Date of Conferral

5-19-2025

Date of Award

May 2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Dr. Tolulope Osoba

Abstract

Among older U.S. adults, functional disabilities are critical determinants of quality of life (QoL), influencing mobility, social engagement, and independence. Despite growing evidence of these impacts, limited research examines how healthcare access, social support, and socioeconomic factors moderate this relationship. This quantitative study explored the effects of functional disabilities on QoL, operationalized through self-reported health, while examining the moderating roles of key social determinants. Using a cross-sectional design, secondary data from the Health and Retirement Study (HRS) were analyzed. The sample included 42,405 participants aged 60 years and above from all 50 states. Multiple regression analyses and ANOVA were employed to test relationships between functional disabilities, QoL, and moderating variables. Results indicated that functional disabilities, measured by the Functional Disability Index (FDI), significantly reduced QoL, accounting for 6.3% of variance (R² = 0.063, p < .001) while socioeconomic factors accounted for 6.6% of total variance. When healthcare access and social support were included as moderators, the variance increased to 10% (R² = 0.100, p < .001), with social support showing the strongest moderating effect. Theoretically, results support the social-ecological model which was applied to this study, showing how individual, interpersonal, and societal factors interact to influence health outcomes. Practical implications include developing integrated interventions that combine healthcare access improvements, social support enhancement, and policy reforms targeting socioeconomic disparities. While limited by self-reported measures and cross-sectional design, this study provides crucial evidence for multidimensional approaches to improving QoL among older adults with functional disabilities.

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