Health and Well-Being of Older Adults in Ghana: Social Support, Gender, and Ethnicity

Paul K. Ayernor

doi:10.3368/gs.19.1.95

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Figure 1.
Conceptual Framework Depicting the Associations between Social Support, Health, and Well-Being. (Adapted from [Uchino, 2006, p. 378].)

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Table 1.

Descriptive Statistics of Respondents

Characteristics	% of Respondents	N=5019	Characteristics	% of Respondents	N=5019
Household Financial Situation			Body Mass Index
Good	5.14	258	Underweight	15.89	797
Moderate	29.71	1,491	Normal	55.95	2,808
Bad	65.15	3,270	Overweight	18.57	932
Household Wealth Quintile			Obese	9.60	482
Lowest	19.91	999	Contacts with Social Ties
Second	19.97	1,002	Never	14.21	713
Third	20.26	1,017	Once or twice a year	17.16	861
Fourth	19.67	987	Once or twice a month	25.36	1,273
Fifth	20.19	1,013	Once or twice a week	27.71	1,391
Household Size			Daily	15.56	781
1	9.98	500	Loneliness
2–5	44.94	2,256	Yes	10.72	538
6–10	35.34	1,774	No	89.28	4,481
11+	9.74	489	Relationship Quality
Age			Satisfied	75.10	3,769
50–59 years	39.83	1,999	Neither	15.76	791
60–69 years	27.70	1,390	Dissatisfied	9.14	459
70–79 years	22.58	1,133	Confidant
80 and above years	9.89	496	Yes	78.63	3,946
			No	21.37	1,073
Sex
Male	49.76	2,497	Received Support
Female	50.24	2,522	Yes	42.05	2,110
Marital Status			No	57.95	2,909
Never married	1.61	81	Provided Support
Married/Cohabiting	55.58	2,790	Yes	52.74	1,143
Separated/Divorced	14.55	730	No	47.26	3,876
Widowed	28.26	1,418	Perceived Support
Religion			Yes	22.77	2,647
None	4.99	250	No	77.23	2,372
Christianity	68.52	3,439	Functional Difficulty
Eastern and Other	0.53	27	Severe/Extreme	14.99	752
[slam	16.18	812	Medium/Moderate	66.53	3,339
Traditional	9.79	491	None	18.48	928
Ethnicity			Self-Report Health Status
Akan	47.47	2,383	Bad	16.78	842
Ewe	6.73	338	Moderate	42.60	2,138
Ga-Adangme	10.17	510	Good	40.62	2,039
Mole-Dagbani	2.52	126	Depression
Other	33.12	1,788	No	85.16	4,274
			Yes	14.84	745
Place of Residence			Well-Being
Rural	46.76	2,311	Bad	16.78	842
Urban	50.24	2,708	Moderate	53.51	2,686
Education			Good	29.71	1,491
No education	54.98	2,760
Primary school	20.77	1,042
Secondary and above	24.25	1,217
Occupation
Professional/Managerial	7.35	369
Tech/Clerks/Service	4.17	209
Agriculture	58.06	2,914
Craft/Traders/Machine	7.85	394
operators
Unskilled/Manual	22.58	1,133
Employment Status
Yes	70.40	3,533
No	29.60	1,486

Source: SAGE (2007)

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Table 2.

