1
|
Zhang Y. Neighborhood safety perception and depressive symptoms in China: a moderated mediation relationship. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02642-0. [PMID: 38498149 DOI: 10.1007/s00127-024-02642-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Despite rich data on neighborhood safety perception's role in shaping depressive symptoms, a comprehensive view of this dynamic interplay remains a frontier. This study seeks to unravel the intricate interplay of neighborhood safety perception and depressive symptoms, utilizing the lens of social safety theory. METHODS Employing the 2016 and 2020 waves of the China Family Panel Studies (CFPS), this study utilized ordered logistic regression (ologit) for statistical analysis. The approach encompassed descriptive analysis of variables, Spearman's correlation analyses to explore associations between variables, and a moderated mediation analysis. Sensitivity analyses were also conducted to affirm the robustness of findings against model assumptions and data processing techniques. RESULTS The study uncovered a significant negative correlation between neighborhood safety perception and depressive symptoms (Direct effect = - 0.338, Z = - 2.564, p = 0.010). A key finding was the steeper slope of the relationship between neighborhood safety perception and neighborhood relation perception among individuals with a higher perception of neighborhood environment quality. As neighborhood environment quality perception increases, the strength of the mediated negative impact on depressive symptoms intensifies (- 0.102 > - 0.132 > - 0.162). CONCLUSION This study offers a comprehensive moderated mediation model that establishes a novel connection between neighborhood safety perception and depressive symptoms. It integrates the complexities of social safety theory and social information processes, revealing key strategies such as enhancing perceived neighborhood environment quality and neighborhood relationship quality.
Collapse
Affiliation(s)
- Yujie Zhang
- School of Public Policy and Administration, Chongqing University, No.174 Shazheng Street, Shapingba District, Chongqing, 400044, China.
| |
Collapse
|
2
|
Yuan Y, Knight KR, Weeks J, King S, Olsen P, Kushel M. Loneliness among homeless-experienced older adults with cognitive or functional impairments: qualitative findings from the HOPE HOME study. BMC Public Health 2024; 24:569. [PMID: 38388904 PMCID: PMC10885402 DOI: 10.1186/s12889-024-18052-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging in the United States; now, 48% of single homeless adults are 50 and older. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among homeless-experienced older adults with cognitive and functional impairments and the individual, social, and structural conditions that shaped these loneliness experiences. METHODS We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants perceived social support and social isolation. We conducted qualitative content analysis. RESULTS Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants' loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: (1) "lonely- distressed", characterized by physical impairment and severe isolation; (2) "lonely- rather be isolated", reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; (3) "lonely- transient", as a result of aging, acceptance and grieving; and (4) "not lonely"- characterized by stability and connection despite having experienced homelessness. CONCLUSIONS Loneliness is a complex and heterogenous social phenomenon, with homeless-experienced older adults with cognitive or functional impairments exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences.
Collapse
Affiliation(s)
- Yeqing Yuan
- School of Social Work, University of Alaska Anchorage, 2533 Providence Dr., Suite 234, 99508, Anchorage, AK, USA
- Benioff Homelessness and Housing Initiative, San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg, University of California - San Francisco, 94143, San Francisco, CA, UCSF Box 1339, USA
| | - Kelly R Knight
- Department of Humanities and Social Sciences, School of Medicine, University of California - San Francisco, 490 Illinois Street, 7th Floor, 94143, San Francisco, CA, USA
| | - John Weeks
- Benioff Homelessness and Housing Initiative, San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg, University of California - San Francisco, 94143, San Francisco, CA, UCSF Box 1339, USA
| | - Stephen King
- Benioff Homelessness and Housing Initiative, San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg, University of California - San Francisco, 94143, San Francisco, CA, UCSF Box 1339, USA
| | - Pamela Olsen
- Benioff Homelessness and Housing Initiative, San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg, University of California - San Francisco, 94143, San Francisco, CA, UCSF Box 1339, USA
| | - Margot Kushel
- Benioff Homelessness and Housing Initiative, San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, Center for Vulnerable Populations at Zuckerberg, University of California - San Francisco, 94143, San Francisco, CA, UCSF Box 1339, USA.
