Over the past few years, I have pursued a research agenda that focuses on identifying the social determinants of recovery from physical impairment among older adults. This line of research is unique because recovery is typically overlooked by social scientists. Much of current research applies a biomedical perspective to recovery, which stresses individual-level risk factors such as disease symptoms and lifestyle, while neglecting social factors.
However, using a sociological perspective, I have identified important social determinants of recovery from physical impairment (specifically mobility limitation) among older adults. Three published articles exemplify how social factors (i.e., socioeconomic status, neighborhoods, and social relationships) shape recovery from mobility limitation (i.e., difficulty walking and climbing stairs). Below I describe the major findings from each article:
Latham-Mintus, K., & Aman, K. M. (2019). Childhood Disadvantage, Psychosocial Resiliency, and Later Life Functioning: Linking Early-Life Circumstances to Recovery From Mobility Limitation. Journal of Aging and Health, 31(3), 463–483. https://doi.org/10.1177/0898264317733861
This research examined the association between childhood disadvantage and recovery from mobility limitation. In general, economic and health disadvantage before age 16 was associated with lower odds of recovery from mobility limitation.
We also investigated whether certain psychosocial factors buffered the effect of childhood disadvantage on recovery outcomes. High levels of mastery protected older adults from the negative effects of financial hardship in childhood. However, low levels of mastery were particularly harmful effects among those with childhood disadvantage experiences.
This research stresses that socioeconomic status (in both childhood and adulthood) is a salient social determinant of recovery from mobility limitation. Not only do socioeconomic inequalities shape risk of mobility limitation, they also influence risk of recovery. Affluent older adults are less likely to develop mobility limitation *and* more likely to recovery when they do develop mobility limitation—ultimately contributing to socioeconomic disparities in mobility limitation and disability.
Latham, K., & Williams, M. M. (2015). Does Neighborhood Disorder Predict Recovery From Mobility Limitation? Findings From the Health and Retirement Study. Journal of Aging and Health, 27(8), 1415–1442. https://doi.org/10.1177/0898264315584328
This research investigated whether perceived neighborhood disorder (i.e., amount of vacant homes/buildings, litter/rubbish, vandalism/graffiti, and crime) was associated with recovery from mobility limitation. We found that higher levels of perceived neighborhood disorder decreased the odds of recovery among older adults. This suggests that an older adult’s neighborhood environment can influence whether they experience recovery from mobility limitation.
Furthermore, we tested whether psychosocial (i.e., mastery and depressive symptoms) and behavioral (i.e., physical activity) indicators were significant mediators. Both psychosocial indicators and physical activity were significant individual partial mediators. This research provides evidence that neighborhood disorder influences recovery from physical impairment via psychosocial processes and barriers to physical activity. In other words, older adults who lived in disordered neighborhoods were more likely to have low mastery, more depressive symptoms, and participate in less physical activity, which all contributed to lower odds of recovery.
“Place matters” is a key concept within the social determinants of health (SDoH) framework. A person’s environment shapes their risk of disease and disability. This research extends this line of thinking to include recovery as well.
Latham, K., Clarke, P. J., & Pavela, G. (2015). Social relationships, gender, and recovery from mobility limitation among older Americans. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(5), 769-781. https://doi.org/10.1093/geronb/gbu181
This research examined multiple dimensions of social relationships including familial social network, neighborhood engagement and embeddedness, community engagement, and instrumental support (both giving and receiving) and recovery from severe mobility limitation (i.e., difficulty walking one block or across the room). We find that providing instrumental support (i.e., helping friends and family) was associated with increased odds of partial and complete recovery from severe mobility limitation. We also examined whether there were any differences in recovery between men and women. In general, married or partnered men were more likely to recover relative to married or partnered women.
Additionally, we documented differences among men and women with regard to visiting neighbors and partial recovery. Staying engaged in the neighborhood was beneficial to both men and women, but the association was stronger in men. Disengaged women appeared to be the most vulnerable as they were the least likely to experience partial recovery.
Our findings underscore the potential for social relationships to facilitate recovery from mobility limitation. In particular, encouraging older adults with mobility limitation to provide help to friends and family may be an especially fruitful avenue for intervention.
Like the two prior articles, this research connects the social determinants of health to recovery outcomes. The social and community context can facilitate recovery from severe mobility limitation.
In sum, these publications underscore that social factors shape patterns of recovery among older adults, which solidly places recovery under the purview of sociologists. Given that recovery from physical impairment is largely ignored by social scientists, this line of research enables me to bring to light the social determinants that underlie the recovery process and to inform health-promotion strategies.