Aging Clinical and Experimental Research

Background and aims: A narrative review of quantitative population-based longitudinal studies was conducted to examine the association of formal voluntary work and personal well-being among older people doing the voluntary work and those being served. Methods: To be included, the study had to be published in a peer-reviewed journal, written in English and conducted in Western countries, participants were at least 60 years of age, the study employed a longitudinal or experimental design, the methodology and outcomes were explicitly described, and voluntary work quantified as visits or hours within a certain time frame. Results: Sixteen studies out of 2897 met the inclusion criteria for the review reporting on benefits of volunteering for those doing the voluntary work. Outcomes were collapsed into three categories of personal well-being: physical health, mental health, and psychosocial resources. All included studies came from the United States and showed that volunteering in old age predicted better self-rated health, functioning, physical activity and life satisfaction as well as decreased depression and mortality. However, it did not decrease the risk of chronic diseases or nursing home admission in old age. Only one study which met the inclusion criteria on the benefits of volunteering for older recipients was identified. Conclusions: Studies mainly used data from large datasets with only limited information about volunteering, which limits more detailed analyses. Randomized controlled trials are needed to study the effect of voluntary work on those being served, as well as to reveal the healthy participant effect among volunteers. (Aging Clin Exp Res 2011; 23: 162-169) ©2011, Editrice Kurtis INTRODUCTION Volunteering is defined as an activity which involves spending time, unpaid, doing something that aims to benefit the community in general, its individuals, or specified subsets of community members who are in need, such as older house-bound persons (1, 2). This review focused on formal volunteering and excluded informal volunteering such as helping and caring for close relatives, friends or neighbors. What differentiates formal and informal volunteering is a sense of obligation which is often stronger in informal volunteering than in formal volunteering, where volunteering depends more on the ability and opportunity of the helper (1). Volunteering has been quantified according to its intensity (amount of time spent), diversity (how many organizations) and consistency (how regularly the individual volunteers across the lifespan). Formal volunteering is usually coordinated by public agencies, non-profit agencies and religious organizations, or through government programs covering a wide range of activities (1, 3). Volunteering typically includes activities such as tutoring or mentoring, either instrumental, supportive or non-skilled; skilled or unskilled assistance or technical advice and public safety (4). The increase in the older population in the 21st century will be a challenge to public economies and healthcare service systems, but it may also offer possibilities. The predicted shortage in the labor force will increase the demand for volunteers in the future. The healthy active older population who are not engaged in paid work constitutes a growing reservoir of human and social capital (5-7), and volunteering is potentially a good venue to contribute to society (8). The generation born between 1946 and 1960 will enter old age with a great deal of experience and skills which may be transferred to the non-profit sector. In addition, increasing longevity, health and wealth REVIEW ARTICLE aging_11_34_vonBonsdorff*.qxp:. 20-09-2011 11:19 Pagina 162 © 201 1, E ditr ice Kur tis FOR PER SON AL U SE O NLY allows for non-profit activities such as volunteering in later life (9, 10). Volunteering could be a cornerstone of productive aging, as it helps provide services of economic and social value (11, 12). Most studies on volunteering have been done in the United States, which is the most active nation in volunteer work in Western countries. According to the Current Population Survey, the rate of volunteering in the US among people aged 65 years or over was 23.5% in 2008 (13). The long-standing tradition of volunteering in the US is partly due to the welfare system which, for example, builds on non-profit and religious organizations, as well as the fact that US policy-makers have actively encouraged volunteering (14). In Europe, the rate of volunteering differs among countries, depending on welfare policy (15). In Nordic countries, where the public healthcare system is responsible for social welfare, older people participate more actively in voluntary work than in Mediterranean countries. There, interfamily exchange is strong and cohabitation among generations more usual than in Northern Europe (16). Cross-national data from the Survey of Health, Ageing and Retirement in Europe (SHARE) on volunteering showed that the rate of volunteering ranged between 2 and 21%, with an average of 10%, depending strongly on the countries’ societal context concerning volunteering (17). In Australia about 20% (18) and in Canada about 18% (19) of the older population had volunteered in the previous year. The relationship between volunteering and well-being has been identified in cross-sectional studies (20-22). However, there is the problem of causal order between well-being and volunteering, which can only be addressed with a prospective study design (23). Good health and adequate social resources tend to increase the probability of doing volunteer work (7, 23-26). It has been argued that persons who are physically and mentally fit are not only able, but also likely to be equipped with personal resources, such as high self-esteem or control over their lives, which increase the likelihood of volunteering (1, 23, 26). It is equally plausible that health determines volunteering, rather than the other way around. In addition, the curvilinear relationship between volunteering and well-being (27, 28) also shows that a moderate but not high number of hours spent doing voluntary work enhances late-life health and well-being. Although a fairly large body of literature exists regarding the various benefits of volunteering for those doing such work, earlier reviews (9, 20, 29, 30) did not investigate the benefits of volunteering systematically, with clearly defined inclusion and exclusion criteria. The aim of this review was to conduct a systematized narrative literature review on quantitative data, to examine the association of formal voluntary work and personal well-being among older people doing voluntary work and those being served. METHODS