Abstract
BACKGROUND: Participation in community activities (eg, sports and hobby groups or volunteer organizations) is believed to be associated with better health status in the older population. We sought to (1) determine whether a greater diversity of group membership is associated with better self-rated health and (2) identify the key dimension of the membership diversity (eg, gender, residential area, or age). METHODS: We performed a cross-sectional study of 129,740 participants aged 65 years and older who were enrolled in the Japan Gerontological Evaluation Study in 2013. We assessed the diversity of group membership using (1) a continuous variable (range 0-4) accounting for the total degree of each diversity dimension or (2) dummy variables for each dimension. We estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for better self-rated health according to the diversity of group membership, using Poisson regression and robust variance with multiple imputation, adjusted for other covariates. RESULTS: The participants involved in social groups with greater diversity had better self-rated health: the PR per one point unit increase in diversity was 1.03 (95% CI, 1.02-1.04). Participation in gender-diverse groups was associated with the best profile of health (PR 1.07; 95% CI, 1.04-1.09). CONCLUSIONS: Among the older population in Japan, higher group diversity is associated with better self-rated health. Gender is the key dimension of diversity that is associated with better self-rated health.