Ordered Logistic Regressions for Self-Rated Physical Health

	Model 1		Model 2		Model 3
	OR	CI	OR	CI	OR	CI
Marital Status
Never married	1.00	—			1.00	—
Married/cohabiting	1.40	(0.92–2.13)			1.40	(0.92–2.13)
Separated/Divorced	1.27	(0.83–1.94)			1.29	(0.84–1.96)
Widowed	1.32	(0.87–2.00)			1.31	(0.87–1.99)
Household Size
1	1.00	—			1.00	—
2–5	0.83	(0.69–1.00)*			0.83	(0.68–0.99)*
6–10	0.77	(0.62–0.95)*			0.76	(0.61–0.95)*
11+	0.75	(0.56–0.99)*			0.74	(0.55–0.99)*
Contact with Social Ties
Never	1.00	—			1.00	—
Once or twice a year	1.46	(1.09–1.93)*			1.46	(1.09–1.95)*
Once or twice a month	1.15	(0.89–1.50)			1.15	(0.88–1.51)
Once or twice a week	1.91	(1.43–2.53)***			1.91	(1.43–2.26)***
Daily	1.81	(1.31–2.50)***			1.83	(1.32–2.54)***
Loneliness
No	1.00	—			1.00	—
Yes	0.88	(0.70–1.12)			0.89	(0.69–1.12)
Relationship Quality
Satisfied	1.00	—			1.00	—
Neither	0.46	(0.36–0.59)***			0.46	(0.36–0.59)***
Dissatisfied	0.19	(0.14–0.27)***			0.19	(0.14–0.27)***
Confidant
No	1.00				1.00	—
Yes	1.13	(0.93–1.36)			1.12	(0.92–1.36)
Received Support
No			1.00	—	1.00	—
Yes			0.92	(0.79–1.07)	0.68	(0.50–0.91)*
Perceived Support
No			1.00	—	1.00	—
Yes			1.09	(0.89–1.32)	1.04	(0.85–1.27)
Provided support
No			1.00	—	1.00	—
Yes			0.95	(0.78–1.16)	0.94	(0.75–1.21)
*SexReceived Support**
Male*Received support					1.00	—
Female*Received support					1.38	(1.05–1.81)*
*EthnicityReceived**
Akan*Received support			1.00	—
Ewe*Received support			1.04	(0.63–1.72)
Ga-Adan*Rec_support			1.30	(0.79–2.12)
Mole-Dagbani*Received			1.13	(0.54–2.38)
Other*Received support			1.03	(0.69–1.53)
*SexEthnicityRec_Support*
Women Akan Rec_support			1.00
Women EweRec_support			1.60	(0.39–6.57)
Women Ga-ARec_support			1.53	(0.55–4.26)
WomenMole-DangRec_support			0.21	(0.05–0.86)*
WomenOtherRec_support			1.75	(0.92–3.31)+
N (weighted)	4277	5017	4,277
F	35.60***	18.95***	33.12***
(df)	(47,108)	(36,107)	(62,108)

Note: All models were conditioned on the effects of age, gender, ethnicity, household quintile and financial situation, education, place of residence, occupation, living arrangement and BMI. Self-rated health is coded such that higher values indicate better health. Source: SAGE, (2007) +P<.10. *P<.05. **P<.01. ***P<.001

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Table 3.

