Abstract
While literature attempts to explain why self-reported subjective wellbeing (SWB) generally increases with age in most high-income countries based on a social determinants of a health framework, little work attempts to explain the low levels of self-report SWB among older persons in sub-Saharan Africa. Using the 2013 Uganda Study on Global Aging and Health with 470 individuals, this research examines (i) direct and indirect effects of age on SWB through social and structural determinants, and (ii) how direct and indirect effects vary by gender. Results show a significant direct and negative effect of age on SWB (β = 0.42, p = 0.01). Six indirect paths were statistically significant and their indirect effects on wellbeing varied by gender. Providing support, education, working status, asset level, financial status and financial improvement were significantly positively associated with men’s SWB, whereas younger age, providing community support, participating in group activities, number of close friends/relatives, government assistance and all socio-economic variables were significantly positively associated with women’s SWB. Strategies to address gendered economic, social and political inequalities among and between elderly populations are urgently needed.
Highlights
As older populations increasingly comprise a larger share of the global population, countries and international organizations are seeking ways to enhance the subjective wellbeing (SWB) of older populations [1,2]
The results suggest that in old age, women derive more positive effects from participating in groups and providing community support, which may moderate some of the negative interactions between age and SWB
In the context of population aging and declining rates of subjective wellbeing in LMICs, these results demonstrate the value of applying the Commission on Social Determinants of Health (CSDH) framework to examine how socioeconomic and political contexts configure socioeconomic hierarchies that produce inequalities in old age SWB [52,56,59,60]
Summary
As older populations increasingly comprise a larger share of the global population, countries and international organizations are seeking ways to enhance the subjective wellbeing (SWB) of older populations [1,2] This growing attention is due in part to the recognition that SWB is associated with positive health outcomes, such as improved immune responses [3] and the adoption of healthy behaviors [4], as well as increased longevity [5]. Numerous studies examining the association between age and SWB in high-income contexts consistently reveal that across individuals, countries and cultures in high-income western societies, SWB generally increases with age [6,7,8] This relationship is typically depicted as a U-shape relation, whereby the highest levels of SWB are achieved during youth and old age [6,7,8]. Using Gallup World Poll data from more than 160 countries, Steptoe, Deaton and Stone found progressive reductions in wellbeing with age in former Soviet Union, Eastern
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