Quality of Life Research

, Volume 22, Issue 6, pp 1371–1379 | Cite as

The role of gender in the association of social capital, social support, and economic security with self-rated health among older adults in deprived communities in Beirut

  • Hiam Chemaitelly
  • Caroline Kanaan
  • Hind Beydoun
  • Monique Chaaya
  • Mona Kanaan
  • Abla M. Sibai
Article

Abstract

Purpose

To examine gender variations in the association of self-rated health (SRH) with social capital, social support, and economic security among older adults from three deprived communities in the suburbs of metropolitan Beirut.

Methods

A population-based cross-sectional study using the Older Adult Component of the Urban Health Survey. Face-to-face interviews were conducted with 328 older men and 412 older women aged 60 years and above. SRH was assessed by a single question and treated as a dichotomous outcome, and several indicators of social capital, social support, and economic security were examined as independent variables.

Results

Women were significantly more likely to report poor SRH compared to men (37.2 vs. 25.9 %, respectively). Better social capital indicators decreased significantly the odds of poor SRH among both men (OR = 0.76, 95 % CI: 0.65–0.89) and women (OR = 0.71, 95 % CI: 0.62–0.82). Social support was strongly associated with SRH among women (OR = 0.56), but not among men (OR = 0.94). The reverse situation was observed for economic security (OR = 0.57 among men, OR = 0.80 among women).

Conclusions

In these deprived neighborhoods, social and economic factors may have gender-specific effects on the promotion of well-being among older adults, with social support being more salient to women’s SRH and economic security being more salient to men’s SRH. In health studies among older people, SRH captures not only social and physical health but also broader economic well-being.

Keywords

Economic security Lebanon Older people Self-rated health Social capital Social support 

Abbreviations

ADL

Activities of daily living

CI

Confidence interval

LP

Lebanese pounds

OR

Odds ratio

SD

Standard deviation

SRH

Self-rated health

UHS

Urban Health Survey

Notes

Acknowledgments

This study was part of a larger multidisciplinary research project on urban health sponsored by the Center for Research on Population and Health at the American University of Beirut and supported by grants from the Wellcome Trust, the Mellon Foundation, and the Ford Foundation.

