Neighborhood social cohesion and physical disorder in relation to social isolation in older adults: racial and ethnic differences.
Humans
Aged
Male
Social Isolation
/ psychology
Female
Longitudinal Studies
United States
Aged, 80 and over
Ethnicity
/ statistics & numerical data
Neighborhood Characteristics
/ statistics & numerical data
Residence Characteristics
/ statistics & numerical data
Racial Groups
/ statistics & numerical data
Minority health
Neighborhood context
Older adults
Social isolation
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
20 Sep 2024
20 Sep 2024
Historique:
received:
30
10
2023
accepted:
17
09
2024
medline:
21
9
2024
pubmed:
21
9
2024
entrez:
20
9
2024
Statut:
epublish
Résumé
Neighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship. We used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation. Approximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47-0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults. This study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts.
Sections du résumé
BACKGROUND
BACKGROUND
Neighborhood factors of social isolation have been understudied, hindering efforts to reduce social isolation at the neighborhood level. This study aims to investigate the longitudinal effects of neighborhood social cohesion and physical disorder on social isolation in community-dwelling older adults, as well as to examine whether race/ethnicity moderates the neighborhood-isolation relationship.
METHODS
METHODS
We used 11-year data from the National Health and Aging Trend Study, a longitudinal national study of Medicare beneficiaries aged 65 and older. Social isolation was measured through a summary score across four domains: marital/partner status, family and friend contact, religious attendance, and club participation. A series of weighted mixed-effects logistic regression models were performed to test the study aims. Sample sizes ranged from 7,303 to 7,291 across individual domains of social isolation.
RESULTS
RESULTS
Approximately 20% of participants reported social isolation. Findings indicated a negative association between neighborhood social cohesion and social isolation. Higher levels of neighborhood social cohesion were longitudinally associated with lower odds of social isolation (odds ratio [OR] = 0.52, 95% CI: 0.47-0.58). Yet, the presence of neighborhood physical disorder was associated with an increased risk of overall social isolation ([OR] = 1.2, 95% CI: 1.00, 1.44). Race/ethnicity significantly moderated the effects of neighborhood social cohesion and physical disorder on social isolation. The odds of no in-person visits associated with neighborhood social cohesion are smaller among Black adults compared to White adults. Black adults had constantly lower odds of isolation from religious attendance compared to White adults regardless of the level of neighborhood social cohesion. Hispanic adults had decreased odds of having no friends associated with signs of physical disorder, while no associations were found among older White adults. White adults had higher odds of isolation from in-person visits when living in neighborhoods with signs of physical disorder, whereas no association was observed among older Black and Hispanic adults.
CONCLUSIONS
CONCLUSIONS
This study elucidates the role of neighborhood characteristics in shaping social isolation dynamics among older adults. Furthermore, the observed moderation effects of race/ethnicity suggest the need for culturally sensitive interventions tailored to address social isolation within specific neighborhood and racial contexts.
Identifiants
pubmed: 39304855
doi: 10.1186/s12889-024-20112-9
pii: 10.1186/s12889-024-20112-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2574Subventions
Organisme : NIA NIH HHS
ID : T32AG000221
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG066613
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG072959
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Pohl JS, Cochrane BB, Schepp KG, Woods NF. Measuring social isolation in the National Health and Aging trends Study. Res Gerontol Nurs. 2017;10(6):277–87. https://doi.org/10.3928/19404921-20171002-01 .
doi: 10.3928/19404921-20171002-01
pubmed: 28981918
Malani P, Singer D, Kirch M, et al. Trends in Loneliness among older adults from 2018–2023. University of Michigan National Poll on Healthy Aging; 2023. https://doi.org/10.7302/7011 .
