Health and wellbeing of older adults in the United States and Japan: A comparative study

The global population is projected to reach 9.1 billion in 2050 due to an increase in the number of older adults. Older adults are living longer; however, life expectancy values vary by country. While a country’s degree of economic development is a contributor to the health of its national population, life expectancy varies among economically developed countries as well. Social engagement has been studied as a factor contributing to longevity and the health of older adults. According to the convoy model of social relations, family members begin to play an increasingly integral role in the lives of older adults as they age. Literature has demonstrated preventive benefits of family engagement for the physical, psychological, and cognitive health of older adults. However, family engagement has also been linked to low health among older adults as a means of accommodating functional decline. Cultural values and attitudes have been shown to influence family engagement behaviors as well in both individualist and collectivist nations.

This study examined the association of family engagement and self-rated health status (SHS) of older adults (ages 50 to 75 years) in the United State and Japan through a secondary cross-sectional analysis of the 2008 wave of the Health and Retirement Study and the 2007 Japanese Study of Aging and Retirement. Logistic regression found SHS, frequency of family engagement, and proximity of children’s residence to be significantly associated with the survey country. In the combined sample, family contact of at least once a week (OR: 1.9, 95% CI: 1.0-3.5), residence within 10 miles of their children (OR: 0.8, 95% CI: 0.7-1.0), and residence with children (OR: 0.6, 95% CI: 0.5-0.7) were significantly associated with SHS, even after controlling for age, gender, ethnicity, marital status, income, and comorbidities. Future research may consider a longitudinal analysis to observe whether family engagement demonstrates protective factors for maintaining high SHS over time. While these national surveys had been modeled after each other, increasing alignment of survey instruments for improved equivalence and comparability would strengthen the internal and external validity of findings.