Mediated Pathways From Formal Social Participation to Chronic Conditions in Older Adults

Aotearoa is an aging society which means expected increases of chronic conditions in the growing older adult population will need to be addressed. Treating multiple chronic conditions at once, also known as multimorbidity, requires more complex health solutions which place strains on health systems and individuals’ support networks. Social connectedness is a known protective factor against a variety of physical and mental health conditions. Influencing social connectedness as a preventative solution is a useful focus for policy makers because protecting from multimorbidity can save more costs and resources than treating large numbers of older adults with multimorbidity. The current thesis investigated the health-protecting role of social participation as a form of social connectedness by using volunteering and community-based social participation as operationalizations of social participation. This thesis was able to use secondary data from the Health, Work, and Retirement project provided by the Health and Aging Research Team. The HWR project is an ongoing longitudinal postal survey that started in 2006, is conducted biennially, and recruited new participants in 2009, 2014, 2016, 2018, 2020, and 2022. The current study used data from the 2018, 2020, and 2022 waves. The final sample size used in the current study was N = 4768, the sample was 55.4% female and 44.5% male, over-representative of the Māori population (42.1% of participants indicated Māori descent), predominantly in partnered relationships (71.1%), with mostly good economic living standards, and high educational qualifications. The current study conducted a longitudinal mediation analysis between social participation and multimorbidity through the potential mediators of quality of life, depressive symptoms, and loneliness. While many of the anticipated mediating pathways were not supported; this thesis found support for longitudinal mediating pathways of volunteering through quality of life on loneliness and depressive symptoms. These findings address an important gap in current literature on the relationship between volunteering and quality of life. Overall, the findings indicate that social participation in Aotearoa is associated with better mental and social health outcomes for older adults.