Health and Volunteering in Europe: A Longitudinal Study

Longitudinal reciprocal associations between volunteering, health and well-being: evidence for middle-aged and older adults in Europe

BACKGROUND

There is substantial evidence on the importance of voluntary activities for the health of middle-aged and older adults. Evidence on the effects of health and well-being on volunteering is more limited. This study examines reciprocal longitudinal associations between voluntary and/or charity activities and 21 indicators related to physical health, well-being, cognitive impairment and daily life functioning among middle-aged and older adults.

METHODS

Longitudinal data were collected between 2011 and 2020 from a sample of 19 821 middle-aged and older adults from 15 countries participating in the Survey of Health, Ageing and Retirement in Europe. An outcome-wide analysis and an exposure-wide analysis were applied and generalized estimating equations were used. Robustness analyses were conducted.

RESULTS

Voluntary and/or charity activities almost every week or more often were prospectively associated with greater emotional well-being, reduced risks of limitations in activities of daily living and of being diagnosed with Alzheimer's disease at a 6-year follow-up. Positive reverse associations were found from emotional well-being to volunteering. Limitations in daily life activities, increased loneliness, high blood cholesterol, hypertension and chronic lung disease were found to impede participation in voluntary and/or charity activities over time. Feedback loops between voluntary and/or charity activities and well-being and limitations in daily activities may exist.

CONCLUSION

Understanding the reciprocal nature of the relationship between volunteering and health and well-being can help identify strategies to encourage volunteering among middle-aged and older adults with specific health conditions and to target health promotion efforts towards volunteers.

Is Transition to Retirement Associated With Volunteering? Longitudinal Evidence from Europe

Studies have shown that retired older adults are more likely to volunteer than their working counterparts. However, whether the transition to retirement is associated with increased volunteering frequency and whether this varies according to material and time resources of participants is unclear. We used four waves of data from the longitudinal Survey of Health, Ageing and Retirement in Europe, collected between 2011-2018 across 19 countries (n = 12,400 person-observations from 6200 individuals over 50). Within-person (or panel fixed-effect) regression analyses revealed that transition to retirement was associated with an increased volunteering frequency over time. This association was stronger among individuals with better health, higher education, improved financial situation and in countries with higher gross domestic product per capita. Overall, transition to retirement tends to open new ways of organizing everyday life and is associated with increased frequency of volunteering.

Helping and Volunteering During COVID-19: Associations With Well-Being and Psychological Distress

INTRODUCTION

Salutogenic effects of volunteering and helping activities have been well recognized in the pre-COVID-19 era. This study examines associations between helping others as well as additional volunteer activities during the first wave of the COVID-19 pandemic and 6 psychological distress and well-being outcomes one year later.

METHODS

Longitudinal data collected between 2019 and 2021 were used. Analyses were based on data from 42,005 middle-aged and older adults from 27 European countries who participated in the Survey of Health, Ageing, and Retirement in Europe (SHARE) and two SHARE Corona Surveys. Prospective associations were examined using generalized estimating equations. A series of secondary analyses and the sensitivity of the associations to unmeasured confounding provided evidence for the robustness of results. All analyses were conducted in December 2022.

RESULTS

Helping others outside one's home in the first wave of COVID-19 was associated with subsequent increased risks of depression and anxiety. It was concurrently associated with an increased probability of an uplifting, hope, and happiness-inducing experience. Engagement in volunteer activities conducted in addition to helping was found to be prospectively associated with higher probability of an uplifting experience, but not with depression and anxiety. These associations were independent of demographic and socioeconomic characteristics, personality traits, prior quality of life and health history as well as pre-COVID-19 engagement in altruistic activities.

CONCLUSIONS

Helping and volunteering during the COVID-19 pandemic likely led to positive experiences. However, a negative impact on psychological distress of the same activities was also noted.

