Social capital, health and wellbeing in ageing populations in the UK and Brazil

Lead Research Organisation: University College London
Department Name: Social Science

Abstract

My PhD was on the importance of social relationships and activities for the health and wellbeing of older adults living in England. I used oral health as a marker of the health of older adults as it is a neglected but important aspect of the wellbeing among older adults. The PhD investigated whether older people who participate more in social organisations or who get more support from family and friends have better oral health than older people who participate less or have less social support. Participation in society and social or family support is known as social capital. The reason why this is important to investigate is because of the idea of active ageing- if older people are able to participate more fully in society and have greater social capital, they may be able to age more healthily and have less problems with their health as they get older. I found that older adults with lower social support reported poorer oral health. I also found that as people got older, those who increased their social support had improved levels of wellbeing.
Following the PhD, I now wish to extend this research into other countries. In developing countries like Brazil, the social relationships of older adults tend to be constrained within households and families. In the UK, older adults have more extended relationships with people and organisations outside their household, and some studies show that this is better for their wellbeing than just having family based relationships. Apart from comparing the social capital and wellbeing of older people in Brazil and the UK, I also wish to examine social relationships across the adult lifespan, not just among older adults. We know that social relationships change as people get older, but we don't know if this change is caused by a deterioration in their health and wellbeing, or if their social relationships affects their level of wellbeing. Furthermore, we also know that poverty and financial hardship affects relationships and wellbeing, but we don't know if having good social relationships can reduce some of the negative effects of being poor on wellbeing. This is especially important to investigate given the wide disparities between the rich and poor in Brazil.
The aim of the fellowship is to establish myself as a research leader on social capital, health and wellbeing in the context of ageing and socio-economic inequalities in the UK and Brazil. I will extend my PhD on social capital, health and wellbeing among older adults by examining this association in a new study of older adults in Brazil, and also by looking at this association using new data from the UK with measures of social capital, health and wellbeing across the whole adult lifespan. I plan on publicising the main research findings in Brazil through blogs, local journals and media organisations, working with the leading public health organization in Brazil (Fiocruz), as well as the leading think tank on ageing in Brazil (ILC-Brazil). I will write a report for this think tank on the unique challenges Brazil faces in relation to the social capital of its ageing population and organize a workshop to publicise this report. I will also go to leading conferences on ageing, present my research to international researchers and develop international collaborations with leading researchers and policy organisations on ageing, particularly from middle-income countries in Latin America. I will gain further research skills especially relevant to comparing populations in Brazil and the UK. This will form the backbone for future high quality research and grant applications by laying the foundations for original research on social capital and ageing across the life course in the UK and Brazil.

Publications

10 25 50
publication icon
Chandola T (2018) Retirement and Socioeconomic Differences in Diurnal Cortisol: Longitudinal Evidence From a Cohort of British Civil Servants. in The journals of gerontology. Series B, Psychological sciences and social sciences

publication icon
Rouxel P (2017) Oral health-related quality of life and loneliness among older adults. in European journal of ageing

publication icon
Rouxel P (2018) Oral Health-A Neglected Aspect of Subjective Well-Being in Later Life. in The journals of gerontology. Series B, Psychological sciences and social sciences

 
Description The GCRF fellowship enabled me to develop my PhD research area on social capital and health. This was achieved through further academic publications on this research topic, collaborations with the UKHLS biomarker research group and new research collaboration with the ELSA-Brasil study team. Through the fellowship activities, I have learnt from an international network of research leaders and have planned future collaborative research projects on my PhD research topic.

Since I obtained the fellowship, I published 5 papers in international peer-reviewed journals related to the topic social capital and health. This has helped to establish my reputation as an independent researcher on the topic area, which has led to requests for reviewing other papers by journals and help for other researchers in the area. I was the first author on three of those papers.

The fellowship enabled me to work with UKHLS biomarkers research group. This led to an invitation to present my work at their workshop and conference on UKHLS biomarkers research. My presentation at this event has led to a joint paper (still at draft stage) with the leading international researcher on social capital and allostatic load, Professor Teresa Seeman, UCLA. Findings from this study showed that adults with negative social relationships characterized by interpersonal conflicts or criticism had higher levels of chronic stress-related biomarkers than their peers with more positive relationships. Although the lack of emotional support was similarly associated with chronic stress biomarkers, it was clear that negative social relationships had a stronger effect on chronic stress than the lack of emotional support. Moreover, contrary to much of the literature which focuses on social relationships among older adults, I found that negative social relationships appear to be more stressful during early adulthood (age 21-35) compared to later life. The structure and quality of social relationships could affect multiple physiological regulatory systems related to the stress response, especially among younger men and women.

