Material resources and population health: disadvantages in health care, housing, and food among adults over 50 years of age

Abstract

Objectives: We examined associations between material resources and late-life declines in health.

Methods: We used logistic regression to estimate the odds of declines in self-rated health and incident walking limitations associated with material disadvantages in a prospective panel representative of US adults aged 51 years and older (N = 15,441).

Results: Disadvantages in health care (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.23, 1.58), food (OR = 1.69; 95% CI = 1.29, 2.22), and housing (OR = 1.20; 95% CI = 1.07, 1.35) were independently associated with declines in self-rated health, whereas only health care (OR = 1.43; 95% CI = 1.29, 1.58) and food (OR = 1.64; 95% CI = 1.31, 2.05) disadvantage predicted incident walking limitations. Participants experiencing multiple material disadvantages were particularly susceptible to worsening health and functional decline. These effects were sustained after we controlled for numerous covariates, including baseline health status and comorbidities. The relations between health declines and non-Hispanic Black race/ethnicity, poverty, marital status, and education were attenuated or eliminated after we controlled for material disadvantage.

Conclusions: Material disadvantages, which are highly policy relevant, appear related to health in ways not captured by education and poverty. Policies to improve health should address a range of basic human needs, rather than health care alone.

FIGURE 1

Number of domains disadvantaged and adjusted probability of decline in (a) self-rated health and (b) incident walking limitation: Health and Retirement Study, United States, 2004 and 2006. Note. Predicted probability using regression model 4, setting the value of each covariate to equal the sample mean value: demographics (age, gender, race/ethnicity, education, poverty, marital status, and proxy report), comorbid conditions (heart disease, cancer, stroke, pulmonary disease, and diabetes), weight status, smoking status, and (a) baseline self-rated health or (b) baseline walking limitations; error bars represent 95% confidence intervals.