Mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community

Abstract

With the growing urbanization of China, which has changed older adults’ living conditions, lifestyle, and the source of support, coupled with rapid population aging, the health status of the elderly should be paid attention to. In addition to objective indicators such as the decline of function, specific factors, such as social support, health literacy, and productive aging, also have an impact on the health outcomes of the elderly. However, the interrelationships among these factors and their potential mechanisms in the context of urbanization remain unclear. Thus, this study was the first to explore the interrelationships among social support, health literacy, productive aging, and self-rated health in older adults living in a newly urbanized community in China. We aimed to investigate the mediating effect of social support on the associations between health literacy, productive aging, and self-rated health among elderly Chinese adults in a newly urbanized community to provide reference data for future health interventions for the elderly. This cross-sectional study was conducted between June and August 2013. Questionnaires on social support, health literacy, productive aging, and self-rated health were administered to 992 elderly residents. Structural equation models were used to examine the relationships among these 4 variables. Statistical analyses were performed using IBM SPSS Statistics 21.0 and Mplus 7.0. The mean scores for social support, health literacy, productive aging, and self-rated health were 34.5 ± 5.8, 13.6 ± 4.4, 11.3 ± 3.0, and 3.4 ± 0.7, respectively. Social support was directly related to self-rated health (β=0.119, 95% confidence interval [CI]: 0.041–0.198), while productive aging and health literacy had indirect associations with self-rated health via social support (β=0.071, 95% CI: 0.054–0.216; β=0.049, 95% CI: 0.066–0.183). Both productive aging (β=0.214, 95% CI: 0.047–0.381) and health literacy had direct associations with social support (β=0.327, 95% CI: 0.175–0.479), while health literacy had a direct association with productive aging (β=0.676, 95% CI: 0.604–0.748). Productive aging mediated the relationship between health literacy and social support. Overall, improving health outcomes among older adults requires enhancement of social support, along with consideration of productive aging and health literacy.

Subjective Generic Health Literacy and Its Associated Factors among Adolescents: Results of a Population-Based Online Survey in Germany

“…Besides self-efficacy, social support also tends to have mediating effects between health literacy and health-related outcomes [ 36 ] or self-rated health [ 35 ] among adults. With regard to adolescents, the importance of social support for adolescents’ health literacy and health can be presumed.…”

“…Similar associations were found by Guo et al (2020), who compared health literacy among adolescents in Melbourne/Australia and Beijing/China in a cross-cultural comparison [ 34 ]. Social support, which can be regarded as a social factor (interpersonal), was associated with health literacy in various populations, e.g., older adults living in urban areas of China [ 35 ] or smokers with a low socio-economic status in the USA [ 36 ], but also among adolescents in Melbourne/Australia and Beijing/China [ 34 ].…”

Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information–Seeking Intentions Among Social Media Users in China: Cross-sectional Survey

“…And there has been no study to comprehensively investigate how health information with different features on social media influenced the trust in such health information. Some studies [ 39 , 40 ] have examined the role of past experience and social media use individually, and some studies [ 18 , 20 , 21 ] have tested the associations between self-efficacy and other health outcomes; however, there are few empirical studies examining the relationship among health literacy, past experience, health-related social media use, and health behavioral intention on social media.…”

Associations of Health Literacy, Social Media Use, and Self-Efficacy With Health Information–Seeking Intentions Among Social Media Users in China: Cross-sectional Survey (Preprint)

“…And there has been no study to comprehensively investigate how health information with different features on social media influenced the trust in such health information. Some studies [39,40] have examined the role of past experience and social media use individually, and some studies [18,20,21] have tested the associations between self-efficacy and other health outcomes; however, there are few empirical studies examining the relationship among health literacy, past experience, health-related social media use, and health behavioral intention on social media.…”