Multiple Trajectories and Predictors of Self-Esteem Change in Later Life: A Latent Growth Mixture Modeling Approach

Applying latent growth mixture modeling (GMM), this study delves into the examination of self-esteem trajectories in a sample of 5,597 older adults over a nine-year period. Four distinct patterns of self-esteem changes have emerged: low, decreasing, increasing, and high. Additionally, the study explores the relationships between each trajectory and various predictors encompassing demographic factors, socioeconomic status, health, and interpersonal relationships. The findings highlight the significance of these factors in predicting the likelihood of an individual following a specific self-esteem trajectory. Notably, maintaining employment, fostering satisfactory social relationships, and being free of frequent depressive feelings emerged as strong predictors for the stability and increase of high self-esteem. Intriguingly, an average or above-average income was unexpectedly associated with lower levels of self-esteem. The study emphasizes the contribution of GMM to advancing aging research.

Senior volunteers: addressing loneliness in times of COVID-19

Volunteering in old age plays an important role in addressing feelings of loneliness, but little research has been conducted on the impact of engaging in volunteering activities during the COVID-19 pandemic. This study investigates the longitudinal impact of volunteering on feelings of loneliness. We analyzed data from 31,667 adults aged 50 years and older in the Survey of Health, Ageing and Retirement in Europe (SHARE), across three consecutive waves (one before the pandemic and two during the COVID-19 pandemic). Binary logistic regression analyses were conducted for loneliness, using volunteering and several control variables as independent variables, and found that even after controlling for previous loneliness, volunteering has a protective effect against experiencing feelings of loneliness. Those who participated in volunteering activities before or during the second pandemic period had a lower risk of loneliness during the second pandemic period. Volunteering during the second pandemic period, before and during the second pandemic period, and during all three periods measured in the study was negatively associated with the odds of feeling lonely. Encouraging volunteering among older adults can be a useful strategy to prevent loneliness during future emergency situations like the COVID-19 outbreak.

The Role of Primary Care in Advancing Civic Engagement and Health Equity: A Conceptual Framework

Policy Points Health and civic engagement are reciprocally and longitudinally linked: Poor health is associated with less civic engagement. Well-established social drivers of health and health inequality such as inadequate access to health care, poverty, racism, housing instability, and food insecurity are also drivers of lower civic engagement. A robust primary care system can play a key role in advancing civic engagement (e.g., voting, volunteerism, community service, and political involvement) at the population level but has received little attention. Policy and practice solutions at the individual and structural levels should support and leverage potential synergies among health equity, civic engagement, and primary care.

CONTEXT

Health and civic engagement are linked. Healthier people may be able to participate more fully in civic life, although those with poorer health may be motivated to address the roots of their health challenges using collective action. In turn, civically active people may experience better health, and societies with more equitable health and health care may experience healthier civic life. Importantly, a robust primary care system is linked to greater health equity. However, the role of primary care in advancing civic engagement has received little study.

METHODS

We synthesize current literature on the links among health, civic engagement, and primary care. We propose a conceptual framework to advance research and policy on the role of primary care in supporting civic engagement as a means for individuals to actualize their health and civic futures.

FINDINGS

Current literature supports relationships between health equity and civic engagement. However, this literature is primarily cross-sectional and confined to voting. Our integrative conceptual framework highlights the interconnectedness of primary care structures, health equity, and civic engagement and supports the crucial role of primary care in advancing both civic and health outcomes. Primary care is a potentially fruitful setting for cultivating community and individual health and power by supporting social connectedness, self-efficacy, and collective action.

CONCLUSIONS

Health and civic engagement are mutually reinforcing. Commonalities between social determinants of health and civic engagement constitute an important convergence for policy, practice, and research. Responsibility for promoting both health and civic engagement is shared by providers, community organizations, educators, and policymakers, as well as democratic and health systems, yet these entities rarely work in concert. Future work can inform policy and practice to bolster primary care as a means for promoting health and civic engagement.

Stress load and volunteer motivation of patient volunteers in Fangcang shelter hospitals in Shanghai, China during the COVID-19 pandemic: a cross-sectional survey

OBJECTIVES

This study aims to assess the volunteer motivation and stress load of patient volunteers in the Fangcang shelter hospitals (FSHs), examine their associations, and explore the potential influence factors of volunteer motivation.

