Trajectories of subjective health status among married postmenopausal women based on the ecological system theory: a longitudinal analysis using a latent growth model

Abstract

Purpose: This study investigated the trajectory of subjective health status in married postmenopausal women and aimed to identify predictive factors affecting subjective health status. Methods: Data were obtained from women who participated in wave 4 (2012) of the Korean Longitudinal Survey of Women & Families Longitudinal Study and continued to the latest phase (wave 7, 2018). A latent growth model (LGM) was used to analyze data from 1,719 married postmenopausal women in the framework of the ecological system theory. Results: The mean age of the participants at wave 4 was 56.39±4.71 years, and the average subjective health status was around the midpoint (3.19±0.84). LGM analysis confirmed that subjective health status decreased over time (initial B=3.21, slope B=–0.03). The factors affecting initial subjective health were age, body mass index, frequency of vigorous physical activity (microsystem level), marital satisfaction (mesosystem level), and medical service utilization (macrosystem level). Medical service utilization and the frequency of vigorous physical activity were identified as predictive factors affecting the slope in subjective health status. The model fit was satisfactory (TLI=.92, CFI=.95, and RMSEA=.04). Conclusion: This analysis of the trajectory of subjective health status of married postmenopausal women over time confirmed that subjective health is influenced by overall ecological system factors, including the microsystem, mesosystem, exosystem, macrosystem, and chronosystem. Therefore, it is necessary to assess physical activity and support policies promoting access to medical services in order to improve the subjective health status of married postmenopausal women.