References

  1. 1.
    Grundy, E., & Holt, G. (2001). The socioeconomic status of older adults: How should we measure it in studies of health inequalities? Journal of Epidemiology and Community Health, 55(12), 895–904.PubMedCrossRefGoogle Scholar
  2. 2.
    Manor, O., Matthews, S., & Power, C. (2000). Dichotomous or categorical response? Analysing self-rated health and lifetime social class. International Journal of Epidemiology, 29(1), 149–157.PubMedCrossRefGoogle Scholar
  3. 3.
    Wilkinson, R. G. (1997). Socioeconomic determinants of health. Health inequalities: Relative or absolute material standards? BMJ, 314(7080), 591–595.PubMedCrossRefGoogle Scholar
  4. 4.
    Murray, C. J. L., & Lopez, A. D. (1996). The global burden of disease: A comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard School of Public Health on behalf of the World Health Organization and the World Bank; Harvard University Press.Google Scholar
  5. 5.
    Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: a review of twenty-seven community studies. Journal of Health and Social Behavior, 38(1), 21–37.Google Scholar
  6. 6.
    Kennedy, B. P., Kawachi, I., Glass, R., & Prothrow-Stith, D. (1998). Income distribution, socioeconomic status, and self rated health in the United States: Multilevel analysis. BMJ, 317(7163), 917–921.PubMedCrossRefGoogle Scholar
  7. 7.
    Kawachi, I., Kennedy, B. P., Lochner, K., & Prothrow-Stith, D. (1997). (1997) Social capital, income inequality, and mortality. American Journal of Public Health, 87(9), 1491–1498.PubMedCrossRefGoogle Scholar
  8. 8.
    Veenstra, G. (2000). Social capital, SES and health: An individual-level analysis. Social Science and Medicine, 50(5), 619–629.PubMedCrossRefGoogle Scholar
  9. 9.
    Pollack, C. E., & von dem Knesebeck, O. (2004). Social capital and health among the aged: Comparisons between the United States and Germany. Health Place, 10(4), 383–391.PubMedCrossRefGoogle Scholar
  10. 10.
    Nummela, O., Sulander, T., Karisto, A., & Uutela, A. (2009). Self-rated health and social capital among aging people across the urban-rural dimension. International Journal of Behavioral Medicine, 16(2), 189–194.PubMedCrossRefGoogle Scholar
  11. 11.
    Nummela, O., Sulander, T., Rahkonen, O., Karisto, A., & Uutela, A. (2008). Social participation, trust and self-rated health: A study among ageing people in urban, semi-urban and rural settings. Health Place, 14(2), 243–253.PubMedCrossRefGoogle Scholar
  12. 12.
    Cheng, S. T., & Chan, A. C. (2006). Social support and self-rated health revisited: Is there a gender difference in later life? Social Science and Medicine, 63(1), 118–122.PubMedCrossRefGoogle Scholar
  13. 13.
    Lynch, J., Due, P., Muntaner, C., & Smith, G. D. (2000). Social capital–is it a good investment strategy for public health? Journal of Epidemiology and Community Health, 54(6), 404–408.PubMedCrossRefGoogle Scholar
  14. 14.
    Kondo, N., Sembajwe, G., Kawachi, I., van Dam, R. M., Subramanian, S. V., & Yamagata, Z. (2009). Income inequality, mortality, and self rated health: Meta-analysis of multilevel studies. BMJ, 339, b4471.PubMedCrossRefGoogle Scholar
  15. 15.
    Kavanagh, A. M., Bentley, R., Turrell, G., Broom, D. H., & Subramanian, S. V. (2006). Does gender modify associations between self rated health and the social and economic characteristics of local environments? Journal of Epidemiology and Community Health, 60(6), 490–495.PubMedCrossRefGoogle Scholar
  16. 16.
    Jawad, M. H., Sibai, A. M., & Chaaya, M. (2009). Stressful life events and depressive symptoms in a post-war context: Which informal support makes a difference? Journal of Cross-Cultural Gerontology, 24(1), 19–32.PubMedCrossRefGoogle Scholar
  17. 17.
    Khawaja, M., & Mowafi, M. (2006). Cultural capital and self-rated health in low income women: Evidence from the Urban Health Study, Beirut, Lebanon. Journal of Urban Health, 83(3), 444–458.PubMedCrossRefGoogle Scholar
  18. 18.
    Colletta, N. J., & Cullen, M. L. (2000). Violent conflict and the transformation of social capital: Lessons from cambodia, rwanda, guatemala, and somalia. Washington, D.C.: World Bank.Google Scholar
  19. 19.
    Harpham, T., Grant, E., & Thomas, E. (2002). Measuring social capital within health surveys: Key issues. Health Policy and Planning, 17(1), 106–111.PubMedCrossRefGoogle Scholar
  20. 20.
    McKenzie, K., Whitley, R., & Weich, S. (2002). Social capital and mental health. British Journal of Psychiatry, 181, 280–283.PubMedCrossRefGoogle Scholar
  21. 21.
    Falk, I., & Kilpatric, S. (2000). What is social capital? A study of interaction in a rural community. Sociologia Ruralis, 40(1), 87–110.CrossRefGoogle Scholar
  22. 22.
    Onyx, J., & Bullen, P. (2000). Measuring social capital in five communities. The Journal of Applied Behavioural Science, 36(1), 23–42.CrossRefGoogle Scholar
  23. 23.