Through the academic conference networking opportunities provided by the fellowship, I met some of the principal investigators of the ELSA-Brasil study team. They were very interested in my research topic and suggested that I could use the longitudinal ELSA-Brasil data to examine the association between social capital and health in addition to the ELSI-Brasil data. This has led to a joint research proposal to the ESRC-GCRF mental health in developing countries funding call that was submitted in January 2018.
Exploitation Route 1. The research finding that shows how public transport use has a beneficial effect on the physical health of older adults is extremely relevant to the current concerns about cuts to local transport services such as bus routes. Many city councils are under pressure to cut funding for local transport services, despite the importance of such services for many communities. My findings could be taken up by campaign groups against cuts to public transport infrastructure as evidence for the health benefits of public transport use.
2. I showed how the wellbeing of older adults was related to their oral health status, and that there is a general lack of awareness of the importance of dental health for the wellbeing of older adults. These results could be used by health and care professionals that look after older adults.
3. The research on how childhood obesity is influenced by the presence of a TV in the child's bedroom could be used by parents of young children who are concerned about their children's health and development.
Sectors Communities and Social Services/Policy,Healthcare,Transport,Other

 
Description ELSA Brasil 
Organisation Federal University of Rio Grande do Sul
Country Brazil 
Sector Academic/University 
PI Contribution I met with one of the Principal Investigators of the ELSA Brasil study (Longitudinal Study of Adult Health - Estudo Longitudinal de saúde do Adulto, in Portuguese) during the Brazilian Congress of Epidemiology, in Florianopolis - Brazil (07 to 09 October 2017). At the conference, we discussed my research on social capital and health, particularly around the effect on biomarkers of stress such as allostatic load. The ELSA-Brasil research team were very interested in collaborating on further research and encouraged me to use their longitudinal data in addition to the ELSI-Brasil study. This led to a collaborative research proposal that we submitted to the ESRC GCRF call on mental health in developing countries that is currently under review.
Collaborator Contribution The ELSA Brasil study have agreed that if the research proposal to the ESRC GCRF mental health competition is funded, longitudinal data from the ELSA Brasil study will be shared. In addition, members of the ELSA Brasil study team will donate a percentage of their time to working on the specific research topic of mental health resilience.
Impact We submitted a collaborative research proposal on the factors that enable mental health resilience among Brazilian workers to the ESRC-GCRF funding call on mental health in developing countries. This collaboration is multi-disciplinary and involves researchers in sociology, social statistics, public health, epidemiology, psychiatry and medicine.
Start Year 2017
 
Description ELSI-Brasil 
Organisation Fiocruz - Research Center RenĂª Rachou
Country Brazil 
Sector Public 
PI Contribution As part of my GCRF fellowship, I had an agreement with the ELSI-Brasil study (Brazilian Longitudinal Study of Ageing - Estudo Longitudinal da Saúde e bem estar dos Idosos Brasileiros, in Portuguese) team to analyse their wave 1 data on social capital and health. I was meant to be contributing to their research outputs on social capital among older Brazilian adults. However, due to the slippages in their data collection timing and their need to clean and analyse the data first, I was not able to access their data so far. In my visit to the ELSI-Brasil team, I presented my research ideas for the GCRF proposal and had discussions with them about the concepts of social capital and how this can be a resource for the health of older adults. I also discussed ideas for how ELSI-Brasil biomarker data could be used to measure chronic stress related biological processes such as allostatic load, and how using concepts like allostatic load could enhance the research uses of ELSI-Brasil.
Collaborator Contribution I now have a verbal agreement with the ELSI-Brasil team that I will get access to wave 1 in 2018 which I am following up now. They have promised me that I will get access to their wave 1 data on social capital and health.
Impact There are no outcomes as yet as I still do not have access to wave 1 of the ELSI-Brasil study. However, I do have a verbal agreement in place for access to the data, alongside an agreement of my specific topics of research with the dataset.
Start Year 2017
 
Description European Public Health Conference Stockholm - 30/10 to 04/11 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The European Public Health conference was an opportunity to discuss and situate my research within the context of global and European public health research, methods and practices. The theme of the conference "sustaining resilient and healthy communities" was an important theme for my current work. I was able to discuss my research on social capital and health as well as my past experience of volunteering in Brazil with representatives of VSO international (https://www.vsointernational.org). I also discussed my ongoing research work with researchers from the University of Helsinki who were interested in potential collaborative research.
Year(s) Of Engagement Activity 2017
URL https://ephconference.eu/conference-2017-stockholm-49
 
