Benefits of formal voluntary work among older people. A review.
ABSTRACT A narrative review of quantitative population-based longitudinal studies was conducted to examine the association of formal voluntary work and personal well-being among older people doing the voluntary work and those being served.
To be included, the study had to be published in a peer-reviewed journal, written in English and conducted in Western countries, participants were at least 60 years of age, the study employed a longitudinal or experimental design, the methodology and outcomes were explicitly described, and voluntary work quantified as visits or hours within a certain time frame.
Sixteen studies out of 2897 met the inclusion criteria for the review reporting on benefits of volunteering for those doing the voluntary work. Outcomes were collapsed into three categories of personal well-being: physical health, mental health, and psychosocial resources. All included studies came from the United States and showed that volunteering in old age predicted better self-rated health, functioning, physical activity and life satisfaction as well as decreased depression and mortality. However, it did not decrease the risk of chronic diseases or nursing home admission in old age. Only one study which met the inclusion criteria on the benefits of volunteering for older recipients was identified.
Studies mainly used data from large datasets with only limited information about volunteering, which limits more detailed analyses. Randomized controlled trials are needed to study the effect of voluntary work on those being served, as well as to reveal the healthy participant effect among volunteers.
- SourceAvailable from: Suzanne H Richards[Show abstract] [Hide abstract]
ABSTRACT: Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011--2015 focused on increasing the impact of national service on community needs, supporting volunteers' wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers' physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes. Experimental and cohort studies comparing the physical and mental health outcomes and mortality of a volunteering group to a non-volunteering group were identified from twelve electronic databases (Cochrane Library, Medline, Embase, PsychINFO, CINAHL, ERIC, HMIC, SSCI, ASSIA, Social Care Online, Social Policy and Practice) and citation tracking in January 2013. No language, country or date restrictions were applied. Data synthesis was based on vote counting and random effects meta-analysis of mortality risk ratios. Forty papers were selected: five randomised controlled trials (RCTs, seven papers); four non-RCTs; and 17 cohort studies (29 papers). Cohort studies showed volunteering had favourable effects on depression, life satisfaction, wellbeing but not on physical health. These findings were not confirmed by experimental studies. Meta-analysis of five cohort studies found volunteers to be at lower risk of mortality (risk ratio: 0.78; 95% CI: 0.66, 0.90). There was insufficient evidence to demonstrate a consistent influence of volunteering type or intensity on outcomes. Observational evidence suggested that volunteering may benefit mental health and survival although the causal mechanisms remain unclear. Consequently, there was limited robustly designed research to guide the development of volunteering as a public health promotion intervention. Future studies should explicitly map intervention design to clear health outcomes as well as use pragmatic RCT methodology to test effects.BMC Public Health 08/2013; 13(1):773. · 2.08 Impact Factor
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ABSTRACT: Objectives.This study investigates the interplay among religiosity, spirituality, value-expressive volunteer motivation, and volunteering. We examined religiosity and spirituality as predictors of value-expressive volunteer motivation and volunteering and whether religiosity moderated the relations between (a) spirituality and value-expressive volunteer motivation and (b) value-expressive volunteer motivation and volunteering.Method.After applying multiple imputation procedures to data from the Wisconsin Longitudinal Study among participants 64-67 years old who survived beyond 2004 (N = 8,148), we carried out regression analyses to predict value-expressive volunteer motivation and volunteering from religiosity and spirituality controlling for demographic variables, physical, emotional, and cognitive health, health risk behaviors, and personality traits. Both religiosity and spirituality were significant (p < .001) positive predictors of value-expressive volunteer motivation. Value-expressive volunteer motivation and religiosity were significant (p < .001) positive predictors, whereas spirituality was a significant (p < .001) negative predictor, of volunteering. Religiosity amplified the relation between value-expressive volunteer motivation and volunteering (p < .05) but did not moderate the relation between spirituality and value-expressive volunteer motivation (p > .45).Discussion.Religiosity may provide the way, and value-expressive volunteer motivation the will, to volunteer. The implications of our findings for the forecasted shortage of older volunteers are discussed.The Journals of Gerontology Series B Psychological Sciences and Social Sciences 04/2014; · 3.01 Impact Factor
