Social Network and Functional Health Status among the Elderly

Background: In the absence of adequate public pension benefits, the older people in China have to rely on their social networks for old-age support. However, few empirical studies have been carried out to examine the pattern of social network and their impact on elderly health in China. Methods: Using the data set from two waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2008 and 2014, we examined the characteristics of social network types and their impacts on the health status among the elderly. The dependent variables included the measures of self-rated health (SRH), activities of daily living (ADL), instrumental activities of daily living (IADL), and cognitive score (MMSE). K-means clustering method was used to construct the social network type, which was the primary factor we were interested in examining for association with functional health status. A random-effect regression model was utilized to control for the clustering effects within the observations over time. Results: Four types of the social network were derived among the older people, and they were the diverse network (6.65%), family-focused network (32%), children-focused network (29.89%) and restricted network (31.45%). Compared with the restricted network, the diverse network was associated with the best functional health status and self-rated health among the elderly; the family-focused network was also associated with a better score of ADL, IADL, and MMSE but not significantly with SRH score; and the children-focused network was also associated with a better health status of all measures. Furthermore, social support from family members and friends positively influenced the health status of the elderly. In contrast, having social workers available when needed was associated with the reduced ADL, IADL, and SRH scores. This might be due to that those elderly with the worst health status are in a greater need for support from social workers, and hence, the reverse association may occur. Conclusion: family- and children-focused network were primary types among the older people in China. Consistent with previous studies, while the diverse network was most beneficial for the functional health status in multiple measures, it only accounted for a small proportion; people with the restricted network had the worst health status.