Khaliq, Nadia;
(2023)
The role of social relationships in explaining social inequalities in health in an ageing population – findings from the English Longitudinal Study of Ageing.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
Introduction: Social inequalities in health are universally recognised as a significant public health problem. Whilst material and behavioural pathways between socioeconomic position and health have been studied extensively, few studies have explored the contribution of social relationships to social gradients in health. Aim: To examine the mediating and moderating role of social relationships in the association between socioeconomic position, general health (self-rated health and blood pressure) and oral health (self-rated oral health, edentulousness and oral health-related quality of life) using data from English Longitudinal Study of Ageing (ELSA). Methods: Four pieces of research make up the main body of this thesis. First, evidence was systematically reviewed from 69 studies that quantitatively assessed the role of social relationships in mediating (n = 42) or moderating (n = 33) health inequalities. Second, cross-sectional analyses using imputed data examined the role of loneliness, social isolation, and positive and negative social support in the attenuation of socioeconomic gradients in self-rated health (n = 8681) and systolic blood pressure (n = 6639) at wave 2, and in self-rated oral health, oral health-related quality of life and edentulousness at wave 3 (n = 8617). Third, structural equation modelling was implemented to explore the mediating role of social relationships in explaining wealth inequalities in self-rated health and systolic blood pressure using data from wave 2 to wave 6 (n = 12,723), and in selfrated oral health, oral health-related quality of life and edentulousness using data from wave 3 to wave 7 (n = 11,692). Finally, social relationships were assessed for their moderating role in associations between wealth and self-rated health and systolic blood pressure at waves 2, 4 and 6 (n = 12,594) and self-rated oral health, oral health-related quality of life and edentulousness at waves 3, 5 and 7 (n = 11,362) using random effects models. Systematic review results: There was some evidence suggesting that social relationships partly explained social gradients in health, and that better social relationships buffered the negative effect of low socioeconomic position on health among adults.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | The role of social relationships in explaining social inequalities in health in an ageing population – findings from the English Longitudinal Study of Ageing |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10184674 |
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