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ABSTRACT: Older community-living disabled people often have unmet activity needs and participation restrictions potentially reducing their quality of life (QoL).Aging clinical and experimental research. 06/2014;
Aging Clin Exp Res. First published ahead of print July 16, 2010 as DOI: 10.3275/7200
Copyright© 2010, Editrice Kurtis
Benefits of formal voluntary work among older people – A review
Mikaela B. von Bonsdorff, PhD1,2,3, Taina Rantanen, PhD1
1Gerontology Research Centre, Department of Health Sciences, University of Jyväskylä, Finland
2GeroCenter Foundation for Research and Development, Jyväskylä, Finland
3The Central Finland Health Care District, Jyväskylä, Finland
Corresponding author and reprint requests:
Mikaela von Bonsdorff, Researcher, PhD
Gerontology Research Centre
Department of Health Sciences
University of Jyväskylä
PO Box 35 (Viveca)
FIN-40014 University of Jyväskylä
Tel. +358 14 260 4596, Fax +358 14 260 4600, e-mail firstname.lastname@example.org
Keywords: formal volunteering, well-being, health, post-retirement, older people
Running head: Voluntary work among older people
DISCLAIMER: This is an un-copyedited author manuscript copyrighted by Editrice Kurtis. This may
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owner. From the time of acceptance following peer review, the full text of this manuscript is made
freely available by Editrice Kurtis at http://www.kurtis.it/aging/en/list-preview.cfm. The final copyedited
article will be available at the journal website at http://www.kurtis.it/ after publication on Aging Clinical
and Experimental Research. Editrice Kurtis disclaims any responsibility or liability for errors or
omissions in this version of the manuscript or in any version derived from it. The citation of this
article must include the following information: author(s), article title, journal title, year of publication,
Received March 10, 2010; Accepted in revised form June 17, 2010.
A narrative review of quantitative population-based longitudinal studies was conducted to
examine the association of formal voluntary work and personal well-being among older people
doing the voluntary work and those being served. To be included the study had to be published
in a peer-reviewed journal, written in English and conducted in the Western countries,
participants had to be at least 60 years of age, the study employed a longitudinal or experimental
design, the methodology and outcomes explicitly described and voluntary work quantified as
visits or hours within a certain timeframe. Sixteen studies out of 2897 met the inclusion criteria
for the review reporting on benefits of volunteering for those doing the voluntary work.
Outcomes were collapsed into three categories of personal well-being: physical health, mental
health, and psychosocial resources. All included studies came from the United States and showed
that volunteering in old age predicted better self-rated health, functioning, physical activity and
life satisfaction as well as decreased depression and mortality. However, volunteering did not
decrease the risk of chronic diseases or nursing home admission in old age. Only one study that
met the inclusion criteria on the benefits of volunteering for the older recipients was identified.
Studies predominantly utilized data from large datasets with only limited information about
volunteering which limits more detailed analyses. Randomized controlled trials are needed for
studying the effect of voluntary work for those being served as well as to unmask the health
participant –effect among the volunteers.
Volunteering is defined as an activity that involves spending time, unpaid, doing something that
aims to benefit the community in general or its individuals or specified subsets of community
members who are in need, such as older home bound persons (1, 2). This review focused on
formal volunteering and excluded informal volunteering such as helping and caring for close
relatives, friends or neighbors. What differentiates formal and informal volunteering is a sense of
obligation which is often stronger in informal volunteering than it is in formal volunteering,
where volunteering depends more on the ability and opportunity of the helper (1). Volunteering
has been quantified according to its intensity (the amount of time spent), diversity (how many
organizations), and consistency (how regularly the individual volunteers across the lifespan).
Formal volunteering is usually coordinated by public agencies, nonprofit agencies, religious
organizations, or through government programs covering a wide range of activities (1, 3).
Volunteering typically includes activities such as tutoring or mentoring either instrumental,
supportive or nonskilled; skilled or unskilled assistance or technical advice and public safety (4).