Office of the Surgeon General. Our Epidemic of Loneliness and Isolation. 2023. https://www.ncbi.nlm.nih.gov/books/NBK595227/
Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a Meta-Analytic Review. Perspect Psychol Sci. 2015;10(2):227–37. https://doi.org/10.1177/1745691614568352 .
doi: 10.1177/1745691614568352
pubmed: 25910392
Xiang X, Lai PHL, Bao L, et al. Dual trajectories of social isolation and dementia in older adults: a Population-based longitudinal study. J Aging Health. 2020;33(1–2):63–74. https://doi.org/10.1177/0898264320953693 .
doi: 10.1177/0898264320953693
pubmed: 32865104
pmcid: 7855508
Taylor HO, Taylor RJ, Nguyen AW, Chatters L. Social isolation, Depression, and psychological distress among older adults. J Aging Health. 2016;30(2):229–46. https://doi.org/10.1177/0898264316673511 .
doi: 10.1177/0898264316673511
pubmed: 28553785
pmcid: 5449253
Flowers L, Houser A, Noel-Miller C, et al. Medicare spends more on socially isolated older adults. Washington, D.C.: AARP Public Policy Institute; 2017.
doi: 10.26419/ppi.00016.001
Qin W, Xiang X, Taylor H. Driving Cessation and Social isolation in older adults. J Aging Health. 2019;32(9):962–71. https://doi.org/10.1177/0898264319870400 .
doi: 10.1177/0898264319870400
pubmed: 31431103
pmcid: 7901288
Coyle CE, Steinman BA, Chen J. Visual acuity and self-reported Vision Status: their associations with Social isolation in older adults. J Aging Health. 2016;29(1):128–48. https://doi.org/10.1177/0898264315624909 .
doi: 10.1177/0898264315624909
pubmed: 26762396
pmcid: 4940280
Yu J, Kahana E, Kahana B, Zhang Y. Driving Cessation in Old Age: gender influences on Mortality. J Aging Health. 2021;33(7–8):447–57. https://doi.org/10.1177/0898264321991254 .
doi: 10.1177/0898264321991254
pubmed: 33522849
Dickens AP, Richards SH, Greaves CJ, Campbell JL. Interventions targeting social isolation in older people: a systematic review. BMC Public Health. 2011;11(1):647. https://doi.org/10.1186/1471-2458-11-647 .
doi: 10.1186/1471-2458-11-647
pubmed: 21843337
pmcid: 3170621
Sampson RJ, Groves WB. Community structure and crime: testing social-disorganization theory. Am J Sociol. 1989;94(4):774–802. https://doi.org/10.1086/229068 .
doi: 10.1086/229068
Cagney KA, Glass TA, Skarupski KA, Barnes LL, Schwartz BS, Mendes de Leon CF. Neighborhood-Level cohesion and disorder: measurement and validation in two older adult urban populations. Journals Gerontol Ser B. 2009;64B(3):415–24. https://doi.org/10.1093/geronb/gbn041 .
doi: 10.1093/geronb/gbn041
Ross CE, Mirowsky J. Neighborhood disadvantage, disorder, and Health. J Health Soc Behav. 2001;42(3):258–76. https://doi.org/10.2307/3090214 .
doi: 10.2307/3090214
pubmed: 11668773
Shoff C, Yang TC. Untangling the associations among distrust, race, and neighborhood social environment: a social disorganization perspective. Soc Sci Med. 2012;74(9):1342–52. https://doi.org/10.1016/j.socscimed.2012.01.012 .
doi: 10.1016/j.socscimed.2012.01.012
pubmed: 22425069
pmcid: 3321124
Williams DR, Jackson PB. Social sources of racial disparities in Health. Health Aff. 2005;24(2):325–34. https://doi.org/10.1377/hlthaff.24.2.325 .
doi: 10.1377/hlthaff.24.2.325
Mendes de Leon CF, Cagney KA, Bienias JL, et al. Neighborhood Social Cohesion and Disorder in Relation to walking in Community-Dwelling older adults: a Multilevel Analysis. J Aging Health. 2009;21(1):155–71. https://doi.org/10.1177/0898264308328650 .
doi: 10.1177/0898264308328650
pubmed: 19144973
pmcid: 2650086
Berkman LF. Social Support, Social Networks, Social Cohesion and Health. Soc Work Health Care. 2000;31(2):3–14. https://doi.org/10.1300/J010v31n02_02 .
doi: 10.1300/J010v31n02_02
pubmed: 11081851
Yang J, Moorman SM. Beyond the Individual: evidence linking Neighborhood Trust and social isolation among Community-Dwelling older adults. Int J Aging Hum Dev. 2019;92(1):22–39. https://doi.org/10.1177/0091415019871201 .
doi: 10.1177/0091415019871201
pubmed: 31464138
Yu R, Leung G, Chan J, et al. Neighborhood Social Cohesion Associates with Loneliness differently among older people according to subjective Social Status. J Nutr Heal Aging. 2021;25(1):41–7. https://doi.org/10.1007/s12603-020-1496-z .
