The Effect of Social Determinants of Health on Psychological Health Among Older Adults in Ghana

ABSTRACT

This study examines the effects of various factors, including socioeconomic status, built environment, access to healthcare, educational level, social participation, and economic stability, on older adults’ psychological health. The current study analyzed a nationally representative sub-sample of 2,577 respondents aged 50 and above from the World Health Organization’s Study on Global AGEing and Adult Health (WHO SAGE) Wave 2. WHO SAGE Wave 2 is cross-sectional data collected via in-person structured interviews. Ordinal least square (OLS) was used to measure the average effect of social determinants of health (SDoH), and quantile regression analysis was used to determine the effects of SDoH on older adults’ psychological health at different quantiles, specifically 10^th, 50^th, and 90^th percentiles. Significant determinants of psychological health across all quantiles included age, healthcare access, marital status, economic stability, and neighborhood and built environment. However, the degrees of significance for residence, gender, educational level, chronic diseases, and social participation varied between quantiles, showing differing effects on older adults with high or low psychological health. Religion was insignificant across all quantiles. This study highlights the need for governments and public health agencies to develop targeted interventions and strategies that support the psychological well-being of older adults in the country.

KEYWORDS:

• Social determinants of health (SDoH)
• psychological health
• older adult
• Ghana
• WHO SAGE wave 2

Acknowledgments

We are grateful to the World Health Organization for granting the researchers access to the SAGE Wave 2 data. Also, we are thankful for the support from the Fundamental Research Funds for the Central Universities.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

Study conception, design, and writing original draft: Stephen Addai-Dansoh; Acquisition and interpretation of data: Stephen Addai-Dansoh, Ebenezer Larnyo, Jonathan Aseye Nutakor, Prince Owusu; Provided statistical guidance: Prince Owusu, Jeremiah Osei-Kwakye, Francisca Arboh, Priscilla Yeboah Boahemaa, Bright Boadu; Supervision and funding acquisition: Baozhen Dai; All authors revised the manuscript critically for important intellectual content; All authors read and approved the final manuscript and agree to be accountable for all aspects of the work.

The funder had no role in the study design, data collection and analysis, the writing of the manuscript, or the decision to submit the paper for publication.

Consent

Informed consent was obtained from all individual participants included in the study.

Data availability statement

This study utilized secondary data analysis of a nationally representative sample of older adults in Ghana. The Study on Global AGEing and Adult Health (SAGE) Wave 2 was conducted by the World Health Organization. The data that support the findings of this study are available at http://www.who.int/healthinfo/sage/cohorts/en/

Ethics approval

All study procedures were conducted ethically per the Code of Ethics of the World Medical Association (Declaration of Helsinki). SAGE obtained ethical approval from the Ethical Review Committee of the WHO (RPC149) and the Ethics and Protocol Review Committee of the University of Ghana Medical School (Accra).

Additional information

Funding

This work was supported by the Major Project of the National Social Science Fund of China under Grant number 23&ZD188.