Ordered Logistic Regressions for Self-Rated Functional Difficulty

	Model 1		Model 2		Model 3
	OR	CI	OR	CI	OR	CI
Marital Status
Never married	1.00	—			1.00	—
Married/cohabiting	1.05	(0.60–1.85)			1.06	(0.60–1.87)
Separated/Divorced	0.98	(0.54–1.78)			0.98	(0.54–1.80)
Widowed	1.03	(0.59–1.82)			1.04	(0.59–1.85)
Household Size
1	1.00	—			1.00	—
2–5	0.74	(0.54–1.01)+			0.74	(0.54–1.01)+
6–10	0.70	(0.51–0.96)*			0.68	(0.49–0.94)*
11+	0.63	(0.43–0.92)*			0.59	(0.40–1.85)**
Contacts with Social Ties
Never	1.00	—			1.00	—
Once or twice a year	1.22	(0.84–1.77)			1.27	(0.88–1.83)
Once or twice a month	0.91	(0.68–1.22)			0.93	(0.69–1.26)
Once or twice a week	0.87	(0.62–1.21)			0.87	(0.62–1.22)
Daily	1.11	(0.75–1.64)			1.15	(0.78–1.70)
Loneliness
No	1.00	—			1.00	—
Yes	1.07	(0.78–1.48)			1.05	(0.76–1.44)
Relationship Quality
Satisfied	1.00	—			1.00	—
Neither	0.57	(0.43–0.74)***			0.56	(0.43–0.73)***
Dissatisfied	0.26	(0.19–0.36)***			0.26	(0.19–0.36)***
Confidant
No	1.00	—			1.00	—
Yes	0.75	(0.63–0.97)*			0.77	(0.59–1.00)*
Received Support
No			1.00	—	1.00	—
Yes			0.94	(0.81–1.08)	0.94	(0.68–1.29)
Perceived Support
No			1.00	—	1.00	—
Yes			0.80	(0.64–0.99)*	0.78	(0.62–0.98)*
Provided Support
No			1.00	—	1.00	—
Yes			1.00	(0.82–1.22)	0.99	(0.82–1.20)
*SexReceived Support**
Male*Received support					1.00	—
Female*Received support					1.04	(0.74–1.46)
*EthnicityReceived**
Akan*Received support			1.00	—
Ewe*Received support			0.72	(0.47–1.10)
Ga-Adangme*Rec support			1.29	(0.87–1.91)
Mole-Dagbani*Rec Support			1.11	(0.50–2.48)
Other*Received support			1.05	(0.70–1.58)
*SexEthnicityRec_support*
Women Akan Rec_support			1.00
Women EweRec_support			0.78	(0.13–4.56)
Women Ga-ARec_support			0.55	(0.21–1.41)
WomenMole-DangRec_support			0.48	(0.53–4.32)
WomenOtherRec_support			0.77	(0.37–1.60)
N (weighted)	4277	5017	4277
F	34.76***	19.21***	29.04***
(df)	(47, 108)	(36,107)	(62,108)

Note: All models were conditioned on the effects of age, gender, ethnicity, household quintile and financial situation, education, place of residence, occupation, living arrangement, and BMI. Functional difficulty is coded such that higher values represent moderate and none difficulty. Source: SAGE, (2007) + P < .10. *P<.05. **P <.01.***P<.001.

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Table 4.

Logistic Regressions for Self-Report Depression

	Model 1		Model 2		Model 3
	OR	CI	OR	CI	OR	CI
Marital status
Never married	1.00	—			1.00	—
Married/cohabiting	1.38	(0.54–3.55)			1.38	(0.53–3.61)
Separated/Divorced	1.67	(0.64–4.37)			1.67	(0.63–4.44)
Widowed	2.01	(0.79–5.09)			2.03	(0.79–5.23)
Household size
1	1.00	—			1.00	—
2–5	0.84	(0.62–1.15)			0.85	(0.62–1.16)
6–10	0.85	(0.63–1.15)			0.85	(0.62–1.17)
11+	1.34	(0.83–2.17)			1.34	(0.80–2.25)
Contacts with Social ties
Never	1.00	—			1.00
Once or twice a year	1.35	(0.89–2.05)			1.35	(0.88–2.06)
Once or twice a month	1.23	(0.79–1.90)			1.23	(0.79–1.92)
Once or twice a week	3.39	(2.17–5.30)***			3.41	(2.18–5.32)***
Daily	2.44	(1.54–3.85)***			2.41	(1.51–3.84)***
Loneliness
No	1.00	—			1.00	—
Yes	1.82	(1.30–2.54)***			1.80	(1.28–2.52)**
Relationship quality
Satisfied	1.00				1.00	—
Neither	1.91	(1.45–2.50)***			1.93	(1.47–2.53)***
Dissatisfied	1.40	(0.97–2.02)*			1.39	(0.96–2.00)***
Confidant
No	1.00	—			1.00	—
Yes	0.69	(0.52–0.92)***			0.69	(0.51–0.93)***
Received support
No			1.00	—	1.00	—
Yes			1.05	(0.87–1.29)	1.74	(1.15–2.64)**
Perceived support
No			1.00	—	1.00	—
Yes			0.87	(0.68–1.12)	0.98	(0.76–1.28)
Provided support
No			1.00	—	1.00	—
Yes			0.99	(0.77–1.29)	1.05	(0.79–1.40)
*SexReceived support**
Male*Received support					1.00	—
Female*Received support					0.77	(0.54–1.09)
*EthnicityReceived**
Akan*Received support			1.00	—
Ewe*Received support			0.59	(0.18–1.98)
Ga-Adangme*Rec support			0.53	(0.25–1.11)*
Mole-Dagbani*Received			0.60	(0.18–1.99)
Other*Received support			0.67	(0.40–1.10)
N (weighted)	4,277	5,017	4,277
F	12.19***	4.66***	11.56***
(df)	(47,109)	(36,107)	(62,108)

