural areas of South Korea: a cross-sectional study. BMC Public Health. 2010;10:78.PubMedPubMedCentralCrossRef Yun EH, Kang YH, Lim MK, Oh JK, Son JM. The role of social support and social networks in smoking behavior among middle and older aged people in rural areas of South Korea: a cross-sectional study. BMC Public Health. 2010;10:78.PubMedPubMedCentralCrossRef
26.
go back to reference Chuang YC, Chuang KY. Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan. Soc Sci Med. 2008;67(8):1321–30.PubMedCrossRef Chuang YC, Chuang KY. Gender differences in relationships between social capital and individual smoking and drinking behavior in Taiwan. Soc Sci Med. 2008;67(8):1321–30.PubMedCrossRef
27.
go back to reference Li S, Horner P, Delva J. Social capital and cigarette smoking among Latinos in the United States. Subst Abuse Rehabil. 2012(3 (Supplement 1)):83–92. Li S, Horner P, Delva J. Social capital and cigarette smoking among Latinos in the United States. Subst Abuse Rehabil. 2012(3 (Supplement 1)):83–92.
28.
go back to reference Pokhrel P, Fagan P, Cassel K, Trinidad DR, Kaholokula JK, Herzog TA. Social network characteristics, social support, and cigarette smoking among Asian/Pacific islander young adults. Am J Community Psychol. 2016;57(3–4):353–65.PubMedPubMedCentralCrossRef Pokhrel P, Fagan P, Cassel K, Trinidad DR, Kaholokula JK, Herzog TA. Social network characteristics, social support, and cigarette smoking among Asian/Pacific islander young adults. Am J Community Psychol. 2016;57(3–4):353–65.PubMedPubMedCentralCrossRef
29.
go back to reference Liu S, Zhang M, Yang L, Li Y, Wang L, Huang Z, et al. Prevalence and patterns of tobacco smoking among Chinese adult men and women: findings of the 2010 national smoking survey. J Epidemiol Community Health. 2017;71(2):154–61.PubMedCrossRef Liu S, Zhang M, Yang L, Li Y, Wang L, Huang Z, et al. Prevalence and patterns of tobacco smoking among Chinese adult men and women: findings of the 2010 national smoking survey. J Epidemiol Community Health. 2017;71(2):154–61.PubMedCrossRef
30.
go back to reference Burgess DJ, Mock J, Schillo BA, Saul JE, Phan T, Chhith Y, et al. Culture, acculturation and smoking use in Hmong, Khmer, Laotians, and Vietnamese communities in Minnesota. BMC Public Health. 2014;14:791.PubMedPubMedCentralCrossRef Burgess DJ, Mock J, Schillo BA, Saul JE, Phan T, Chhith Y, et al. Culture, acculturation and smoking use in Hmong, Khmer, Laotians, and Vietnamese communities in Minnesota. BMC Public Health. 2014;14:791.PubMedPubMedCentralCrossRef
31.
go back to reference Saw A, Paterniti D, Fung L-C, Tsoh JY, Chen MS, K. Tong E. Social environmental influences on smoking and cessation: qualitative perspectives among Chinese-speaking smokers and nonsmokers in California. J Immigr Minor Health. 2017;19(6):1404–11.PubMedPubMedCentralCrossRef Saw A, Paterniti D, Fung L-C, Tsoh JY, Chen MS, K. Tong E. Social environmental influences on smoking and cessation: qualitative perspectives among Chinese-speaking smokers and nonsmokers in California. J Immigr Minor Health. 2017;19(6):1404–11.PubMedPubMedCentralCrossRef
32.
go back to reference Mao A, Yang T, Bottorff JL, Sarbit G. Personal and social determinants sustaining smoking practices in rural China: a qualitative study. Int J Equity Health. 2014;13:12.PubMedPubMedCentralCrossRef Mao A, Yang T, Bottorff JL, Sarbit G. Personal and social determinants sustaining smoking practices in rural China: a qualitative study. Int J Equity Health. 2014;13:12.PubMedPubMedCentralCrossRef
33.
go back to reference Ding D, Hovell MF. Cigarettes, social reinforcement, and culture: a commentary on "tobacco as a social currency: cigarette gifting and sharing in China". Nicotine Tob Res. 2012;14(3):255–7.PubMedCrossRef Ding D, Hovell MF. Cigarettes, social reinforcement, and culture: a commentary on "tobacco as a social currency: cigarette gifting and sharing in China". Nicotine Tob Res. 2012;14(3):255–7.PubMedCrossRef
34.
go back to reference World Health Organization. Global status report on alcohol and health. Geneva: World Health Organization; 2014. World Health Organization. Global status report on alcohol and health. Geneva: World Health Organization; 2014.
35.
go back to reference Alexander F, Duff RW. Social interaction and alcohol use in retirement communities. Gerontologist. 1988;28(5):632–6.PubMedCrossRef Alexander F, Duff RW. Social interaction and alcohol use in retirement communities. Gerontologist. 1988;28(5):632–6.PubMedCrossRef
36.
go back to reference Rapacciuolo A, Perrone Filardi P, Cuomo R, Mauriello V, Quarto M, Kisslinger A, et al. The impact of social and cultural engagement and dieting on well-being and resilience in a Group of Residents in the metropolitan area of Naples. J Aging Res. 2016;2016:4768420.PubMedPubMedCentralCrossRef Rapacciuolo A, Perrone Filardi P, Cuomo R, Mauriello V, Quarto M, Kisslinger A, et al. The impact of social and cultural engagement and dieting on well-being and resilience in a Group of Residents in the metropolitan area of Naples. J Aging Res. 2016;2016:4768420.PubMedPubMedCentralCrossRef
37.
go back to reference Jones CDB, Donaldson C. Recipe for life: helping older people eat well. Edinburgh: Queen Margaret University College; 2005. Jones CDB, Donaldson C. Recipe for life: helping older people eat well. Edinburgh: Queen Margaret University College; 2005.
