The cumulative influences of socioeconomic status on health outcomes in late adulthood: A latent growth curve analysis.

摘要

The objectives of this study were to examine (a) the cumulative influences of demographic variables as well as socioeconomic status on trajectories of physical limitations, chronic diseases, and depressive symptoms, and (b) cross-domain associations of these health problems in late adulthood. This study used the data (N = 4,374, age > 65 years) from the Health and Retirement Study (HRS), collected biennially during the period from 1998 to 2006. The results of this study indicated that SES was confounded with demographic factors, especially ethnicity/race, because most of the influences of demographic factors and ethnicity/race on health problem trajectories diminished when SES was accounted for. The results of latent growth curve analyses demonstrated long-term influences of socioeconomic status on (a) the levels (severity), and (b) the slopes (rates of change) in health problem trajectories during old adulthood. Graphical analyses revealed that the SES influences on slopes reflect (a) the diverging trajectories in physical limitations reflecting a cumulative influence of SES and (b) the persistent trajectories in depressive symptoms reflecting a parallelism in old age. In addition, the initial level of a health problem influenced the change in another health problem over time, supporting the notion of a stress-manifestation or health proliferation process over late adult years. Overall, the results showed that health problems progress over the later adulthood years as an inter-related dynamic process influenced by SES. By understanding differential influences of SES on different health outcomes in old age and the dynamic health process during this period, better health interventions and prevention programs can effectively be formulated and implemented for older adults.