doi: 10.1007/s12603-020-1496-z
Latham K, Clarke P, Neighborhood Disorder. Perceived Social Cohesion, and Social Participation among Older americans: findings from the National Health & Aging trends Study. J Aging Health. 2016;30(1):3–26. https://doi.org/10.1177/0898264316665933 .
doi: 10.1177/0898264316665933
pubmed: 27566464
Bromell L, Cagney KA. Companionship in the Neighborhood Context: older adults’ living arrangements and perceptions of Social Cohesion. Res Aging. 2013;36(2):228–43. https://doi.org/10.1177/0164027512475096 .
doi: 10.1177/0164027512475096
pubmed: 24860203
pmcid: 4030643
Krause N. Neighborhood Deterioration and Social isolation in later life. Int J Aging Hum Dev. 1993;36(1):9–38. https://doi.org/10.2190/UBR2-JW3W-LJEL-J1Y5 .
doi: 10.2190/UBR2-JW3W-LJEL-J1Y5
pubmed: 8425749
Smith ML, Rosen D. Mistrust and Self-Isolation: barriers to Social Support for older adult Methadone clients. J Gerontol Soc Work. 2009;52(7):653–67. https://doi.org/10.1080/01634370802609049 .
doi: 10.1080/01634370802609049
pubmed: 19787525
Choi EY, Cho G, Chang VW. Neighborhood Social Environment and Dementia: the mediating role of social isolation. Journals Gerontol Ser B. 2024;79(4):gbad199. https://doi.org/10.1093/geronb/gbad199 .
doi: 10.1093/geronb/gbad199
Taylor HO, Tsuchiya K, Nguyen AW, Mueller C. Sociodemographic Factors and Neighborhood/Environmental Conditions Associated with Social isolation among black older adults. J Aging Health. 2022;35(3–4):294–306. https://doi.org/10.1177/08982643221118427 .
doi: 10.1177/08982643221118427
pubmed: 36148575
pmcid: 9896535
Choi EY. Longitudinal associations of Neighborhood Social Cohesion with Self-perceptions of aging and loneliness. Journals Gerontol Ser B Published Online Oct. 2023;7:gbad148. https://doi.org/10.1093/geronb/gbad148 .
doi: 10.1093/geronb/gbad148
Cudjoe TKM, Roth DL, Szanton SL, Wolff JL, Boyd CM, Thorpe Roland JJ. The epidemiology of social isolation: National Health and Aging trends Study. Journals Gerontol Ser B Published Online March. 2018;26:gby037–037. https://doi.org/10.1093/geronb/gby037 .
doi: 10.1093/geronb/gby037
Kannan VD, Veazie PJ. US trends in social isolation, social engagement, and companionship ⎯ nationally and by age, sex, race/ethnicity, family income, and work hours, 2003–2020. SSM - Popul Heal. 2023;21:101331. https://doi.org/10.1016/j.ssmph.2022.101331 .
doi: 10.1016/j.ssmph.2022.101331
Taylor RJ, Chatters LM, Taylor HO. Race and objective social isolation: older African americans, Black Caribbeans, and non-hispanic whites. Journals Gerontol Ser B. 2019;74(8):1429–40. https://doi.org/10.1093/geronb/gby114 .
doi: 10.1093/geronb/gby114
Nicklett EJ, Cheng GJ, Morris ZA. Predictors of food insecurity among older adults before and during COVID-19 in the United States. Front Public Heal. 2023;11. https://doi.org/10.3389/fpubh.2023.1112575 . https://www.frontiersin.org/articles/ .