| |
Collapse
|
3
|
Weldrick R, Dunn JR, Andrews GJ, Ploeg J. Friendly Visiting Programs for Older People Experiencing Social Isolation: A Realist Review of what Works, for whom, and under what Conditions. Can J Aging 2023; 42:538-550. [PMID: 37551541 DOI: 10.1017/s0714980823000302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Many social interventions have been developed with the hopes of reducing and preventing social isolation among older people (e.g., recreation, arts-based programs and social prescription). Friendly visiting programs, also known as befriending schemes, have been a mainstay in this area for decades and are largely thought to be effective at reconnecting older people (≥ 60 years of age) experiencing isolation. Research and evaluations have yet to determine, however, how and why these programs may be most successful, and under what conditions. This article presents the findings of a realist synthesis aimed at identifying the critical mechanisms and contextual factors that lead to successful outcomes in friendly visiting programs. Seven studies are synthesized to inform a friendly visiting program theory accounting for key mechanisms (e.g., provision of informal support) and underlying contexts (e.g., training of volunteers) that can be used to inform future programs. Recommendations for future research are also presented.
Collapse
Affiliation(s)
- Rachel Weldrick
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - James R Dunn
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Gavin J Andrews
- Department of Health, Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
4
|
Finlay J, Westrick AC, Guzman V, Meltzer G. Neighborhood Built Environments and Health in Later Life: A Literature Review. J Aging Health 2023:8982643231217776. [PMID: 37994863 PMCID: PMC11111591 DOI: 10.1177/08982643231217776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Objectives: This literature review aims to assess the current state of the field linking neighborhood environments to later-life health and wellbeing. Methods: We used electronic databases (e.g., PubMed, Google Scholar, and ProQuest) to search for studies published between 2010 and 2022 examining associations between neighborhood built environmental variables and later-life physical, cognitive, mental, and social health outcomes. Results: Among 168 studies reviewed, the majority were quantitative (n = 144) and cross-sectional (n = 122). Neighborhood environmental variables significantly associated with later-life health outcomes included population density/rurality, walkability/street connectivity, access to services and amenities, neighborhood quality and disorder, and parks/green/blue/open space. Neighborhoods operated through behavioral and biological pathways including hazardous exposures, affective states (e.g., stress and restoration), and lifestyle (e.g., exercise, socialization, and diet). Discussion: Neighborhoods and healthy aging research is a burgeoning interdisciplinary and international area of scholarship. Findings can inform upstream community interventions and strengthen clinical care.
Collapse
Affiliation(s)
- Jessica Finlay
- Department of Geography, University of Colorado Boulder, Boulder, CO, USA
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
- Social Environment and Health Program, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Ashly C. Westrick
- Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Viveka Guzman
- Department of Health Psychology, School of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Gabriella Meltzer
- Departments of Environmental Health and Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY, USA
| |
Collapse
|
5
|
Yuan Y, Knight KR, Weeks J, King S, Olsen P, Kushel M. Loneliness among older adults who have experienced homelessness: qualitative findings from the HOPE HOME study. RESEARCH SQUARE 2023:rs.3.rs-3517416. [PMID: 38014138 PMCID: PMC10680940 DOI: 10.21203/rs.3.rs-3517416/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Background Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among older adults who have experienced homelessness and the individual, social, and structural conditions that shaped these loneliness experiences. Methods We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants' perceived social support and social isolation. We conducted qualitative content analysis. Results Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants' loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: 1) "lonely - distressed", characterized by physical impairment and severe isolation; 2) "lonely - rather be isolated", reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; 3) "lonely - transient", as a result of aging, acceptance and grieving; and 4) "not lonely" - characterized by stability and connection despite having experienced homelessness. Conclusions Loneliness is a complex and heterogenous social phenomenon, with older adults who have experienced homelessness exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences.
