Health and social exclusion in older age: evidence from Understanding Society, the UK household longitudinal study

BACKGROUND Social exclusion of the elderly is a key policy focus but evidence on the processes linking health and social exclusion is hampered by the variety of ways that health is used in social exclusion research. We investigated longitudinal associations between health and social exclusion using an analytical framework that did not conflate them. METHODS Data employed in this study came from 4 waves of Understanding Society, the UK Household Longitudinal Study 2009-2013. The sample comprised all adults who took part in all 4 waves, were 65 years or more in Wave 3, and had complete data on our variables of interest for each analysis. We used linear regression to model the relationship between Wave 2/3 social exclusion and Wave1-2 health transitions (N=4312) and logistic regression to model the relationship between Wave2/3 social exclusion and Wave 4 health states, conditional on Wave 3 health (N=4244). RESULTS There was a dose-response relationship between poor health in Waves 1 and 2 and later social exclusion. Use of a car, mobile phone and the internet moderated the association between poor health and social exclusion. Given the health status in Wave 3, those who were more socially excluded had poorer outcomes on each of the three domains of health in Wave 4. CONCLUSIONS Use of the internet and technology protected older adults in poor health from social exclusion. Age-friendly hardware and software design might have public health benefits.