Time spent on work-related activities, social activities and time pressure as intermediary determinants of health disparities among elderly women and men in 5 European countries: a structural equation model.
BACKGROUND
Psychosocial factors shape the health of older adults through complex inter-relating pathways. Besides socioeconomic factors, time use activities may explain gender inequality in self-reported health. This study investigated the role of work-related and social time use activities as determinants of health in old age. Specifically, we analysed whether the impact of stress in terms of time pressure on health mediated the relationship between work-related time use activities (i.e. housework and paid work) on self-reported health.


METHODS
We applied structural equation models and a maximum-likelihood function to estimate the direct and indirect effects of psychosocial factors on health using pooled data from the Multinational Time Use Study on 11,168 men and 14,295 women aged 65+ from Italy, Spain, UK, France and the Netherlands.


RESULTS
The fit indices for the conceptual model indicated an acceptable fit for both men and women. The results showed that socioeconomic status (SES), demographic factors, stress and work-related time use activities after retirement had a significant direct influence on self-reported health among the elderly, but the magnitude of the effects varied by gender. Social activities had a positive impact on self-reported health but had no significant impact on stress among older men and women. The indirect standardized effects of work-related activities on self-reported health was statistically significant for housework (β = - 0.006; P < 0.001 among men and β = - 0.008; P < 0.001 among women) and paid work (β = 0.012; P < 0.01 among men and β = 0.000; P > 0.05 among women), which implied that the paths from paid work and housework on self-reported health via stress (mediator) was very weak because their indirect effects were close to zero.


CONCLUSIONS
Our findings suggest that although stress in terms of time pressure has a direct negative effect on health, it does not indirectly influence the positive effects of work-related time use activities on self-reported health among elderly men and women. The results support the time availability hypothesis that the elderly may not have the same time pressure as younger adults after retirement.
['Adjei|Nicholas Kofi|NK|', 'Jonsson|Kenisha Russell|KR|', 'Brand|Tilman|T|']
D000368:Aged D000369:Aged, 80 and over D004651:Employment D005060:Europe D005260:Female D005602:France D054624:Health Status Disparities D006801:Humans D007558:Italy D008297:Male D009426:Netherlands D057566:Self Report D012737:Sex Factors D012919:Social Behavior D012923:Social Class D012959:Socioeconomic Factors D013030:Spain D013315:Stress, Psychological D013995:Time
Elderly Psychosocial factors Gender Self-reported health Stress Time-use activities