Article Text
Abstract
Background Resilience refers to the ability of an individual to positively adapt to adversity. With roots in developmental psychology, resilience research has expanded to include mid- and later-life adaptations to adversity. Low socioeconomic position (SEP) has been associated with poor physical and psychological outcomes in later life. We aimed to examine the relationship between SEP and resilience; testing the hypotheses that higher SEP and upward social mobility are associated with greater resilience in later life.
Methods The Medical Research Council National Survey of Health and Development (NSHD) is a representative sample of 5,362 singleton births on mainland Britain in March 1946. Data to operationalise resilience were collected at age 60–64 (n = 1756). Standardised protocols for grip strength, chair rise, standing balance time and timed-up-and-go were used by trained nurses to assess performance-based physical capability. Prior to this clinical assessment study members self-completed the 14-item Warwick-Edinburgh Mental Well-being Scale (WEMWBS) in a postal questionnaire. Occupational class of the study member at age 53 and of the father at age 4 was coded using the UK Registrar General’s Social Classification and dichotomised as non-manual (professional, managerial, technical, skilled) and manual (skilled, partly skilled, unskilled). Social mobility was defined as upwards (father: manual occupation; respondent: non-manual occupation), high-high (father: non-manual occupation; respondent: non-manual occupation), low-low (father: manual occupation; respondent: manual occupation), and downward (father: non-manual occupation; respondent: manual occupation). Individuals’ resilience was modelled as the difference between observed and predicted WEMWBS score, i.e. residual values, for the physical capability composite score using linear regression. Residual values were used as a continuous metric of an individual’s level of resilience. Sex-adjusted regression models were used to examine the associations of father’s and own occupational class and social mobility with resilience.
Results Higher physical capability was associated with higher WEMWBS scores in a sex-adjusted model (β = 2.70, p < 0.001, 95% CI: 1.83, 3.56). A positive relationship between resilience and higher participant SEP (β = 1.02, p = 0.012, 95% CI: 0.22, 1.81) in a sex-adjusted model was demonstrated. Additionally, individuals with upward social mobility (n = 478) demonstrated greater resilience than those with downward mobility (n = 148) (β = –1.98, p = 0.007 95% CI: −3.43, –0.542).
Conclusion Higher levels of SEP and upward social mobility are associated with resilience in later life. Further research using life course data is required to unpick the mechanisms of fostering greater resilience.