Collapse
Affiliation(s)
- Yeqing Yuan
- School of Social Work, University of Alaska Anchorage
| | - Kelly R Knight
- Department of Humanities and Social Sciences, School of Medicine, University of California - San Francisco
| | - John Weeks
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California -San Francisco
| | - Stephen King
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California -San Francisco
| | - Pamela Olsen
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California -San Francisco
| | - Margot Kushel
- Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center, Department of Medicine, School of Medicine, University of California -San Francisco
| |
Collapse
|
6
|
Daniel F, Espírito-Santo H, Lemos L, Guadalupe S, Barroso I, Gomes da Silva A, Ferreira PL. Measuring loneliness: Psychometric properties of the three-item loneliness scale among community-dwelling adults. Heliyon 2023; 9:e15948. [PMID: 37215896 PMCID: PMC10192737 DOI: 10.1016/j.heliyon.2023.e15948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/24/2023] Open
Abstract
Loneliness is a prevalent set of negative feelings associated with unsatisfactory and reduced social interactions, inadequate social support, poor satisfaction with life and health, negative emotions, and economic burden. Thus, its measurement is of foremost importance. Therefore, this study aimed (i) to devise the Portuguese version of the three-Item Loneliness Scale (T-ILS), which is ideal for epidemiological studies, and (ii) to evaluate its psychometric properties. Three hundred forty-five community-dwelling Portuguese adults with a mean age of 54.6 ± 19.5 years, 61.7% women, recruited door-to-door, were assessed with the Portuguese versions of T-ILS, Satisfaction With Life Scale-SWLS, Lubben Social Network Scale 6-items-LSNS-6, a question regarding Happiness/Unhappiness, and a sociodemographic questionnaire. The T-ILS showed good psychometric properties and correlated moderately with SWLS and LSNS-6, and happiness, and weakly with the number of people in the household. The Portuguese version of the T-ILS proved to be a valid and reliable instrument, easy and quick to administer. It proved to be a valuable tool in screening loneliness in Portugal, being potentially useful to the identification of lonelier people in need of intervention.
Collapse
Affiliation(s)
- Fernanda Daniel
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Portugal
| | - Helena Espírito-Santo
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Portugal
| | - Laura Lemos
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
| | - Sónia Guadalupe
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Portugal
| | - Isabel Barroso
- Miguel Torga Institute of Higher Education, Coimbra, Portugal
| | - Alexandre Gomes da Silva
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Portugal
- Polytechnic Institute of Coimbra (IPC), Coimbra, Portugal
| | - Pedro Lopes Ferreira
- Centre for Health Studies and Research of the University of Coimbra (CEISUC), Portugal
- Faculty of Economics (FEUC), University of Coimbra, Portugal
| |
Collapse
|
7
|
Learnihan V, Kinfu Y, Turrell G. Social determinants of depression among mid-to-older aged Australians: A prospective study of the effects of neighbourhood disadvantage and crime. SSM Popul Health 2022; 19:101190. [PMID: 35990410 PMCID: PMC9385683 DOI: 10.1016/j.ssmph.2022.101190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/14/2022] [Accepted: 07/23/2022] [Indexed: 11/21/2022] Open
Abstract
Background Few studies examining social determinants of depression have incorporated area level objectively measured crime combined with self-report measures of perceived crime. How these factors may interrelate with neighbourhood disadvantage is not well understood, particularly in Australia, where mental health disorders are of major concern. This study examined relationships between area-level objective crime, self-reported perceptions of crime, neighbourhood disadvantage and depression, and potential mechanisms by which these variables indirectly lead to depression. Methods This study used data from the HABITAT Project, a representative longitudinal study of persons aged 40–65 years residing in 200 neighbourhoods in Brisbane, Australia, during 2007–2016. A prospective sample of residentially stable persons who reported depression at two years (n =3120) and five years (n=2249) post-follow-up was developed. Area level objective crimes were categorised as either crimes against the person, social incivilities or unlawful entry. Logistic regression was used to establish relationships with depression, followed by a decomposition analysis to establish potential mechanisms. Results Neighbourhoods in the highest quartile of crimes against the person had an increased risk of individuals reporting depression at all periods of follow-up. Associations were also found between unlawful entry and depression. Decomposition analysis indicated a positive and significant total effect of crime against the person on depression for all periods of follow-up, while an indirect effect of perceived crime was found to partially explain this relationship at 2-years after baseline (prop. Mediated = 46.5%), and at either or both periods of follow-up (prop. Mediated = 53.7%), but not at 5-years follow-up. Discussion Neighbourhoods with the highest levels of crime against the person may influence depression over time through a pathway of perceived crime. Perceived crime, particularly in areas of high crime against the person should be considered as part of a multi-faceted strategy aimed at improving population mental health. Prospective study of depression amongst mid to older aged Australians. Objective and perceived crime are rarely included together in one study. Area level crime against the person associated with the incidence of depression. Neighbourhood disadvantage associated with depression. Perceived crime partly mediates association between crime against the person and depression.