York Cornwell E, Cagney KA. Assessment of Neighborhood Context in a nationally Representative Study. Journals Gerontol Ser B. 2014;69(Suppl2):S51–63. https://doi.org/10.1093/geronb/gbu052 .
doi: 10.1093/geronb/gbu052
Anthony N, RK E, Rachel MF. Redlines and Greenspace: the relationship between historical redlining and 2010 Greenspace across the United States. Environ Health Perspect. 2023;129(1):17006. https://doi.org/10.1289/EHP7495 .
doi: 10.1289/EHP7495
Kephart L. How racial residential segregation structures Access and exposure to greenness and Green Space: a review. Environ Justice. 2021;15(4):204–13. https://doi.org/10.1089/env.2021.0039 .
doi: 10.1089/env.2021.0039
Kelly CM, Schootman M, Baker EA, Barnidge EK, Lemes A. The association of sidewalk walkability and physical disorder with area-level race and poverty. J Epidemiol Community Health. 2007;61(11):978. https://doi.org/10.1136/jech.2006.054775 . LP – 983.
doi: 10.1136/jech.2006.054775
pubmed: 17933956
pmcid: 2465610
Franzini L, Taylor W, Elliott MN, et al. Neighborhood characteristics favorable to outdoor physical activity: disparities by socioeconomic and racial/ethnic composition. Health Place. 2010;16(2):267–74. https://doi.org/10.1016/j.healthplace.2009.10.009 .
doi: 10.1016/j.healthplace.2009.10.009
pubmed: 19896408
Powell LM, Slater S, Chaloupka FJ, Harper D. Availability of physical activity–related facilities and Neighborhood demographic and socioeconomic characteristics: a National Study. Am J Public Health. 2006;96(9):1676–80. https://doi.org/10.2105/AJPH.2005.065573 .
doi: 10.2105/AJPH.2005.065573
pubmed: 16873753
pmcid: 1551946
Wong R, Wang Y. Role of Neighborhood Physical disorder and social cohesion on racial and ethnic disparities in Dementia Risk. J Aging Health. 2022;34(9–10):1178–87. https://doi.org/10.1177/08982643221101352 .
doi: 10.1177/08982643221101352
pubmed: 35580113
Rankin BH, Quane JM. Neighborhood Poverty and the Social isolation of inner-city African American Families*. Soc Forces. 2000;79(1):139–64. https://doi.org/10.1093/sf/79.1.139 .
doi: 10.1093/sf/79.1.139
Millar RJ. Neighborhood Cohesion, Disorder, and physical function in older adults: an examination of Racial/Ethnic differences. J Aging Health. 2019;32(9):1133–44. https://doi.org/10.1177/0898264319890944 .
doi: 10.1177/0898264319890944
pubmed: 31789070
pmcid: 7261622
Montaquila J, Freedman V, Edwards B, Kasper JD. National Health and Aging Trends Study Round 1 Sample Design and Selection.; 2012. https://www.nhats.org
Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda county residents. Am J Epidemiol. 1979;109(2):186–204. https://doi.org/10.1093/oxfordjournals.aje.a112674 .
doi: 10.1093/oxfordjournals.aje.a112674
pubmed: 425958
Qin W, Clarke PJ, Ehrlich JR. Self-reported Visual Difficulty and Daily Activity limitations: the moderating role of Neighborhood characteristics. Gerontologist Published Online September. 2022;21:gnac143. https://doi.org/10.1093/geront/gnac143 .
doi: 10.1093/geront/gnac143
Kasper JD, Freedman VA, Spillman B. Classification of Persons by Dementia Status in the National Health and Aging Trends Study. Technical Paper #5.; 2013. www.NHATS.org.
Löwe B, Kroenke K, Gräfe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005;58(2):163–71. https://doi.org/10.1016/J.JPSYCHORES.2004.09.006 .
doi: 10.1016/J.JPSYCHORES.2004.09.006
pubmed: 15820844
Pristavec T, Luth EA. Informal Caregiver Burden, benefits, and older adult mortality: a survival analysis. Journals Gerontol Ser B. 2020;75(10):2193–206. https://doi.org/10.1093/geronb/gbaa001 .
doi: 10.1093/geronb/gbaa001
Skolarus LE, Sánchez BN, Morgenstern LB, et al. Validity of proxies and correction for Proxy Use when evaluating Social determinants of Health in Stroke patients. Stroke. 2010;41(3):510–5. https://doi.org/10.1161/STROKEAHA.109.571703 .
doi: 10.1161/STROKEAHA.109.571703
pubmed: 20075348
pmcid: 2838184
Heeringa S, West B, Berglund P. Applied Survey Data Analysis. 2nd ed. CRC Press, Taylor & Francis Group; 2017.
Hedeker D, Gibbons RD. Longitudinal Data Analysis.; 2006.
StataCorp. Stata Statistical Software: Release 18. College Station, TX: StataCorp LLC; 2023.
