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Development in self-rated health among older people as determinant of social relations

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark, r.lund{at}socmed.ku.dk

Kirsten Avlund

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

Jens Modvig

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

Pernille Due

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

Bjørn E. Holstein

Department of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

Aim: The purpose of this study was to analyse whether development in self-rated health (SRH) over four years was associated with the structure of and satisfaction with social relations, at four and eight years follow-up, among elderly women and men. Methods: A longitudinal questionnaire-based study was undertaken of non-institutionalized Danes, aged 70 - 95 years, with baseline in 1986. The response rate at baseline was 69%, n=1,231. First follow-up was carried out in 1990, with 91% of eligible individuals participating (n=911). Second follow-up took place in 1994, where 83% of eligible individuals participated (n=542). The association was studied between development in SRH from 1986 to 1990 and social relations in 1990 and in 1994. Results: A sustained poor SRH predicted low contact frequency OR=1.7 (1.1 - 2.6), small contact diversity OR=1.6 (1.0 - 2.6) and low contact satisfaction OR=3.4 (2.3 - 5.2) in the two-point analyses. Furthermore, a deterioration in SRH predicted poor contact satisfaction OR=2.8 (1.7 - 4.5). All analyses were adjusted for age, gender, mental health, functional ability, cohabitation status, and a measure of social relations at baseline. Results for the three-point analyses were similar to those for the two-point analyses. The associations were weaker for contact satisfaction OR=2.8 (1.7 - 4.7), but stronger for contact frequency OR=2.5 (1.4 - 4.4) and diversity OR=2.1 (1.2 - 3.6). Conclusion: Sustained poor SRH and, to some degree, deterioration in SRH were predictors of poor social relations after four and eight years.

Key Words: ageing • health deterioration • longitudinal studies • self-rated health • social support.

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