DESIGN

Cross-sectional online survey conducted from 21 April to 20 May 2022.

SETTING

Questionnaires were collected from patient volunteers selected by random cluster sampling in the FSHs in Shanghai, China.

PARTICIPANTS

197 participants who met the inclusion criteria as patients who were asymptomatic or presenting with mild symptoms in the FSHs and who volunteered to assist with routine work under quarantined settings.

OUTCOME MEASURES

We investigated sociodemographic information, stress load and volunteer motivation through an online survey using the Volunteer Function Inventory and the Stress Overload Scale. Comparisons between groups were conducted by applying t-tests or analysis of variance. The correlation between volunteer motivation and stress was analysed by Pearson correlation. Influencing factors of volunteer motivation were determined by multivariable linear regression models. A value of p<0.05 was used to declare statistical significance.

RESULTS

The mean score of volunteer motivation of patient volunteers was 73.24 (SD 12.00), while that of stress load was 46.08 (SD 21.28). The mean scores of the personal vulnerability (PV) and event load (EL), two dimensions of stress load, were 26.99 (SD 12.46) and 19.09 (SD 9.63), respectively. The majority of the participants (136, 69.04%) were grouped in the low (PV)-low (EL) stress category. Participants' volunteer motivation was negatively correlated with stress load (r=-0.238, p<0.001), as well as PV (r=-0.188, p<0.01) and EL (r=-0.283, p<0.001). Multivariable linear regression analysis identified that the potential influencing factors of volunteer motivation were occupation (B=1.100, 95% CI 0.037 to 2.164, p=0.043), health condition (B=-3.302, 95% CI -5.287 to -1.317, p<0.001) and EL (B=-0.434, 95% CI -0.756 to -0.111, p=0.009). Participants who worked in the public sector, had better health conditions and had lower EL were more likely to have higher volunteer motivation.

CONCLUSIONS

Our study suggested that reducing stress load might be a possible pathway to encourage and maintain volunteerism in the FSH context. Implications and suggestions for future research on patient volunteer recruitment and management could be drawn from our findings.

Engagement in volunteering activities by persons with multiple sclerosis in Switzerland

BACKGROUND

Informal and formal volunteering engagement is a proxy for social integration and may have beneficial effects for physical and mental well-being in persons with multiple sclerosis (pwMS). As literature on the topic among the pwMS is lacking, this study aimed to determine frequency and type of volunteering performed by pwMS and to identify factors associated with volunteering.

METHODS

Cross-sectional, self-reported data of 615 pwMS participating in the Swiss Multiple Sclerosis Registry were analyzed using descriptive statistics to determine frequency and type of volunteering engagement. Univariable and multivariable generalized linear models with binomial distribution and log link function were used to identify factors associated with volunteering. Age, sex, employment status and gait disability were added to the multivariable model as fixed confounders. Sociodemographic, health-, work- and daily activity-related factors were included in the analysis.

RESULTS

About one third (29.4%) of participants reported engagement in volunteering activities, most often through charities (16.02%) and cultural organizations (14.36%). In the multivariable model, participants who had a university degree were more likely to volunteer than those with lower level of education (RR = 1.48 95% CI [1.14; 1.91]). The ability to pursue daily activities (as measured by the EQ-5D subscale) was strongly associated with participation in volunteering among pwMS. Compared with pwMS who had no or only slight limitations in daily activities, those with severe problems were markedly less likely to engage in volunteering (RR = 0.41, 95% CI [0.21; 0.80]) . Finally, pwMS who reported caring for and supporting their family (i.e., being a homemaker) were more likely to engage in volunteering activities than those who did not (RR = 1.52, 95% CI [1.15; 2.01]).

CONCLUSION

Nearly one in three pwMS engaged in diverse volunteering activities. Having a university degree, being less limited in daily activities and being a homemaker increased the probability of pursuing volunteering activities. Contingent on individual-level motivations, resources or physical abilities, pwMS who experience challenges in performing daily activities or social barriers should be made aware of barrier-free offers of socially inclusive and volunteering activities, often provided by the national MS societies and health leagues.