The growth in the older population in the 21st century will be a challenge to the public economy
and health care service system but it might also offer possibilities. The predicted shortage in the
labor force will increase the demand for volunteers in the future. The healthy active older
population who are not engaged in paid work constitutes a growing reservoir of human and
social capital (5-7), and volunteering is potentially a good venue to contribute to the society (8).
The generation born between 1946 and 1960 will enter into old age with a great deal of
experience and skills that could be transferred to the non-profit sector. In addition, increasing
longevity, health and wealth allows for non-profit activities such as volunteering in later life (9,
10). Volunteering could be a cornerstone of productive aging, as volunteering helps provide
services that are of economical and social value (11, 12).
Most studies on volunteering have been done in the United States, which is the most active
nation in volunteer work in Western Countries. According to the Current Population Survey, the
rate of volunteering in the U.S among people aged 65 years or over was 23.5% in the year 2008
(13). The long-standing tradition in volunteering in the U.S is partly due to their welfare system
that e.g. builds on non-profit and religious organizations as well as the fact that the U.S policy
makers have actively encouraged volunteering (14). In Europe, the rate of volunteering differs
between the countries, depending on the welfare policy (15). In Nordic countries, where the
public health care system is responsible for social welfare, older people participate more actively
in voluntary work than in the Mediterranean countries. There interfamily exchange is strong and
cohabitation among generations more usual than in north Europe (16). Cross-national data from
the Survey of Health, Ageing and Retirement in Europe (SHARE) on volunteering showed that
the rate of volunteering ranged between 2 and 21%, with an average of 10%, depending strongly
on the countries’ societal context concerning volunteering (17). In Australia about 20% (18) and
in Canada about 18% (19) of the older population had volunteered in the previous year.
In cross-sectional studies, the relationship between volunteering and well-being has been
identified (20-22). There is, however, the problem of causal order between well-being and
volunteering, which can only be addressed with a prospective study design (23). Good health and
adequate social resources tend to increase the probability of doing volunteer work (7, 23-26). It
has been argued that persons who are physically and mentally fit are not only able, but also
likely to be equipped with personal resources such as high self-esteem or control over life that
increase the likelihood of volunteering (1, 23, 26). It is equally plausible that health determines
volunteering than the other way around. Furthermore, the curvilinear relationship between
volunteering and well-being (27, 28) also showed that a moderate, but not high, number of hours
spent doing voluntary work enhanced late-life health and well-being.
Although a fairly large body of literature exists regarding the various benefits of volunteering for
those doing the voluntary work, earlier reviews (9, 20, 29, 30) have not investigated the benefits
of volunteering systematically with clearly defined inclusion and exclusion criteria. The aim of
this review was to conduct a systematized narrative literature review on quantitative data to
examine the association of formal voluntary work and personal well-being among older people
doing the voluntary work and those being served.
We searched for relevant studies published in English through November 31, 2009, without a
start date, using the following databases: PubMed, the Cochrane Central Register of Controlled
Trials, Cochrane Database for Systematic Reviews, CINAHL (Cumulative Index to Nursing and
Allied Health Literature), ERIC (Education Resources Information Center), PsycINFO, Ovid
MEDLINE, ISI Web of Knowledge, and CSA (Sociological Abstracts). Depending on the
database, search terms included combinations of volunteering; “voluntary work”; aged; “older
people”; volunteerism; “benefits of volunteering”; “people being served”; “quality of life”;
intervention; trial. In addition, the reference lists of identified papers and reviews were searched
through for relevant articles. On the basis of the abstract, it was assessed whether the study had
the potential to be included. Based on the full article, it was decided whether the study met the
The following inclusion criteria were used: a) the study was published in a peer-reviewed journal
b) The paper was written in English and conducted in the Western countries c) participants were
at least 60 years of age, d) the study employed a longitudinal or experimental design, e) the study
methodology and outcomes were explicitly described and f) voluntary work was quantified as
visits or hours within a certain timeframe. The selection was made by the reviewer (M.v.B) and
in case of any uncertainty regarding the study inclusion the senior reviewer (T.R) was consulted.
