Family, Social Support and Health Status of Older People in Tehran

Iran has recently undergone an exceptionally fast fertility transition. The Total Fertility Rate decreased from 7 in 1980 to 1.8 in 2006 along with declines in adult mortality rates. Consequently, Iran is currently experiencing rapid population ageing. As these demographic changes are intertwined with huge social changes, some major challenges may be anticipated in future. One important concern is that the health status of older people, particularly their mental well-being, may be adversely affected if fewer children lead to a reduction in the support available to older people. The aim of the research described in this thesis was to examine direct and stress-buffering associations between social support and mental health in older age groups. Potential differences between men and women in the associations and the role of different sources of support were also examined. A review of the existing literature indicated that this topic is under-researched in Iran or culturally similar countries. A quantitative cross-sectional survey of a random sample of 800 people aged 60+ years resident in Tehran was conducted. In total, 644 people responded. Multilevel mixed-effects models were used to examine the hypotheses. The findings supported the hypothesis of a direct association between functional aspects of social support and mental health but not that of an association between structural aspects of social support and mental health. No strong evidence of a stress-buffering effect of social support in the association between physical functioning and mental health was found, except in the case of receipt of social support with transportation. The only type of support that showed a significant interaction with gender was receipt of support with paperwork. The source of support did not seem to matter. Implications of these findings for older people currently living in Tehran are considered and recommendations for appropriate social support interventions, taking account of the results, are made.