Effect of human development on the relationship between generalised trust and health: an international cross-sectional investigation

Abstract

BackgroundA growing amount of research, primarily from Western developed countries, has suggested that generalised trust (ie, trust of others in general) is positively linked to psychological and physical health, and health behaviours. This study aimed to test if the relationship between generalised trust and health would be moderated by the level of human development among older adults in six developing countries. MethodsThe study utilised a cross-sectional dataset from the World Health Organization's “Study on global AGEing and adult health, the sixth wave”. Measures included generalised trust, and health outcomes such as self-rated health, history of illnesses (eg, angina, arthritis, asthma, cataracts, depression, hypertension, and lung disease), happiness, life satisfaction, health behaviours (physical activity, diet), and health-compromising behaviours (sedentary behaviour, cigarette and alcohol consumption). Participants were adults aged 50 years and older from China, Ghana, India, Mexico, South Africa, and Russia (35 329 adults in total; mean age 63·54 years [SD 9·76]). Hierarchical linear regression was used to test if generalised trust was related to the health outcomes, and if the strength of relationships were moderated by human development index of the countries. The regression models controlled for the effect of age, gender, and household income. FindingsConsistent with the hypothesis, generalised trust correlated positively with self-rated health (β 0·06, p<0·0001), happiness (β 0·09, p<0·0001), life satisfaction (β 0·06, p<0·0001), and quality of life (β 0·11, p<0·0001), and negatively with illnesses (ie, angina [OR 0·69, 95% CI 0·64–0·75, p<0·0001]), arthritis [0·87, 0·83–0·92, p<0·0001], asthma [0·83, 0·74–0·93, p=0·0011], cataracts [0·89, .83–0·96, p=0·0017], diabetes [0·72, 0·67–78, p<0·0001], depression [0·48, 0·42–0·55, p<0·0001], hypertension [0·71, 0·68–0·75, p<0·0001], and stroke [0·80, 0·71–0·90, p=0·0002]) and sedentary behaviour (β −0·01, p=0·0227). Significant interactions between generalised trust and human development index supported the hypothesis that the relationship between generalised trust and health outcomes was moderated by human development index. It was found that stronger relationships were observed for countries with higher human development index than countries with lower human development index. InterpretationThe findings were consistent with those from previous studies in developing countries, and found that the positive relationship between generalised trust and health could be impaired by poor level of human development. FundingNone.