Collapse
Affiliation(s)
- Vincent Learnihan
- Health Research Institute, University of Canberra, Canberra, Australia
- Corresponding author. Health Research Institute, University of Canberra, University Drive, Bruce, ACT, 2617, Australia.
| | - Yohannes Kinfu
- Faculty of Health, University of Canberra, Canberra, Australia
- College of Medicine, Qatar University, Doha, Qatar
- Department of Health Metrics, University of Washington, Seattle, USA
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Gavin Turrell
- Health Research Institute, University of Canberra, Canberra, Australia
- Centre for Urban Research, RMIT University, Melbourne, Australia
| |
Collapse
|
8
|
Paine N, Lowe M, Rachele J, Turrell G. “I'm definitely not socially excluded!”- Perceptions of social exclusion among Australian government housing residents aged 80 and older who live alone. J Aging Stud 2022; 61:101011. [DOI: 10.1016/j.jaging.2022.101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
|
9
|
Knight KR, Weiser J, Handley MA, Olsen P, Weeks J, Kushel M. Temporary stays with housed family and friends among older adults experiencing homelessness: Qualitative findings from the HOPE HOME study. QUALITATIVE SOCIAL WORK : QSW : RESEARCH AND PRACTICE 2022; 21:542-558. [PMID: 35706979 PMCID: PMC9197090 DOI: 10.1177/14733250211012745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The proportion of adults age 50 and older experiencing homelessness is growing. People at risk for homelessness may stay with family and friends to prevent homelessness. Moving in with housed family and friends is a strategy used to exit homelessness. Little is known about these stays with family and friends. This study examined the motivations for and challenges of older adults experiencing homelessness staying with or moving in with family or friends. METHODS We purposively sampled 46 participants from the HOPE HOME study, a cohort of 350 community-recruited adults experiencing homelessness age ≥50 in Oakland, CA. Inclusion criteria included having stayed with housed family/friends for ≥1 nights in the prior 6 months. We sampled 19 family/friends who had hosted participants experiencing homelessness. We conducted separate, semi-structured interviews, summarized, memoed and coded data consistent using a grounded theory approach. RESULTS Older adults experiencing homelessness reported primarily temporary stays. Motivations for stays on the part of participants included a need for environmental, physical, and emotional respite from homelessness. Both individuals experiencing homelessness and hosts cited the mutual benefits of stays. Barriers to stays included feelings of shame, concerns about burdening the hosts, and interpersonal conflicts between older adults experiencing homelessness and host participants. CONCLUSIONS There are potential opportunities and concerns surrounding temporary stays between older adults experiencing homelessness and their family or friends. Policy solutions should support the potential mutual benefits of temporary stays, while addressing interpersonal barriers to strengthen kinship and friendship networks and mediate the negative impacts of homelessness.
Collapse
Affiliation(s)
- Kelly R Knight
- Department of Humanities and Social Sciences, University of California, San Francisco, CA, USA
| | - Jeremy Weiser
- School of Medicine, University of California, San Francisco, CA, USA
| | - Margaret A Handley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Pamela Olsen
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - John Weeks
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| | - Margot Kushel
- UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA
| |
Collapse
|
10
|
Paine N, Rachele JN, Turrell G. Sociodemographic characteristics and social exclusion among the oldest old. Australas J Ageing 2022; 41:563-572. [PMID: 35445519 PMCID: PMC10084279 DOI: 10.1111/ajag.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/01/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The socioeconomically disadvantaged oldest old (people aged 85 years and over) are more vulnerable to social exclusion than the general population. Using a population representative sample, this paper examined associations between sociodemographic characteristics and social exclusion among the oldest old. METHODS This cross-sectional study included 307 participants aged 85 years and over from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. Sociodemographic characteristics were measured using household composition, country of birth, housing tenure, income, education and neighbourhood-level disadvantage. Three social exclusion domains were derived representing unsupportive relationships, neighbourhood exclusion and community disengagement. Analysis was undertaken separately for men and women. RESULTS Among men, living alone was associated with higher levels of unsupportive relationships (β = 11.6, 95%CI 2.1, 21.0) and having a lower income was associated with lower levels of neighbourhood disunity (β = -16.7, 95%CI -31.2, -2.2). Among women, living alone was associated with lower levels of community disengagement (β = -7.2, 95%CI -13.4, -0.9) and neighbourhood disadvantage was associated with lower levels of neighbourhood disunity (β = -10.4, 95%CI -19.6, -1.2). Both men and women with lower levels of education had higher levels of community disengagement (men: β = 8.3, 95%CI 1.9, 14.7; women: β = 17.0, 95%CI 8.6, 25.5). CONCLUSIONS This study showed few and unexpected associations between sociodemographic characteristics and social exclusion among oldest-old Australians, suggesting a homogeneous effect of advancing age. Government approaches aimed at reducing social exclusion in this age group should consider gender and taking action across all socioeconomic stratification. Further research is warranted to understand the underlying mechanisms linking sociodemographic characteristics to social exclusion.
