Disabled and Out? Social Interaction Barriers and Mental Health Among Older Adults with Physical Disabilities

Over one-third of older adults in the U.S. are physically disabled. Having a disability is a chronic stressor for older adults, and this chronic stress significantly compromises mental health. Because disablement likely restricts older adults\u27 ability to engage in interpersonal interactions, the link between physical disability and mental health may reflect consequences of such unmet social needs. Social interactions are associated with better mental health, yet prior work on social context of disablement focuses on the quality of social relations or perceptions of support, not on actual access to social interactions. There remains a need to understand how and why physical disability affects individuals\u27 desire for and ability to engage in interactions. Improving scientific understanding of factors shaping social interactions patterns is important because a lack of social interactions is associated with poor mental health, lower self-rated health, greater healthcare utilization and expenditures, and increased mortality risks. The main objective of this dissertation is to advance scientific understanding of how barriers to social interactions shape mental health among older adults with physical disabilities. Specific objectives aimed at exploring the effects of unique interpersonal and environmental barriers to social interactions experienced by disabled older adults were examined with longitudinal data from a nationally representative survey of older adults (National Social Life, Health and Aging Project), complemented by 60 semi-structured interviews with older adults living with physical disabilities. Specifically, I use quantitative and qualitative data to analyze the differential effects of the social environment and of the physical environment for people with disabilities’ mental health. Drawing on social psychology research, this project also employs interviews to examine the effect internal dialogue by people with disabilities has on their social life and their mental health outcomes. Finally, integrating theoretical frameworks used in sociology and gerontology, this project analyzes the relationship between physical disability, social interactions, and mental health outcomes by gender. Results highlight that having a physical disability is associated with less frequent social interactions, feelings about social interactions, and alters locations of social interactions. The relationship between physical disability and social interactions in turn relates to an inverse relationship with mental health