Description Gerontological Society of America conference - New Orleans, USA 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Gerontological Society of America conference - New Orleans, USA. Presentation on "Oral health - a neglected aspect of subjective well-being in later life". The discussion helped shape an Oxford University Press blog about the importance of considering the oral health of older people in well-being research.
Year(s) Of Engagement Activity 2016
URL https://blog.oup.com/2016/04/oral-health-well-being-older-adults/?utm_source=feedblitz&utm_medium=Fe...
 
Description Oral health and subjective well-being - Blog 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact This paper highlights the importance of considering oral health as an integral part of general health, particularly as common measures of disability among older adults do not include aspects of oral health functioning. Even though most studies on subjective well-being among older adults take disability into account, we find that oral health predicts well-being independently of disability.
Year(s) Of Engagement Activity 2017
URL https://oxfordjournals.altmetric.com/details/6475724
 
Description Public transport and walking speed- media activity 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Our study demonstrates that the decline in functional mobility with age was slower among older adults who used public transport frequently, and that older adults at risk of faster declines in walking speed were not only those who did not use public transport because of health problems, but also those who did not use public transport because of structural barriers to public transport use or through choice. This research is especially important given the current context of cuts in public transport availability in England. A press release of the paper "Does public transport use prevent declines in walking speed among older adults living in England? A prospective cohort study" and related twitter activity resulted in greater awareness of the issues raised by the study. We engaged in correspondence with members of the general public regarding the implications of the findings for public transport use among older adults. The Medical Research Council published the press release on their website
Year(s) Of Engagement Activity 2017
URL https://www.mrc.ac.uk/news/browse/over-60s-not-using-public-transport-despite-health-benefits/
 
Description Society for Social Medicine presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The Society for Social Medicine's 61st Annual Scientific Meeting - Manchester, UK. 06 to 08 September 2017. Presentation on "Does the quality of social relationships buffer the association of social disadvantage with allostatic load? an analysis of adults from the UK household longitudinal study". 20 researchers attended the presentation and there was a discussion about how to measure Allostatic Load.
Year(s) Of Engagement Activity 2017
URL https://socsocmed.files.wordpress.com/2014/01/manchester-flyer.jpg
 
Description Tv in the bedroom and childhood obesity - Media activities 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A press release of the paper "Longitudinal associations between television in the bedroom and body fatness in a UK cohort study" resulted in 30 news stories and 2 blogs. This sparked further discussion on the role of screen time use among children as a potential cause of the increasing trend in childhood obesity.
Year(s) Of Engagement Activity 2017
URL https://www.altmetric.com/details/20773753
 
Description UKHLS Biomarker research group workshop 13-16 March 2017 London 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I made a presentation on social capital and health-related biomarkers at the UKHLS Biomarker research group workshop/conference on 13 to 16 March 2017. The presentation to experts on stress-related biomarkers led to a collaboration on a joint paper on social capital and health, exploring the biological pathways between social relationships and health.

The study shows how negative aspects of social relationships, such as social strain (e.g interpersonal conflicts, or criticism) from one's social network is a powerful predictor of stress-related biomarkers. Moreover the negative aspect of social relationships appear to be more stressful during early adulthood compared to later life. Previous research on the topic focused only on older adults. We discovered that it was the younger adults with strained social relationships who were particularly at high risk of stress related biomarkers.

Research on social stress needs to focus on early stage of the adult life course. Younger adults need help in managing the stressors in their lives. A reduction in their stress level is likely to increase their productivity and improve their long term health.
Year(s) Of Engagement Activity 2017
URL https://www.understandingsociety.ac.uk/events/2017/03/15/understanding-society-biomarker-conference
 
Description World Congress of Epidemiology presentation - Japan 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 21st International Epidemiological Association (IEA) World Congress of Epidemiology (WCE2017) - Saitama, Japan. Presentation on "The quality of social relationships and allostatic load: An analysis of adults from the UK Household Longitudinal Study". The discussion after the presentation led to potential collaboration with University of Helsinki researchers on health.
Year(s) Of Engagement Activity 2017
URL http://ieaweb.org/iea-world-congress-of-epidemiology-19-22-august-2017-saitama-japan/