Collapse
Affiliation(s)
- Naomi Paine
- La Trobe University, Bendigo, Victoria, Australia
| | | | | |
Collapse
|
11
|
Lutz J, Van Orden KA, Bruce ML, Conwell Y. Social Disconnection in Late Life Suicide: An NIMH Workshop on State of the Research in Identifying Mechanisms, Treatment Targets, and Interventions. Am J Geriatr Psychiatry 2021; 29:731-744. [PMID: 33622593 PMCID: PMC8286287 DOI: 10.1016/j.jagp.2021.01.137] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
Both social disconnection and suicide are significant public health concerns among older adults, and social disconnection is associated with greater risk for suicide-related thoughts and behaviors in late life. We present a synthesis of research discussed during a workshop hosted by the National Institute of Mental Health on social disconnection and late-life suicide. Social disconnection is related to suicide risk in late life via a variety of mechanisms, including biological, behavioral, and psychological correlates. Researchers in several scientific fields have begun to establish these connections and identify targets for interventions to reduce risk in late life. While research has demonstrated that social connection is amenable to change, there is little research to date on the most evidence-based interventions to mitigate social disconnection or the related risks. However, there are several promising biological, behavioral, and psychological interventions that may target various mechanisms, as well as social disconnection itself. With a relative paucity of research in this area, these lines of study are ripe for innovative investigation. In order to most effectively advance the field, we must establish more consistent definitions of social connection and disconnection; more accurately measure and assess older adults' social needs; examine the most effective approaches and modalities for assessment and intervention; take into account important contextual factors; and apply a translational, convergent scientific approach.
Collapse
Affiliation(s)
- Julie Lutz
- Center for the Study and Prevention of Suicide, Department of Psychiatry (JL), University of Rochester Medical Center, Rochester, NY.
| | - Kimberly A Van Orden
- Center for the Study and Prevention of Suicide, Department of Psychiatry (KAVO), University of Rochester Medical Center, Rochester, NY
| | - Martha L Bruce
- Department of Psychiatry (MLB), Geisel School of Medicine, Dartmouth, NH
| | - Yeates Conwell
- Center for the Study and Prevention of Suicide, Department of Psychiatry (YC), University of Rochester Medical Center, Rochester, NY
| |
Collapse
|
12
|
Lee JLC, Guo Y, Lo TLT, Ho RTH. Prisoner and Creator of Space and Place: An Interpretive Descriptive QGIS Study to Understand Exercise Experiences of Community-Dwelling Older Adults in a Low-Income Neighborhood. JOURNAL OF AGING AND ENVIRONMENT 2021. [DOI: 10.1080/26892618.2021.1932009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Janet L. C. Lee
- School of Nursing and Health Studies, The Open University of Hong Kong, Hong Kong, China
| | - Yingqi Guo
- Department of Social work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
| | - Temmy L. T. Lo
- Department of Social work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Rainbow T. H. Ho
- Department of Social work and Social Administration, The University of Hong Kong, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
13
|
Crowe CL, Domingue BW, Graf GH, Keyes KM, Kwon D, Belsky DW. Associations of Loneliness and Social Isolation with Healthspan and Lifespan in the US Health and Retirement Study. J Gerontol A Biol Sci Med Sci 2021; 76:1997-2006. [PMID: 33963758 DOI: 10.1093/gerona/glab128] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Loneliness and social isolation are emerging public health challenges for aging populations. METHODS We followed N=11,302 US Health and Retirement Study (HRS) participants aged 50-95 from 2006-2014 to measure persistence of experiences of loneliness and exposure to social isolation. We tested associations of longitudinal loneliness and social isolation phenotypes with disability, morbidity, mortality, and biological aging through 2018. RESULTS During follow-up, 18% of older adults met criteria for loneliness, with 6% meeting criteria at two or more follow-up assessments. For social isolation, these fractions were 21% and 8%. HRS participants who experienced loneliness and were exposed to social isolation were at increased risk for disease, disability, and mortality. Those experiencing persistent loneliness were at a 57% increased hazard of mortality compared to those who never experienced loneliness. For social isolation, the increase was 28%. Effect-sizes were somewhat larger for counts of prevalent activity limitations and somewhat smaller for counts of prevalent chronic diseases. Covariate adjustment for socioeconomic and psychological risks attenuated but did not fully explain associations. Older adults who experienced loneliness and were exposed to social isolation also exhibited physiological indications of advanced biological aging (Cohen's-d for persistent loneliness and social isolation=0.26 and 0.21, respectively). For loneliness, but not social isolation, persistence was associated with increased risk. CONCLUSION Deficits in social connectedness prevalent in a national sample of US older adults were associated with morbidity, disability, and mortality and with more advanced biological aging. Bolstering social connectedness to interrupt experiences of loneliness may promote healthy aging.
