Social determinants of health resilience among the elderly: evidence from the German Socio-Economic Panel

Andreas Mergenthaler, Federal Institute for Population Research, Germany

The objective of the study is to examine whether distinct forms of health lifestyles as well as individual and collective social capital predict the probability of health resilience among a cohort of men and women aged 65 and older from lower social strata. The method employed a longitudinal study design based on data from four waves (2002 to 2008) of the German Socio-Economic Panel. The study cohort included 2,075 participants. Analyses were performed using hierarchical-linear models and binary logistic regressions. The two main outcome measures were health-related quality of life, based on a modified form of the SF12, and a dichotomised measure for health resilience based on the SF12 scores. A health gradient was observed for the physical health of men and for the mental health women, respectively, with participants from lower social strata reporting lesser scores of health-related quality of life compared to participants with higher socioeconomic status. Regarding the physical resilience of elderly men, a moderate health-conscious lifestyle was the most pronounced predictor (OR=9.5, 95%-CI: 5.9-15.4). Compared to men with a health-risk lifestyle, even the group with a moderate health-risk lifestyle had 4.7 (95%-CI: 3.1-7.1) times the odds of being physically resilient. Social capital did not elevate the probability of physical resilience among men. Mental resilience of women was strongly associated with a health-conscious lifestyle (OR=4.2, 95%-CI: 3.0-5.9) as well as a moderate health-risk lifestyle (OR=4.1, 95%-CI: 2.9-6.0). Quantitative aspects of social capital, like an above-average number of friends and close relatives, were positively associated with mental resilience of elderly women (OR=1.9, 95%-CI: 1.5-2.5 and OR=1.3, 95%-CI: 1.0-1.7, respectively). The data provides evidence that health-conscious as well as moderate health-risk lifestyles and quantitative aspects of individual social capital serve as protective factors for health resilience among older men and women with low socioeconomic status.