    Travis, L. A., Lyness, J. M., Shields, C. G., King, D. A., & Cox, C. (2004). Social support, depression, and functional disability in older adult primary-care patients. The American Journal of Geriatric Psychiatry, 12(3), 265–271.PubMedGoogle Scholar
  24. 24.
    Katz, S., Downs, T. D., Cash, H. R., & Grotz, R. C. (1970). Progress in development of the index of ADL. Gerontologist, 10(1), 20–30.PubMedCrossRefGoogle Scholar
  25. 25.
    Rahman, M. O., & Barsky, A. J. (2003). Self-reported health among older Bangladeshis: How good a health indicator is it? Gerontologist, 43(6), 856–863.PubMedCrossRefGoogle Scholar
  26. 26.
    Kabir, Z. N., Tishelman, C., Aguero-Torres, H., Chowdhury, A. M., Winblad, B., & Hojer, B. (2003). Gender and rural-urban differences in reported health status by older people in Bangladesh. Archives of Gerontology and Geriatrics, 37(1), 77–91.PubMedCrossRefGoogle Scholar
  27. 27.
    Zimmer, Z., Natividad, J., Lin, H. S., & Chayovan, N. (2000). A cross-national examination of the determinants of self-assessed health. Journal of Health and Social Behavior, 41(4), 465–481.PubMedCrossRefGoogle Scholar
  28. 28.
    Kawachi, I., Kennedy, B. P., & Glass, R. (1999). Social capital and self-rated health: A contextual analysis. American Journal of Public Health, 89(8), 1187–1193.PubMedCrossRefGoogle Scholar
  29. 29.
    Putnam, R. D. (1993). Making democracy work. Princeton, NJ: Princeton University Press.Google Scholar
  30. 30.
    Edmondson, R. (2003). Social capital: A strategy for enhancing health? Social Science and Medicine, 57(9), 1723–1733.PubMedCrossRefGoogle Scholar
  31. 31.
    Rowe, J. W. (1997). The new gerontology. Science, 278(5337), 367.PubMedCrossRefGoogle Scholar
  32. 32.
    Adelmann, P. K. (1994). Multiple roles and psychological well-being in a national sample of older adults. Journal of Gerontology, 49(6), S277–S285.PubMedCrossRefGoogle Scholar
  33. 33.
    Mendes de Leon, C. F., Seeman, T. E., Baker, D. I., Richardson, E. D., & Tinetti, M. E. (1996). Self-efficacy, physical decline, and change in functioning in community-living elders: A prospective study. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 51(4), S183–S190.CrossRefGoogle Scholar
  34. 34.
    Cooper, H., Arber, S., Fee, L., et al. (1999). The influence of social support and social capital on health. London, UK: Health Education Authority.Google Scholar
  35. 35.
    Stansfeld, S. A., Fuhrer, R., Shipley, M. J., & Marmot, M. G. (2002). Psychological distress as a risk factor for coronary heart disease in the Whitehall II Study. International Journal of Epidemiology, 31(1), 248–255.PubMedCrossRefGoogle Scholar
  36. 36.
    Okamoto, K., & Tanaka, Y. (2004). Gender differences in the relationship between social support and subjective health among elderly persons in Japan. Preventive Medicine, 38(3), 318–322.PubMedCrossRefGoogle Scholar
  37. 37.
    Gurung, R. A., Taylor, S. E., & Seeman, T. E. (2003). Accounting for changes in social support among married older adults: Insights from the MacArthur Studies of Successful Aging. Psychology and Aging, 18(3), 487–496.PubMedCrossRefGoogle Scholar
  38. 38.
    Prus, S. G., & Gee, E. (2003). Gender differences in the influence of economic, lifestyle, and psychosocial factors on later-life health. Canadian Journal of Public Health, 94(4), 306–309.PubMedGoogle Scholar
  39. 39.
    Grundy, E., & Sloggett, A. (2003). Health inequalities in the older population: The role of personal capital, social resources and socio-economic circumstances. Social Science and Medicine, 56(5), 935–947.PubMedCrossRefGoogle Scholar
  40. 40.
    Norstrand, J. A., & Xu, Q. (2012). Social capital and health outcomes among older adults in China: The Urban-rural dimension. Gerontologist, 52(3), 325–334.PubMedCrossRefGoogle Scholar
  41. 41.
    Gele, A. A., & Harslof, I. (2010). Types of social capital resources and self-rated health among the Norwegian adult population. International Journal for Equity in Health, 9, 8.PubMedCrossRefGoogle Scholar
  42. 42.
    Janevic, T., Sripad, P., Bradley, E., & Dimitrievska, V. (2011). “There’s no kind of respect here” A qualitative study of racism and access to maternal health care among Romani women in the Balkans. International Journal for Equity in Health, 10, 53.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  • Hiam Chemaitelly
    • 1
  • Caroline Kanaan
    • 2
  • Hind Beydoun
    • 3
  • Monique Chaaya
    • 4
  • Mona Kanaan
    • 5
  • Abla M. Sibai
    • 4
  1. 1.Weill Cornell Medical College-QatarDohaQatar
  2. 2.Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  3. 3.Graduate Program in Public HealthEastern Virginia Medical SchoolNorfolkUSA
  4. 4.Department of Epidemiology and Population Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
  5. 5.Department of Health SciencesThe University of YorkHeslington, YorkUK

Personalised recommendations