Note: All models were conditioned on the effects of age, gender, ethnicity, household quintile and financial situation, education, place of residence, occupation, living arrangement, and BMI. 1 represent experiencing depression and null not experiencing depression. Source: SAGE, (2007) + P < .10. *P<.05. **P <.01. ***P<.001.

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Table 5.

Ordered Logistic Regressions for Well-Being

	Model 1		Model 2		Model 3
	OR	CI	OR	CI	OR	CI
Marital status
Never married	1.00	—			1.00	—
Married/cohabiting	1.05	(0.62–1.78)			1.01	(0.58–1.73)
Separated/Divorced	1.07	(0.62–1.83)			1.04	(0.60–1.80)
Widowed	0.97	(0.57–1.63)			0.94	(0.55–1.60)
Household Size
1	1.00	—			1.00	—
2–5	0.90	(0.69–1.16)			0.92	(0.71–1.19)
6–10	0.79	(0.60–1.03)*			0.82	(0.62–1.07)*
11+	0.78	(0.56–1.08)			0.83	(0.60–1.17)
Contacts with Social Ties
Never	1.00	—			1.00	—
Once or twice a year	1.46	(1.07–2.00)*			1.43	(1.04–1.96)**
Once or twice a month	1.09	(0.79–1.51)			1.07	(0.77–1.50)
Once or twice a week	1.64	(1.23–2.20)**			1.66	(1.24–2.22)***
Daily	2.75	(1.90–3.96)***			1.71	(1.88–3.90)***
Loneliness
No	1.00	—			1.00
Yes	0.99	(0.71–1.36)			1.01	(0.72–1.40)
Relationship Quality
Satisfied	1.00	—			1.00	—
Neither	0.31	(0.24–0.42)***			0.35	(0.27–0.44)***
Dissatisfied	0.71	(0.05–0.11)***			0.07	(0.05–0.11)***
Confidant
No	1.00	—			1.00	—
Yes	1.36	(1.08–1.72)**			1.33	(1.06–1.68)*
Received Support
No			1.00	—	1.00	—
Yes			1.13	(0.96–1.33)	1.11	(0.76–1.61)
Perceived Support
No			1.00	—	1.00	—
Yes			1.23	(0.99–1.52)*	1.17	(0.95–1.44)
Provided Support
No			1.00	—	1.00	—
Yes			1.12	(0.91–1.37)	1.11	(0.91–1.34)
*SexReceived Support**
Male*Received support					1.00	—
Female*Received support					0.99	(0.77–1.28)
*EthnicityReceived**
Akan*Received support			1.00	—
Ewe*Received support			1.44	(0.79–2.64)
Ga-Adangme*Rec support			0.92	(0.55–1.52)
Mole-Dagbani*Received			1.28	(0.68–2.42)
Other*Received support			1.34	(0.92–1.95)
*EthnicityReceived**
Akan*Received support			1.00
Ewe*Received support			1.60	(0.39–6.57)
Ga-Adangme*Rec support			1.53	(0.55–4.26)
Mole-Dagbani*Received			0.21	(0.05–0.86)
Other*Received support			1.75	(0.92–3.31)
N (weighted)	4277	5017	4277
F	35.60***	20.12***	39.48***
(df)	(47,108)	(36.107)	(62,108)

Note: All models were conditioned on the effects of age, gender, ethnicity, household quintile and financial situation, education, place of residence, occupation, living arrangement, and BMI. Well-being is coded such that higher values represent moderate and good well-being. Source: SAGE, (2007) +P<.10. *P<.05. **P<.01. ***P<.001.