Structural Relationships of Socioeconomic Factors Influencing Diet, Lifestyle Habits, Having a Dentist, and Health Factors That Impact Healthy Life Longevity for the Elderly

Background: “Healthy Life Longevity” (a latent variable) is defined as the number of survival days, along with recommended subjective health and long-term care needs. This study aimed to clarify the structural relationships among several related factors. Methods: In September 2001, a postal survey using a self-administered questionnaire was conducted among 16,462 elderly residents of Tokyo. In a cohort study, 8162 individuals with confirmed survival after six years were examined. We analyzed data to evaluate the need for long-term care three years after the initial survey. Additionally, the number of days survived was calculated from the third year after the initial survey. Covariance structure analysis was used to explore the structural relationships. Results: The direct effects of lifestyle habits, including a healthy diet, dental care rather than physician care, and socioeconomic factors, were minimal in improving “Healthy Life Longevity.” However, a structural relationship was established: desirable lifestyles, including diet and dental care, were selected based on socioeconomic status, thereby influencing mental, physical, and social health and reducing disease incidence. This relationship ultimately enhanced “Healthy Life Longevity.” Socioeconomic factors were identified as confounders in the association between preferred lifestyle choices, including diet, and Healthy Life Longevity. The determination coefficient of “Healthy Life Longevity” is 83%. Conclusions: Although healthy longevity can be achieved by improving mental, physical, and social health, and reducing disease burden, the relevant structure is shaped by socioeconomic status. Additionally, socioeconomic status is associated with healthy longevity by facilitating the choice of a preferred lifestyle, including diet, and the selection of a dentist. Future randomized intervention studies focused on socioeconomic status should explore ways to promote healthy longevity.