Date of Award

5-31-2018

Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Jeffrey A. Burr

Second Advisor

Edward Alan Miller

Third Advisor

Rena R. Wing

Abstract

The majority of U.S. older adults are overweight or obese. Social relationships are a key factor linked to obesity among younger age groups, but there are no known investigations of this association among older adults. This study examined the association between quantitative and qualitative indicators of social relationships and obesity among middle-aged and older adults. Further, this study investigated psychosocial and health behavior variables as mediators and moderators of the association between social relationships and obesity as well as explored demographic differences in this relationship.

Using the 2004, 2006, and 2010 waves of the Health and Retirement Study, a series of ordinary least squared (OLS) regression models were used to examine the hypothesized association between social relationships and obesity both cross-sectionally and longitudinally. Psychosocial and health behaviors variables were sequentially added into the OLS regression models to explore the potential mediation of these variables and interaction terms were utilized to estimate their moderation effects. The sample was stratified by age, gender, and race to investigate demographic differences in the cross-sectional and longitudinal regression model analyses.

In summary, the analyses showed that only qualitative indicators of social relationships were significantly related to obesity for the full sample. Specifically, results indicated that higher positive social support and lower negative social support were associated with lower waist circumference cross-sectionally and longitudinally. Daily exercise was observed to be a full mediator of these associations and anxiety was a partial mediator; both variables also acted as moderators. Longitudinal analyses also revealed that higher positive support and lower negative support were associated with decreased self-reported BMI from 2004 to 2010. In the stratified analyses, higher loneliness was associated with lower waist circumference for those 65 and older compared to middle-aged adults and higher social participation and weekly contact with friends were associated with lower waist circumference for non-Hispanic blacks compared to non-Hispanic whites. There were generally no other significant demographic differences.

Findings from this study highlight several conceptual, programmatic, and policy implications and recommendations based upon these findings are presented. Healthcare providers are encouraged to inquire about older adults’ levels of social support and loneliness in order to achieve a more comprehensive assessment of wellness. Service providers and policymakers are encouraged to develop and fund programs that provide widespread and ample opportunities for older adults to engage socially, particularly those that incorporate or encourage physical activity and healthy eating.

Comments

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