The relationship between social participation and self-rated health by sex and age: A cross-sectional survey

Background: Social participation contributes to better health and has been regarded as an important component of quality of life. Despite its importance, social participation significantly decreases as age advances. Social participation may vary by sex and age and, consequently, may have different influences on health by age and sex. Few studies have examined how sex and age affect individual health status in this regard. Objectives: This paper focuses on whether the association between self-rated health and social participation differs between men and women, and among age groups. Design: The study was based on cross-sectional analysis of data from the 2003 Social Statistics Survey. Settings: This survey was conducted in South Korea. Participants: The survey respondents were 59,202 Koreans aged 25 and over. The sample population comprised each household member of 33,000 sample households who were selected by multistage probability sampling of household registries based on geographic area, sex and age group. Methods: Face-to-face interviews were nationally conducted. Multiple logistic regression analysis was performed to examine factors that associated social participation with self-rated health, and the adjusted odds ratios (ORs) were presented, together with their 95% confidence intervals (CIs). The model included various individual socioeconomic characteristics, health behaviors, and morbidity variables, such as marital status, education level, housing tenure, employment status, smoking status, alcohol intake, number of restricted activity days, and bed days. Results: For both sexes, self-rated good health was strongly associated with social participation levels in all age groups. The influence of social participation increased as age advanced. Particularly among elderly women, those who had participated in more than two activities had more than twice the odds of self-rated good health of those who did not participate in any activities. Conclusions: Social participation significantly decreases as people age, however, the influence of social participation on health status increases with age. This study has shown that social participation, which is an individual psychological resource, is important for health in all age groups, notwithstanding that the effect of social participation differs by age and sex. Social participation should be a basic consideration in the field of community nursing intervention, especially for the elderly and women's health promotion. Promoting social participation by individuals may lead to better health, and may therefore be an effective strategy for enhancing health. (C) 2007 Elsevier Ltd. All rights reserved.