Browning CR, Cagney KA, Boettner B, Neighborhood. Place, and the Life Course. In: Shanahan MJ, Mortimer JT, Kirkpatrick Johnson M, editors. Handbook of the Life Course: volume II. New York, NY: Springer; 2016. pp. 597–620. https://doi.org/10.1007/978-3-319-20880-0_26 .
doi: 10.1007/978-3-319-20880-0_26
McFarland MJ. Religion and Mental Health among older adults: do the effects of religious involvement vary by gender? Journals Gerontol Ser B. 2010;65B(5):621–30. https://doi.org/10.1093/geronb/gbp112 .
doi: 10.1093/geronb/gbp112
Locher JL, Ritchie CS, Roth DL, Baker PS, Bodner EV, Allman RM. Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences. Soc Sci Med. 2005;60(4):747–61. https://doi.org/10.1016/j.socscimed.2004.06.023 .
doi: 10.1016/j.socscimed.2004.06.023
pubmed: 15571893
pmcid: 2763304
Lincoln CE, Mamiya LH. The Black Church in the African American experience. Durham, NC: Duke University Press; 1990.
doi: 10.1215/9780822381648
Cone JH. A black theology of Liberation. Maryknoll, NY: Orbis Books; 2010.
Wormald B. America’s Changing Religious Landscape.; 2015.
Chatters LM, Taylor RJ, Bullard KM, Jackson JS. Race and ethnic differences in religious involvement: African americans, Caribbean blacks and non-hispanic whites. Ethn Racial Stud. 2009;32(7):1143–63. https://doi.org/10.1080/01419870802334531 .
doi: 10.1080/01419870802334531
pubmed: 20975850
pmcid: 2962581
Taylor RJ, Chatters LM, Brown RK. African American Religious participation. Rev Relig Res. 2014;56(4):513–38. https://doi.org/10.1007/s13644-013-0144-z .
doi: 10.1007/s13644-013-0144-z
pubmed: 25580034
Golding JM, Burnam MA. Stress and social support as predictors of depressive symptoms in Mexican americans and non-hispanic whites. J Soc Clin Psychol. 1990;9(2):268–87. https://doi.org/10.1521/jscp.1990.9.2.268 .
doi: 10.1521/jscp.1990.9.2.268
Thoits PA. Mechanisms linking social ties and support to physical and Mental Health. J Health Soc Behav. 2011;52(2):145–61. https://doi.org/10.1177/0022146510395592 .
doi: 10.1177/0022146510395592
pubmed: 21673143
Almeida J, Kawachi I, Molnar BE, Subramanian SV. A Multilevel Analysis of Social ties and Social Cohesion among latinos and their neighborhoods: results from Chicago. J Urban Heal. 2009;86(5):745–59. https://doi.org/10.1007/s11524-009-9375-2 .
doi: 10.1007/s11524-009-9375-2
McPherson M, Smith-Lovin L, Cook JM. Birds of a feather: Homophily in Social Networks. Annu Rev Sociol. 2001;27(1):415–44. https://doi.org/10.1146/annurev.soc.27.1.415 .
doi: 10.1146/annurev.soc.27.1.415
O’Brien DT, Farrell C, Welsh BC. Broken (windows) theory: a meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors. Soc Sci Med. 2019;228:272–92. https://doi.org/10.1016/j.socscimed.2018.11.015 .
doi: 10.1016/j.socscimed.2018.11.015
pubmed: 30885673
Elo IT, Mykyta L, Margolis R, Culhane JF. Perceptions of Neighborhood Disorder: the role of Individual and Neighborhood characteristics. Soc Sci Q. 2009;90(5):1298–320. http://www.jstor.org/stable/42940632 .
doi: 10.1111/j.1540-6237.2009.00657.x
pubmed: 20174462
pmcid: 2822409
O’Connor B. From isolation to community: exploratory study of a Sense-Of-Community intervention. J Community Psychol. 2013;41(8):973–91. https://doi.org/10.1002/jcop.21587 .
doi: 10.1002/jcop.21587
pubmed: 31007302
pmcid: 6474243
Shellman J, Mokel M, Walton N, Bailey-Addison K. Development of a culturally tailored peer-led reminiscence intervention to decrease depressive symptoms in older black adults. Int J Reminisc Life Rev. 2017;4(2):48–58.