Collapse
Affiliation(s)
| | | | - Gloria H Graf
- Department of Epidemiology, Columbia University Mailman School of Public Health.,Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health
| | | | - Dayoon Kwon
- Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health
| | | |
Collapse
|
14
|
Kim MH, Clarke PJ, Dunkle RE. Urban Neighborhood Characteristics and the Spatial Distribution of Home and Community-Based Service Organizations in Michigan Metropolitan Statistical Areas. Res Aging 2021; 44:156-163. [PMID: 33853449 DOI: 10.1177/01640275211005079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Living in a neighborhood with dense HCBS organizations can promote older adults' health and well-being and may mitigate health disparities generated by living in materially deprived urban neighborhoods. Using 2016 US County Business Patterns and the American Community Survey (2013-2017), focused on 516 ZIP Codes in Michigan Metropolitan Statistical Areas, this study examines the association between neighborhood characteristics and the relative density of businesses offering services for older adults and persons with disabilities (e.g., senior centers, adult day service centers, personal care) and businesses offering home health care. Results from a series of spatial econometric models show that social care organization density tends to be high in neighborhoods with a greater number of residents who have a bachelor's degree, who are older, and who are in poverty. Home health care density was not explained by neighborhood factors. Multiple neighborhood socio-demographic indicators explain the spatial distribution of social care organizations.
Collapse
Affiliation(s)
- Min Hee Kim
- Philip R. Lee Institute for Health Policy Studies, 8785University of California San Francisco, CA, USA
| | - Philippa J Clarke
- Institute of Social Research, 1259University of Michigan, Ann Arbor, MI, USA
| | - Ruth E Dunkle
- School of Social Work, 1259University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
15
|
Flores M, Ruiz JM, Butler EA, Sbarra DA. Hispanic Ethnic Density May Be Protective for Older Black/African American and Non-Hispanic White Populations for Some Health Conditions: An Exploration of Support and Neighborhood Mechanisms. Ann Behav Med 2021; 56:21-34. [PMID: 33821886 DOI: 10.1093/abm/kaab014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Hispanic ethnic density (HED) is associated with salubrious health outcomes for Hispanics, yet recent research suggests it may also be protective for other groups. The purpose of this study was to test whether HED was protective for other racial-ethnic groups. We tested whether social support or neighborhood social integration mediated the association between high HED and depressive symptoms (CES-D) and physical morbidity 5 years later. Lastly, we tested whether race-ethnicity moderated both main and indirect effects. METHODS We used Waves 1 (2005-2006), and 2 (2010-2011) from The National Social Life, Health, and Aging Project, a national study of older U.S. adults. Our sample was restricted to Wave 1 adults who returned at Wave 2, did not move from their residence between waves, and self-identified as Hispanic, non-Hispanic White (NHW), or non-Hispanic Black (NHB; n = 1,635). We geo-coded respondents' addresses to a census-tract and overlaid racial-ethnic population data. Moderated-mediation models using multiple imputation (to handle missingness) and bootstrapping were used to estimate indirect effects for all racial-ethnic categories. RESULTS Depressive symptoms were lower amongst racial-ethnic minorities in ethnically (Hispanic) dense neighborhoods; this effect was not stronger in Hispanics. HED was not associated with physical morbidity. Sensitivity analyses revealed that HED was protective for cardiovascular events in all racial-ethnic groups, but not arthritis, or respiratory disease. Social support and neighborhood social integration were not mediators for the association between HED and outcomes, nor were indirect effects moderated by race-ethnicity. CONCLUSIONS This study offers some evidence that HED may be protective for some conditions in older adults; however, the phenomena underlying these effects remains a question for future work.
