Bringing the Social World into Our Understanding of Health: Implications for Morbidity and Mortality

• In Event: 289 - Regular Session. Health and Mortality in Later Life

Abstract

The World Health Organization (WHO) defines health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” However, social well-being has been consistently ignored as a component of overall health in both research and medical practice. Instead, the dominant model of health is a disease-centered Medical Model (MM), which actively ignores many relevant domains. We develop a Comprehensive Model (CM+S) of health consistent with the WHO definition, giving equal consideration to multiple health domains including medical, physical, psychological, functional, sensory, sexual and social dimensions. We apply Latent Class Analysis (LCA) to data from the National Social Life, Health and Aging Project to identify distinct classes of individuals using constellations of indicators of their health across these dimensions. We compare health as defined using only physical health to health of the same individuals as seen using a comprehensive definition that includes the dimensions above, with a focus on sexual and social well-being. We find that many individuals classified as generally healthy when we consider only diseases identified by the Medical Model are revealed to have important health challenges in sexual and social well-being. Others with significant chronic disease are shown to have excellent overall health due to their strengths on other dimensions. Our results show a key role for sexual and social well-being in the health of older adults, with wide disparities across groups of people in their well-being on social dimensions; these disparities have profound implications for later morbidity and mortality.

Authors

• Linda J. Waite, University of Chicago

• William Dale, University of Chicago

• Michael Jeffrey Kozloski, University of Chicago

• Edward O. Laumann, University of Chicago

• Martha McClintock, Department of Psychology, University of Chicago