Socioeconomic inequalities in resilience and vulnerability among older adults: a population-based birth cohort analysis

• Published in: International psychogeriatrics 2018-05, Vol.30 (5), p.695-703
• Main Authors: Cosco, T. D., Cooper, R., Kuh, D., Stafford, M.
• Format: Article
• Language: English
• Subjects: Adults; Age; Aging; Child & adolescent psychiatry; Cohort analysis; Cohort Studies; Data collection; Diabetes; Epidemiology; Exercise; Female; Humans; Leisure Activities; Male; Mental health; Middle Aged; Morbidity; Older people; Resilience, Psychological; Social Class; Social Support; Socioeconomic factors; Surveys and Questionnaires; Theory; Vulnerable Populations
• ISSN: 1041-6102; 1741-203X
• DOI: 10.1017/S1041610217002198

ABSTRACTBackground:Aging is associated with declines in physical capability; however, some individuals demonstrate high well-being despite this decline, i.e. they are "resilient." We examined socioeconomic position (SEP) and resilience and the influence of potentially modifiable behavioral resources, i.e. social support and leisure time physical activity (LTPA), on these relationships. Data came from the Medical Research Council National Survey of Health and Development, a nationally-representative birth cohort study. Resilience-vulnerability at age 60-64 years (n = 1,756) was operationalized as the difference between observed and expected levels of well-being, captured by the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), given the level of performance-based physical capability. SEP was assessed by father's and own social class, parental education, and intergenerational social mobility. PA and structural/functional social support were reported at ages 53 years and 60-64 years. Path analysis was used to examine mediation of SEP and resilience-vulnerability through LTPA and social support. Participants in the highest social class had scores on the resilience to vulnerability continuum that were an average of 2.3 units (β = 0.46, 95% CI 0.17, 0.75) higher than those in the lowest social class. Greater LTPA (β = 0.58, 95% CI 0.31, 0.85) and social support (β = 3.27, 95% CI 2.90, 3.63) were associated with greater resilience; LTPA partly mediated participant social class and resilience (23.4% of variance). Adult socioeconomic advantage was associated with greater resilience. Initiatives to increase LTPA may contribute to reducing socioeconomic inequalities in this form of resilience in later life.