38.
go back to reference Holmes BA, Roberts CL. Diet quality and the influence of social and physical factors on food consumption and nutrient intake in materially deprived older people. Eur J Clin Nutr. 2011;65(4):538–45.PubMedCrossRef Holmes BA, Roberts CL. Diet quality and the influence of social and physical factors on food consumption and nutrient intake in materially deprived older people. Eur J Clin Nutr. 2011;65(4):538–45.PubMedCrossRef
39.
go back to reference Wang Z, Xiang X, Li X, He Y, Yang Y. Survey on diet and nutrition intake for customers from out-home eating in Beijing. Wei Sheng Yan Jiu. 2015;44(2):232–6 241.PubMed Wang Z, Xiang X, Li X, He Y, Yang Y. Survey on diet and nutrition intake for customers from out-home eating in Beijing. Wei Sheng Yan Jiu. 2015;44(2):232–6 241.PubMed
40.
go back to reference Llanaj E, Adany R, Lachat C, D'Haese M. Examining food intake and eating out of home patterns among university students. PLoS One. 2018;13(10):e0197874.PubMedPubMedCentralCrossRef Llanaj E, Adany R, Lachat C, D'Haese M. Examining food intake and eating out of home patterns among university students. PLoS One. 2018;13(10):e0197874.PubMedPubMedCentralCrossRef
41.
go back to reference Owen N, Sugiyama T, Eakin EE, Gardiner PA, Tremblay MS, Sallis JF. Adults' sedentary behavior determinants and interventions. Am J Prev Med. 2011;41(2):189–96.PubMedCrossRef Owen N, Sugiyama T, Eakin EE, Gardiner PA, Tremblay MS, Sallis JF. Adults' sedentary behavior determinants and interventions. Am J Prev Med. 2011;41(2):189–96.PubMedCrossRef
43.
go back to reference Win T, Yamazaki T, Kanda K, Tajima K, Sokejima S. Neighborhood social capital and sleep duration: a population based cross-sectional study in a rural Japanese town. BMC Public Health. 2018;18(1):343.PubMedPubMedCentralCrossRef Win T, Yamazaki T, Kanda K, Tajima K, Sokejima S. Neighborhood social capital and sleep duration: a population based cross-sectional study in a rural Japanese town. BMC Public Health. 2018;18(1):343.PubMedPubMedCentralCrossRef
44.
go back to reference Nieminen T, Prattala R, Martelin T, Harkanen T, Hyyppa MT, Alanen E, et al. Social capital, health behaviours and health: a population-based associational study. BMC Public Health. 2013;13:613.PubMedPubMedCentralCrossRef Nieminen T, Prattala R, Martelin T, Harkanen T, Hyyppa MT, Alanen E, et al. Social capital, health behaviours and health: a population-based associational study. BMC Public Health. 2013;13:613.PubMedPubMedCentralCrossRef
45.
go back to reference Kuck J, Pantke M, Flick U. Effects of social activation and physical mobilization on sleep in nursing home residents. Geriatr Nurs. 2014;35(6):455–61.PubMedCrossRef Kuck J, Pantke M, Flick U. Effects of social activation and physical mobilization on sleep in nursing home residents. Geriatr Nurs. 2014;35(6):455–61.PubMedCrossRef
46.
go back to reference Lei P, Xu L, Nwaru BI, Long Q, Wu Z. Social networks and health-related quality of life among Chinese old adults in urban areas: results from 4th National Household Health Survey. Public Health. 2016;131:27–39.PubMedCrossRef Lei P, Xu L, Nwaru BI, Long Q, Wu Z. Social networks and health-related quality of life among Chinese old adults in urban areas: results from 4th National Household Health Survey. Public Health. 2016;131:27–39.PubMedCrossRef
47.
go back to reference Rafnsson SB, Shankar A, Steptoe A. Longitudinal influences of social network characteristics on subjective well-being of older adults: findings from the ELSA study. J Aging Health. 2015;27(5):919–34.PubMedCrossRef Rafnsson SB, Shankar A, Steptoe A. Longitudinal influences of social network characteristics on subjective well-being of older adults: findings from the ELSA study. J Aging Health. 2015;27(5):919–34.PubMedCrossRef
48.
go back to reference Litwin H, Shiovitz-Ezra S. Social network type and subjective well-being in a national sample of older Americans. Gerontologist. 2011;51(3):379–88.PubMedCrossRef Litwin H, Shiovitz-Ezra S. Social network type and subjective well-being in a national sample of older Americans. Gerontologist. 2011;51(3):379–88.PubMedCrossRef
49.
go back to reference Takagi D, Kondo K, Kawachi I. Social participation and mental health: moderating effects of gender, social role and rurality. BMC Public Health. 2013;13:701.PubMedPubMedCentralCrossRef Takagi D, Kondo K, Kawachi I. Social participation and mental health: moderating effects of gender, social role and rurality. BMC Public Health. 2013;13:701.PubMedPubMedCentralCrossRef
Metadata
Title
Social engagement pattern, health behaviors and subjective well-being of older adults: an international perspective using WHO-SAGE survey data
Authors
Mengyun Luo
Ding Ding
Adrian Bauman
Joel Negin
Philayrath Phongsavan
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2020
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-7841-7

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