Perceived Adequacy of Tangible Social Support and Associations with Health Outcomes Among Older Primary Care Patients

Abstract

Background: The availability and adequacy of tangible social support may be critical to older adults managing multiple chronic conditions, yet few studies have evaluated the perceived adequacy of needed tangible support and its relation to health outcomes.

Objective: We investigated the association between unmet, tangible social support needs, health status, and urgent healthcare use among community-dwelling older adults.

Design: Cross-sectional analysis.

Participants: English-speaking older adults (n = 469) who participated in the Health Literacy and Cognitive Function cohort study.

Main measures: Perceived adequacy of tangible social support was measured using a brief, validated scale that determined (1) if an individual needed assistance managing his or her health, and (2) if yes, whether this need was met. Health status was measured using physical function, depression, and anxiety PROMIS short-form instruments. Urgent healthcare utilization (emergency department and hospitalization) was self-reported for the past 12 months.

Key results: Participants' mean age was 69 years; 73% were women and 31% were African American, and 16% identified unmet support needs. Unmet support needs were associated with worse physical (β - 6.32; 95% CI - 8.31, - 4.34) and mental health (anxiety: β 3.84; 95% CI 1.51, 6.17; depression: β 2.45; 95% CI 0.32, 4.59) and greater urgent healthcare utilization (ED: OR 2.86; 95% CI 1.51, 5.41; hospitalization: OR 3.75; 95% CI 1.88, 7.50).

Conclusions: Perceived unmet support needs were associated with worse health status and greater urgent healthcare use. Primary care practices might consider screening older patients for unmet tangible support needs, although appropriate responses should first be established if unmet needs are identified.

Keywords: aging; patient-reported outcomes; social support.