Mediators of Life-Course and Late-Life Financial Strain on Late-Life Health in Japan: Based on a Cross-Sectional Survey

• Published in: Journal of multidisciplinary healthcare Vol. 15; pp. 883 - 896
• Main Authors: Sugisawa, Hidehiro, Harada, Ken, Sugihara, Yoko, Yanagisawa, Shizuko, Shinmei, Masaya
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 30.04.2022; Dove; Dove Medical Press
• Subjects: accumulative effects model; Insurance industry; Mediation; multiple health indicators; multiple mediation; Original Research; self-concept; Social aspects; social class; Social networks; Surveys; East Asia; Japan; multiple health indicators; accumulative effects model; self-concept; multiple mediation; social class
• ISSN: 1178-2390; 1178-2390
• DOI: 10.2147/jmdh.s356760

Few studies have examined together the psychosocial mediators of how life-course and late-life socioeconomic status (SES) influence late-life health. This study explored psychosocial mediators of influences of not only life-course but also late-life financial strain on late-life health in Japan, using a cross-sectional survey. It was hypothesized that: 1) both life-course and late-life financial strain will influence late-life health through common mediators, and 2) such mediating influences will be large on health indicators strongly related to psychosocial resources, such as depressive tendencies and self-rated health. The participants (N = 739) were aged 65 years and older and lived in metropolitan Tokyo, Japan. Life-course financial strain was measured retrospectively by the number of financially strenuous experiences over the participants' life-courses. Possible mediators included stressors (life-course and late-life major traumatic life events) and psychosocial resources (self-esteem, sense of control, health literacy, social networks, and social support). Health indicators included multimorbidity, disabled activities of daily living (ADL), depressive tendency, and poorer self-rated health. Having a sense of control mediated the significant influences of both life-course and late-life financial strain on disabled ADL. Furthermore, self-esteem significantly mediated the influences of both life-course and late-life financial strain on depressive tendencies and poorer self-rated health. All such mediating influences were significant at < 0.05. Psychosocial resources did not mediate significant influences of life-course and financial strain on multimorbidity. The results support our hypotheses and make three main contributions on the mechanism through which SES influences late-life health: 1) psychosocial resources mediate the effect of life-course SES on late-life health; 2) the influence differs depending on health type; and 3) these results can generalize to older adults in not only Japan but also Western countries.