Loneliness and health status of Chinese and Anglo-Australian Manningham seniors

This thesis investigated whether there is a significant difference in self-reported health and loneliness between Chinese and Anglo-Australian seniors living in Manningham, a city characterised by green open space with relatively high household incomes. The thesis explored influences of social determinants of health on the experiences and perceptions of the two groups and was guided by the theory of ‘Successful Ageing’. The research followed a mixed methods sequential explanatory design which had three phases: (1) quantitative data collection, (2) qualitative data collection, and (3) integration of results. The quantitative phase utilised computer assisted telephone interviews to identify factors that contributed to loneliness using the shortened UCLA Loneliness Scale and self-reported health. Seniors from the quantitative phase comprised the sample group for the qualitative phase where face-to-face interviews and a focus group were undertaken to explore perceptions of loneliness, health, and neighbourhood to explore in more depth, the information provided by participants in the telephone interviews. Results of quantitative analysis found a relationship between loneliness scores and self-reported health in Chinese and Anglo-Australian seniors. Results of t-tests and chi-squared tests indicate that ethnicity is significantly related to self-reported health. The relationship between loneliness and ethnicity was not established. While the mean loneliness scores between the two groups were similar, a higher proportion of Chinese seniors reported low levels of loneliness, and were nearly three times more likely than Anglo-Australian seniors to self-report poorer health. Results of qualitative analysis revealed that while the majority of seniors stated they did not feel lonely, loneliness was described as: absence of an important relationship; absence of direction, a private experience, and incorporating despair. Health was conceptualised as functional, psycho-social, and healthy living (staying active). Relationships, being responsible for one’s own health, and the place in which they lived were identified as important to health. The results are integrated into three overarching conclusions: l) the concept of loneliness is neither well defined nor measured; 2) ethnicity and culture play a significant role in how seniors conceptualise loneliness and health; and 3) common factors of lifestyle, place, sense of mastery and relationships are important contributors to / supporters of health as promoted by a social determinants approach. The findings of this thesis provide valuable insight into the differences in conceptualisations of loneliness, health and successful ageing between Chinese and Anglo-Australian seniors which would be helpful to governments in the development and implementation of successful / healthy/ active / positive ageing plans. The findings contribute to the health promotion and successful ageing discourses on the influences of culture on living productive and healthy lives. The findings reported in this thesis do not support the UCLA Loneliness Scale as a valid cross cultural instrument, nor the proposition that loneliness is a uni-dimensional phenomenon. The addition of a fourth aspect for the theory of Successful Ageing - ‘a positive outlook’ - is proposed to help incorporate the lay perspective of successful ageing. This thesis proposes that loneliness and health can be more fully understood when contextualised within cultural perspectives