2897 studies on older people volunteering were identified in the literature search of which 16
were accepted to this review (see Figure for review flow). The main reasons for exclusion were
that the study was cross-sectional, participants were under 60 years of age, volunteering was
defined to include also informal volunteering, or the study had not been published in a peer-
reviewed journal. The included studies investigated the associations of volunteering with the
well-being of those who did the voluntary work. 13 observational studies analyzed data from
population-based large prospective datasets and 3 experimental studies used data from one
randomized controlled trial. All studies were conducted in the U.S. Studies that used the same
large datasets were reviewed as separate studies when they investigated different outcomes.
Prospective studies included in the review
In the population-based prospective studies the number of participants ranged from 705 to 7.496,
except for one that included 71 women from the Baltimore Experience Corps Extended Pilot
Study matched with a comparison cohort of 150 women from the Women’s Health and Aging
Study (31), for description of included studies see Table 1. Age ranged between 60 to 97 years
(mean age between 70.1 to 77.0 years). Most of the participants (60-70%) were women and
predominantly white. The volunteers were more educated, had better perceived health and fewer
functional impairments than the non-volunteers (28). Most of the studies, however, did not
present baseline data according to the voluntary status, making it hard to compare the volunteers
to the non-volunteers for socio-demographics, health and functional status.
In the prospective datasets, voluntary work was mostly defined as the number of organizations
the person volunteered for and the total amount of hours dedicated for doing formal voluntary
work during the past 12 months. There was very little information on the nature and duration of
the voluntary work or the setting where volunteering took place. Among persons 65 years and
older, the volunteering rate in the past year ranged between 12-34.5% in the population-based
studies. The organizations for which participants had volunteered included, e.g., church or other
religious organization, school or educational organization, and political group or union. The
average number of organizations that the volunteers worked for was 1.7 (32). Number of hours
spent doing voluntary work ranged from 0 to 200 hours. Among those who volunteered, the
average number of hours spent volunteering was 72-73 during the previous year (28, 32). Some
studies (10, 27) reported the average hours spent volunteering among the entire study population,
which reflects the number of persons who did volunteer rather than the amount of volunteering
among those who actually volunteered.
The large datasets such as ACL and LSOA with several data collection waves during long
surveillance periods had relatively high attrition due to non-response, not being able to contact
the participants, and death. Even though in longitudinal studies missing data are often considered
being ubiquitous, it should be accounted for with current methods to avoid biased results (33). In
terms of missing data, it is important to consider whether it is missing at random or not at
random, where in the latter, systematic differences exist between the missing values and the
observed values even after the observed data are taken into account (34). Different imputation
methods, such as multiple imputation, recommended for dealing with data that are missing at
random, were used in some of the prospective studies on the ACL data (3, 10, 32) and the LSOA
data (35). Attrition in the studies drawing on data from the AHEAD study was stated to have
been small throughout the three data waves and weights were used to compensate for it (11, 36).
Randomized controlled trials included in the review
The Experience Corps implemented in Baltimore, Maryland (6) is so far the only randomized
controlled trial on volunteering among older people. The RCT was designed to generate social
benefits and simultaneously offer a community-based approach to health prevention. The 128
predominantly African American participants were randomized into an intervention group or a
control waiting list. The eligibility criteria for the trial were: 60 years or older, ability to read and
pass a criminal background check, ability to travel to the schools, a Mini-Mental State
Examination (37) score of 24 or above and/or meeting a threshold score on the Trail Making
Test (38). The intervention group participants served at least 15 hours per week in elementary
schools and assisted the children with e.g. reading achievement, library support, and class room
behavior during an academic year (39).
Longitudinal associations of volunteering and personal well-being
Outcomes were pooled together and collapsed into three categories that constituted personal
well-being: physical health, mental health, and psychosocial resources (23), see Table 2. Several
studies found a nonlinear relationship between volunteering and well-being (32), suggesting that
a certain amount of involvement is optimal but that a lower level of volunteering is beneficial for
well-being (27). Morrow-Howell et al. demonstrated that about 100 hours per year yielded the
greatest benefit of volunteering and that more hours per year did not increase the gains (32).
