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

Abstract

Hidehiro Sugisawa,1 Ken Harada,2 Yoko Sugihara,3 Shizuko Yanagisawa,4 Masaya Shinmei5 1International Graduate School for Advanced Studies, J. F. Oberlin University, Machida-shi, Tokyo, Japan; 2Department of Humanities and Social Sciences, Jissen Women’s University, Shibuya-ku, Japan; 3Department of Urban Science and Policy, Tokyo Metropolitan University, Hachioji-shi, Japan; 4Department of Oral Health Science and Social Welfare, Institute of Biomedical Sciences, Tokushima University, Tokushima-shi, Japan; 5Faculty of Human Welfare, Den-En Chofu University, Kawasaki Shi, JapanCorrespondence: Hidehiro Sugisawa, International Graduate School for Advanced Studies, J. F. Oberlin University, 3758, Machida-shi, Tokyo, 194-0294, Japan, Tel/Fax [phone], Email [email protected]: 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.Methods: 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.Results: 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 p < 0.05. Psychosocial resources did not mediate significant influences of life-course and financial strain on multimorbidity.Conclusion: 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.Keywords: accumulative effects model, multiple health indicators, multiple mediation, social class, self-concept

Keywords

• accumulative effects model
• multiple health indicators
• multiple mediation
• social class
• self-concept