Active ageing profiles among older adults in Spain: A Multivariate analysis based on SHARE study

Background

Following the active ageing model based on the Health, Lifelong Learning, Participation and Security pillars, this research has a twofold objective: i) to classify older adults according to active ageing profiles, taking into account the four pillars, and ii) to ascertain the relationship between the profiles and personal and contextual factors, as well as well-being and quality of life in old age.

Methods

A study sample of 5,566 Spanish older adults who participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) was included. Data were analysed in different steps applying several statistical analyses (Principal Component, Cluster, Discriminant, Multiple Correspondence and bivariate analysis with Pearson chi-square and ANOVA).

Results

Five older adult profiles were obtained (I: with moderate activity; II: quasi-dependents; III: with active ageing-limiting conditions; IV: with diverse and balanced activity; V: with excellent active ageing conditions). The first three profiles were characterised by subjects with a high average age, low educational level, who were retired or housewives, and who perceived a moderate level of loneliness, satisfaction with the social network and quality of life, as well as having a larger family network, but living in small households or alone. In contrast, the latter two profiles showed better personal and contextual conditions, well-being and quality of life.

Discussion and conclusions

The multidimensional approach to active ageing followed in this article has revealed the presence of several older adult profiles, which are confined to groups with better or worse active ageing conditions. In this context, if ageing is a process that reflects the previous way of life, intervention priorities will have to consider actions that promote better conditions during the life cycle.

Social Inclusion and Communality of Volunteering: A Focus Group Study of Older People’s Experiences

The aim of this qualitative study was to describe the factors that motivate older people to volunteer and how volunteering influences their social inclusion and communality. Data were collected using focus group interviews in 2020–2021 from older people aged 65–81 years (n = 38) who had experience of volunteering in the community. The data were analyzed using inductive content analysis. Based on the results, the experiences described by older people who participate in volunteering consisted of factors encouraging older people to volunteer and depended on the activation, support, and motivation of volunteer operators. The support provided by the health care services and volunteer action organization for volunteers was a key factor in encouraging older people to participate in volunteering. Moreover, volunteering impacted the communality of volunteers in several ways, influencing social capital. The sense of communality was enhanced by the way in which volunteering was carried out, including collaboration with health care services and associations. In order to strengthen the importance of volunteering in society, there is a need for close collaboration between voluntary organizations and health care service providers to develop volunteering because health care organizations cannot respond to all of the challenges faced by the ageing population.

The health advantage of volunteering is larger for older and less healthy volunteers in Europe: a mega-analysis

There is a vast literature on the health benefits associated with volunteering for volunteers. Such health advantages are likely to vary across groups of volunteers with different characteristics. The current paper aims to examine the health advantages of volunteering for European volunteers and explore heterogeneity in the association between volunteering and health. We carry out a mega-analysis on microdata from six panel surveys, covering 952,026 observations from 267,212 respondents in 22 European countries. We provide open access to the code we developed for data harmonization. We use ordinary least squares, fixed effects, first difference, and fixed effect quantile regressions to estimate how volunteering activities and changes therein are related to self-rated health for different groups. Our results indicate a small but consistently positive association between changes in volunteering and changes in health within individuals. This association is stronger for older adults. For respondents 60 years and older, within-person changes in volunteering are significantly related to changes in self-rated health. Additionally, the health advantage of volunteering is larger for respondents in worse health. The advantage is largest at the lowest decile and gradually declines along the health distribution. The magnitude of the association at the first decile is about twice the magnitude of the association at the ninth decile. These results suggest that volunteering may be more beneficial for the health of specific groups in society. With small health advantages from year to year, volunteering may protect older and less healthy adults from health decline in the long run.