There were only a few studies that investigated volunteering with more than just the number of
hours committed to it. Building on ACL data, Morrow-Howell et al. reported that the number
and type of organization coordinating the voluntary work was not associated with the well-being
outcomes (32). However, in another study using the same data Musick & Wilson showed first
that the risk for death was lower for those who volunteered for one organization (27) and later
that religious volunteering and the longer duration of volunteering predicted better well-being in
older age (3).
Most prospective studies investigated the relationship between volunteering and physical health.
A series of studies found that volunteering predicted better self-rated health. Luoh et al. showed
with the AHEAD data that those who had volunteered 100 hours or more during the last year
rated their health better than those who had volunteered less than 100 hours (36). Two studies
(10, 11), drawing on data from AHEAD and ACL reported, on the other hand, no association
between volunteering and the number of physician diagnosed self-reported chronic diseases. In
all studies, volunteering at the age of 60 years or later predicted less difficulties or disability in
activities of daily living tasks than among the non-volunteers with follow-up ranging from 2 to 8
years (10, 11, 32, 36, 40). Tang used the ACL 1 through 3 data waves for showing that increased
hours spent volunteering at the age of 60 years or later predicted lower level of functional
dependency (10). Lum & Lightfoot found in the AHEAD data that volunteering was not
associated with living in a nursing home at the 7-year follow-up (11). Conversely, volunteering
at the age of 60 years or later predicted lower mortality in the prospective studies drawing on
data from the ACL, AHEAD, and LSOA studies (11, 27, 36, 41, 42).
Mental health and psychosocial resources are less studied outcomes of volunteering among
persons over 60 years of age, with the focus mainly on the association of volunteering and
depression (3, 11, 26, 32, 35, 40). Building on the three wave data from the ACL study, Li &
Ferrano found a beneficial effect of volunteering on depression during the eight year follow-up
(26). However, they further detected evidence of certain self-selection processes in that persons
with higher socioeconomic status and active church attendees had a lower incidence of
depression and were more actively engaged in volunteering (26). Van Willigen showed, drawing
on data from the ACL wave 1 and 2, that voluntary work increased life-satisfaction among
people over 60 years of age (28).
In a prospective study, Tan et al. compared the 71 women from the Experience Corps Pilot study
who did high-intensity voluntary work with 150 non-volunteering women controls from the
Women’s Health and Aging Study with a 3-year follow-up time. The women were aged 65-86
years and had comparable socio-economic status, self-rated health and frailty status. The study
showed that women who volunteered in the high-intensity senior service program reported
sustained increase in their physical activity level compared to the non-volunteering counterparts
during the 3-year follow-up (31).
Effects of volunteering on personal well-being
Three papers investigated in a randomized controlled setting the effect of high-intensity
volunteering on physical functioning (39), physical activity (39, 43) and cognition (39, 44). The
studies showed a positive trend in the effect of volunteering on cognitive and physical
functioning, although the power in the analysis was limited. The intervention increased the over
all physical activity level for the intervention group (39). Further, when measuring in kilocalories
per week, the short-term increase in physical activity was significant among the Experience
Corps volunteers compared to the controls (43).
Benefits of volunteering for those being served
The benefits of volunteering for those being served could not be reviewed, because only one
study that met the inclusion criteria was identified in the literature search. In that study, frail
home-bound older persons participated in the Strong for Life exercise program delivered by
volunteers who had been trained by physical therapists for the task. After the 4-month program,
the frail participants showed significant improvements on the Short Form-20 social functioning
scale, however there were no significant differences in physical functioning, mental health or
self-rated health (45). The study did not include a control group so the effect of the program
could not be evaluated in a controlled setting. The basic idea of the study was to investigate
whether an exercise program such as the Strong for Life program could be feasibly, efficiently
and safely delivered by specifically trained lay volunteers in voluntary organizations.
We identified and critically reviewed 16 studies investigating whether volunteering predicted
personal well-being among older people doing voluntary work. These studies used data from
three population-based prospective datasets and one randomized controlled trial. Volunteering in
old age predicted better self-rated health, functioning, physical activity and life satisfaction, as
well as decreased depression and mortality. However, volunteering did not decrease the risk of
chronic diseases or nursing home admission in old age.
