Financial inclusion and physical health functioning among aging adults in the sub-Saharan African context: Exploring social networks and gender roles.

Razak M Gyasi,Anokye M Adam,Gilbert Kwabena Amoako,Siaw Frimpong

doi:10.1371/journal.pone.0252007

Abstract

It remains poorly understood how financial inclusion influences physical health functioning in later life in sub-Saharan African context and whether the association differs by gender and social relationships. We aim 1) to examine the associations of financial inclusion with functional impairment during older age in Ghana; and 2) to evaluate whether gender and social networks modify this association. The cross-sectional analyses are based on a sample (N = 1,201) of study participants aged 50 years and over (M = 66.5 years, SD = 11.9, 63.3% female) deriving from the 2016-2017 AgeHeaPsyWel-HeaSeeB Study. Ordinary least squares (OLS) regression analyses with interactions were performed to estimate the link between financial inclusion and functional health and how the association is modified by gender and older age social networks. The mean financial inclusion score was 1.66 (SD = 1.74) in women and 2.33 (SD = 1.82) in men whilst mean activities of daily living (ADL) score was 13.03 (SD = 4.99) and 14.85 (SD = 5.06) in women and men respectively. We found that financial inclusion was associated with decreases in ADL (total sample: β = -.548, p < .001; women: β = -.582, p < .001; men: β = -1.082 p < .001) and instrumental ADL (IADL) (total sample: β = -.359, p = .034; women: β = -.445, p = .026 but not in men). Social networks significantly moderated the association of financial inclusion with ADL such that the financially included who were embedded in a stronger constellation of social networks were 6% less likely to report ADL impairment compared to those with weaker social networks (β = -.062, p = .025). The study provides empirical evidence for a better understanding of the association between financial inclusion and physical health functioning in the context of later life social networks. Interventions for functional health through financial inclusion in sub-Saharan Africa should include improving interpersonal and social networks for older adult and also through gender lenses.

Highlights

Trends in demographic aging in sub-Saharan Africa have been massive with serious implications for family structure, social support and public health including functional status [1]
Ordinary least squares (OLS) regression analyses with interactions were performed to estimate the link between financial inclusion and functional health and how the association is modified by gender and older age social networks
We found that financial inclusion was associated with decreases in activities of daily living (ADL) and instrumental ADL (IADL)

Summary

Introduction

Trends in demographic aging in sub-Saharan Africa have been massive with serious implications for family structure, social support and public health including functional status [1]. Interventions targeted at promoting financial inclusion in later life can be innovative in contributing to functional health policy and healthy aging framework in low- and middle-income settings [5,6,7] Despite this broad knowledge base, limited research has evaluated the proximate roles of social factors about the effect of financial inclusion on functional health in sub-Saharan Africa. The Findex data show that approximately 40% of adults globally are unbanked and almost alienated from basic financial activities especially in developing countries [12] It remains poorly understood how financial inclusion influences physical health functioning in later life in sub-Saharan African context and whether the association differs by gender and social relationships. We aim 1) to examine the associations of financial inclusion with functional impairment during older age in Ghana; and 2) to evaluate whether gender and social networks modify this association

Methods

Results

Conclusion