Neighborhood effects on social isolation and loneliness among community-dwelling older adults

Researchers have determined that social isolation and loneliness are major threats to the wellbeing of older adults. To better understand these mechanisms and to design effective interventions for reducing social isolation and loneliness among older adults, growing interests have focused on exploring risk factors. Neighborhoods are important social settings for older adults, as well as locations where social programs aiming at enhancing social engagement are implemented. However, although individual-level risk factors have been widely examined (e.g., age, race/ethnicity, income, and health), relatively fewer studies have empirically tested neighborhood-level risk factors for, and protective factors against, social isolation and loneliness among older adults. This study, therefore, aims at exploring the neighborhood-level risk and protective factors for social isolation and loneliness among community-dwelling older adults, focusing specifically on neighborhood socioeconomic structure and racial/ethnic composition. These structures were measured using a series of proxy variables, including neighborhood deprivation, racial/ethnic diversity, income inequality, and dynamics of neighborhood income and racial/ethnic composition. Two-level data were constructed. Individual survey data were collected in 2015 from 3,701 older adults, defined as 60 and older, who resided in New Jersey. The individual data were then combined with census tract-level sociodemographic and economic indicators from the 2015 American Community Survey (ACS). Subsamples of older White and African American adults were subsequently created and compared. Hotspot analyses were conducted to explore the concentrations of socially isolated and lonely older adults across the state. Multilevel linear regressions were conducted to examine the effects of selected neighborhood indicators on social isolation (distal and proximal) and loneliness among older adults. Four major findings were identified from the regression models: 1) the association between neighborhood deprivation and social isolation/loneliness is primarily due to the concentration of older adults with low socioeconomic status (SES) living in relatively deprived neighborhoods; 2) greater racial/ethnic diversity is associated with more social isolation among older White adults, with only those living in neighborhoods with intermediate levels of diversity reporting statistically positive effects of diversity on loneliness; 3) there is an overall trend toward the increase in diversity and the decrease in percentage of Whites in NJ neighborhoods over time; the change in the percentage of Whites, but not neighborhood income, affects distal social isolation among older African American adults; 4) older adults who live alone and/or without a partner tend to relocate to apartments and senior living communities. In addition, no significant association was identified for income inequality, suggesting that income inequality is more likely to function at a larger geographic scope, such as at the state and country level, or may not be a spatial predictor of social isolation/loneliness among older adults. The findings highlight the importance of neighborhood socioeconomic structure and racial/ethnic composition for the social wellbeing of older adults. Neighborhood-level risk factors are likely to reduce older adults’ motivation and willingness to engage in social activities and likely to impose barriers to accessing social activities. Conversely, however, some findings also imply the possibility of older adults expanding/enhancing their social connections or adjusting their social needs as coping and adaptation strategies when facing individual or neighborhood impediments to social engagement. Practitioners and policy makers should be aware of the importance of neighborhood contexts for older adults to effectively engage in social activities and to obtain support, information, and resources through this process. Community-based programs that aim at reducing social isolation and loneliness should assess the overall neighborhood socioeconomic and political structures (e.g., interracial relationships and the power structure) as well as the more direct neighborhood and individual-level factors (e.g., the transportation system and individual financial barriers) to identify the most vulnerable populations and to better design and distribute services and resources. In addition to directly targeting social isolation, practitioners should respect the choices of older adults in forming their own social support networks and provide direct resources and services to supplement the inadequacies of their social connections.Ph.D.Includes bibliographical reference