Possible mechanisms for the effect of volunteering on well-being have not been extensively
discussed in the literature. The most commonly used explanation is the beneficial association of
social contacts that develop during volunteering or more general social activities. It has been
shown that social contacts and support have an effect on health and survival among older people
and volunteering fosters such connections (36, 42). Volunteering does involve a certain amount
of physical and mental effort and probably these beneficial physiological effects contribute to the
decreased risk of adverse health outcomes. Furthermore, volunteering is known to support
psychological well-being and sense of control, self-efficacy, which is positively related to health
(23). This might also in part explain the curvilinear beneficial effect of volunteering seen in
several studies (27, 36) in that reasonable amounts of volunteering are salubrious, but excessive
amounts are less likely to enhance health. Little empirical work has been done on specific
outcomes of volunteering (4, 32) as well as on the effect of different type of voluntary work on
health (27, 42). The findings on the association of the number of organizations one volunteers for
and subsequent well-being have been inconsistent (3, 27, 32). Thus, to be able to understand and
to investigate the mechanisms underlying the positive association of volunteering, more detailed
information on the nature of the voluntary work is needed.
The problem of causal order between well-being and volunteering is a challenging one.
Furthermore, we cannot completely control for the “healthy participant effect”. It is a fact that
persons who are in good health and possess adequate social and economic resources tend to
volunteer more (23, 26, 27). They are also likely to be equipped with personal resources such as
high self-esteem or control over life that increase the likelihood of volunteering (23, 26). Moen
et al. showed in their prospective study that women who volunteered in 1956 were more likely to
occupy multiple roles 30 years later and have better health outcomes than those who did not
volunteer earlier in their lives (46). That study differs from other studies that compare
volunteering and its benefits across different age groups, like e.g. van Willigen (28), in that the
period and cohort effect is controlled for. Volunteering presumably has a different meaning for
persons in different age groups born in different time periods and in addition, there are
underlying cultural norms and traditions that affect attitudes toward volunteering.
Future implications for practice
Volunteering is collectively seen as a feasible and humane way of helping people who cannot
cope on their own and as a potential field of productive activity for older retired fit persons who
still have a lot to offer. The basic element underlying voluntary work is that it is a social activity
which generates a considerable amount of social capital not only to the receiver, but also to the
giver, and consequently also to the society (9, 12). To date, persons who retire have better health
than ever before and they are expected to live longer without disabilities. Thus they have extra
time on their hands, and in some cases, the retired persons’ children and immediate family live
further away and they do not help their own family on a day-to-day basis. However, to what
extent can older people be expected to be a productive part of the society? The sheer increase in
leisure time after retirement cannot be assumed to result in more voluntary work being done
(12). It is potentially harmful for social cohesion to label those who do not, for some reason,
volunteer as unproductive in the society (47). Older age increases the risk for debilitating
illnesses and functional decline that hinders such activities even though the person would wish to
productively participate in the society.
Some people, who are near retirement age lead hectic lives and are often very committed to their
working careers. They are likely to transfer some of their energy and ambitious attitudes that
they have adopted during their paid working lives into post retirement volunteering, which will
probably result in changes in the current voluntary work policy. Volunteering could serve as a
good extension of the active working career by offering mental and physical challenges and
social contacts that will otherwise cease when the person is retired (36). However, it remains to
be seen whether the baby-boomers will engage more actively in voluntary work than the older
retired population today.
Even though volunteering is a charitable activity, we should bear in mind that it opens up the
doors of vulnerable older persons who do not necessarily understand the potential dangers and
thus might end up as targets for abuse (48). This is why it is crucial that voluntary work is
coordinated and monitored by responsible organizations that have unified standards for voluntary
work. The people who do ‘hands on’ voluntary work need to be properly trained for the task.
Volunteering should be evaluated rigorously and there should be clearly defined quality criteria
for its implementation.
Future implications for research
There are only a few large datasets in the world that have been used for studying volunteering
among older people. The majority of research data on the associations and effects of
volunteering on health and well-being come from the United States and might not apply to the