The Impact of Living Alone on the Relationship Between Social Resources and Physical and Psychological Well-being in the Elderly. Joan M.

Transcription

1 The Impact of Living Alone on the Relationship Between Social Resources and Physical and Psychological Well-being in the Elderly by Joan M. Bennett A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Health Behavior and Health Education) In The University of Michigan 2009 Doctoral Committee: Professor Neal M. Krause, Chair Professor Cathleen M. Connell Professor Ruth E. Dunkle Professor Arline T. Geronimus

2 Joan M. Bennett 2009

3 Dedication This dissertation is dedicated to my family, especially my parents Clarence Henry Bennett and Margaret Thelma Bennett. Whether family by birth or family by my own choosing, you know who you are and how valuable to me your love and support have been and will continue to be throughout my life. It is also dedicated to the many friends I had along the way who did not allow me to take the easy way out, but helped me battle to finish the task. I will not try to list my family and friends by name in fear I may leave someone out. You know who you are. ii

4 Acknowledgements I would like to acknowledge the support and expertise provided to me by my dissertation committee: Neal Krause, Cathleen Connell, Ruth Dunkle, and Arline Geronimus. I wish to acknowledge the overall support of the Health Behavior Health Management faculty whose persistence of support enabled the completion of this dissertation despite my many health complications. There are insufficient words to express my gratefulness to my mentor of 24 years, Jersey Liang. Needless to say, his support continues to mean the world to me. I would also like to thank my friend Renee Lawrence who, amongst many other things, opened my eyes to the study of aging. Finally, thanks are due to Dr. Robert Winfield without whom I may have never survived to see this day. iii

5 Table of Contents Dedication...ii Acknowledgement...iii List of Tables...vi List of Figures...viii Chapter 1. Introduction...1 Methods...4 Analysis Strategies/Issues...6 Preliminary Analyses...8 Summary Social Resources and Well-being in the Elderly: Are the Relationships the Same for Those Living Alone and Living with Others?...10 Model Specifications...22 Methods...27 Results...35 Discussion The Interaction of Living Alone and Social Resources: How Does it Effect Well-being in the Elderly Over Time?...66 Methods...69 Results...77 iv

6 Discussion The Impact of Socioeconomic Status and Living Alone on Life Satisfaction Trajectories among the Elderly...96 Methods Results Discussion Conclusion Next Steps Limitations Summary Bibliography v

7 List of Tables Tables 2.1. Selected Descriptive Statistics for Those Living With Others and Those Living Alone Nested Model Tests Standardized Factor Loadings (λy's) and Measurement Errors (θε's) for the Endogenous Factors (η's): Well-Being Relationships Between Social Relations and Well-Being Pooled Sample (N=1,103) Goodness-of-Fit Measures for Tests of Nested Models Standardized Factor Loadings (λy's) and Measurement Errors (θε's) for the Endogenous Factors (η's): Self-Rated Poor Health Relationships Between Social Relations and Self-Rated Poor Health Pooled Sample (N=1,103) Goodness-of-Fit Measures for Tests of Nested Models: Self-Rated Poor Health Descriptive Statistics for Items in the Analyses Odds Ratio=s (OR) for Multinomial Logistic Regression Analysis of Attrition (N=1103) Regression Coefficients for OLS Hierarchical Regressions Predicting Wave 2 Life Satisfaction (N=605) Regression Coefficients for Hierarchical OLS Regressions Predicting Wave 2 CESD (N=605) Regression Coefficients for OLS Hierarchical Regressions Predicting vi

8 Wave 2 Functional Status (N=605) Regression Coefficients for OLS Hierarchical Regressions Predicting Wave 2 Self-Rated Health (N=605) Regression Coefficients for OLS Hierarchical Regressions Predicting Wave 2 Serious Health Conditions (N=605) Regression Coefficients for OLS Hierarchical Regressions Predicting Wave 2 Chronic Health Conditions (N=605) Descriptive Statistics for Study Variables Linear and Quadratic Unconditional Models Coefficient Estimates Hierarchical Models 1, 2 and Estimates of Life Satisfaction Associated with Figure Estimates of Life Satisfaction Associated with Figure Estimates of Life Satisfaction Associated with Figure vii

9 List of Figures Figures 2.1 A Model of Social Relations and Psychological Well-Being A Model of Social Relations and Self-Rated Poor Health Life Satisfaction by living Arrangement Living Alone by Education Living Alone by Age viii