Socio-economic position and local solidarity in times of crisis. The COVID-19 pandemic and the emergence of informal helping arrangements in Germany

In this article we study the emergence of local solidarity in the wake of the COVID-19 crisis in Germany. The COVID-19 pandemic and ensuing lockdown measures have had far-reaching and quite diverse consequences for different social groups, and have increased the need for practical help, childcare, financial aid, but also emotional support to cope with the psychological consequences of social isolation. Hence, even individuals who are not traditionally receivers of informal help have suddenly become dependent on it. Existing research on volunteering, caregiving and donations has shown that the provision of help and volunteer work has a social gradient, and that social inequalities therein can partly be explained by reference to individuals' attitudes and social networks. Against this backdrop, we ask: (1) Has the COVID-19 pandemic sparked the emergence of a new local solidarity? (2) What types of help are provided, and to whom? (3) How does socio-economic position affect the provision of different forms of help during the COVID-19 crisis? (4) Which sociological mechanisms can explain these inequalities in helping? Using data from a topical online-survey based on a quota sample which was collected, during the heydays of the first lockdown in Germany, we find that one of two respondents engages in some sort of local solidarity. Depending on the recipient and the way of helping - up to half of these helping arrangements has newly emerged and does not build on already existing (pre-crisis) help-arrangements. Differences between income and educational groups can mostly be explained by attitudes and social networks. Embeddedness in formal networks is particularly important for extending help to previously unknown recipients in the community. This article contributes to the literature on the social origins of help and the initiation of social capital during crises in general, and the political discussion about solidarity in the COVID-19 pandemic in particular.

The importance of meaningful participation: health benefits of volunteerism for older adults with mobility-limiting disabilities

Volunteerism has been increasingly recognised as a health promotion activity for older adults. However, volunteerism has largely been the domain of those who are in good health with few to no physical limitations, and there is limited information about the experiences of older adults with disabilities. This study explores why older adults with mobility-limiting disabilities engage in volunteer work and their perceptions of the personal benefits of volunteering. Twenty older adults, from three Midwest towns in the United States of America, participated in semi-structured, in-depth, face-to-face interviews. Participants in this study identified as having serious difficulty walking or climbing stairs due to a health condition and had volunteered in the last year. Participants were selected purposively for maximum variation in terms of type of disability/impairment, race, gender and age. The constant comparative method of analysis was used to identify themes from their discussions. When asked about why they volunteer and the personal benefits of volunteering, participants discussed seeking out activities that were meaningful to them for both altruistic and more self-directed reasons. They identified a number of physical and emotional health benefits that they saw as directly and indirectly related to being able to participate in these meaningful activities. Findings from this study suggest that, for older adults with disabilities who are interested in volunteer activities, volunteerism can be a beneficial health promotion activity and a potential mechanism for increasing opportunities for meaningful inclusion and participation in their communities.

The Impact of Volunteering and Its Characteristics on Well-being After State Pension Age: Longitudinal Evidence From the English Longitudinal Study of Ageing

OBJECTIVES

Volunteering after retirement age is beneficial to well-being. This study furthers previous research by presenting a longitudinal analysis of the well-being of volunteers, compared to non-volunteers, based on characteristics of the voluntary work in which they participate.

METHOD

Participants were 3,740 people aged State Pension Age and over from the English Longitudinal Study of Ageing. Longitudinal regression models were used to determine whether frequent volunteers saw beneficial changes in well-being (depression, satisfaction with life, CASP-19, and social isolation) compared to non-volunteers. The initial model used a hierarchical approach so that we could also examine the impact of social and health factors. Models were then run to determine whether well-being in relation to volunteering was influenced by its continuity, the number of activities engaged in, whether the volunteering was formal or informal in nature, and whether or not the respondent reported feeling appreciated for their efforts.

RESULTS

Although sociodemographic and health circumstances reduce the magnitude of the effects of volunteering on well-being, the effect of volunteering remained significant in almost all analyses. The beneficial effect of volunteering appeared to stop among respondents who stopped volunteering between waves. The best outcomes were observed among those participating in higher numbers of activities, regardless of whether or not these were classed as formal or informal, and who felt appreciated for their work.

DISCUSSION

Certain aspects of volunteering might be especially beneficial to the well-being of older people. That these effects stop when volunteering stops suggest a causal element to this relationship.