Collapse
Affiliation(s)
- Melissa Flores
- Center for Border Health Disparities, Health Sciences, University of Arizona, Tucson, AZ, USA.,The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
| | - John M Ruiz
- The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
| | - Emily A Butler
- Norton School of Family and Consumer Sciences, College of Agricultural Life Sciences, University of Arizona, Tucson, AZ, USA
| | - David A Sbarra
- The Department of Psychology, College of Science, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
16
|
Rowan JM, Yonashiro-Cho J, Wilber KH, Gassoumis ZD. Who is in the revolving door? Policy and practice implications of recurrent reports to adult protective services. J Elder Abuse Negl 2020; 32:489-508. [PMID: 33308080 DOI: 10.1080/08946566.2020.1852142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Repeat referral to adult protective services APS (recurrence) is a much-discussed topic among APS agencies as it may indicate ongoing harm, yet there is limited research examining prevalence or causes. This paper provides a foundational investigation of recurrence within a California APS county program. Drawing from thirty-three months of de-identified reports, we used logistic regression to examine the impact of intake report characteristics on repeat referral within one year after baseline case closure. One-fifth of the sample was recurrent (19.9%, n=987/4,958), with self-neglect being the most common type of report to recur (14.3%, n=307/2,141). Overall recurrence was predicted by female gender, older age, living alone, and multiple elder abuse, neglect, and exploitation (ANE) types reported at baseline, and report placed by social service provider, friends, family, landlords, and victim self-reports. Reporters personally related to the victim and social service providers are potential partners in identifying ANE, and alternate intervention approaches may be necessary.
Collapse
Affiliation(s)
- Julia M Rowan
- Leonard Davis School of Gerontology, University of Southern California , Los Angeles, California, USA
| | - Jeanine Yonashiro-Cho
- Keck School of Medicine, University of Southern California , Los Angeles, California, USA
| | - Kathleen H Wilber
- Leonard Davis School of Gerontology, University of Southern California , Los Angeles, California, USA
| | - Zachary D Gassoumis
- Keck School of Medicine, University of Southern California , Los Angeles, California, USA
| |
Collapse
|
17
|
Gobaud AN, Kramer MR, Stearns ER, Haley DF. Measuring small-area violent crime: a comparison of observed versus model-estimated crime rates and preterm birth. Ann Epidemiol 2020; 55:27-33. [PMID: 33285260 DOI: 10.1016/j.annepidem.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/24/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Research examining the association between crime and health outcomes has been hampered by a lack of reliable small-area (e.g., census tract or census block group) crime data. Our objective is to assess the accuracy of synthetically estimated crime indices for use in health research by using preterm birth as a case study. METHODS We used violent crime data reported by 47 law enforcement agencies in 15 counties in Atlanta, Georgia and compared them with commercially estimated crime rates from the same year to assess (1) how two measures of crime were correlated and (2) if the associations between violent crime rate indices and preterm birth (PTB) varied as a function of the source of crime index. To assess the association between violent crime and PTB, we used multilevel logistic regression and controlled for potential individual- and neighborhood-level confounders. RESULTS Violent crime, both estimated and observed, was positively correlated with poverty, neighborhood proportion Black, and neighborhood deprivation index; however, the association was stronger using estimated rates as compared with observed crime rates. The association between living in a high violent crime neighborhood and PTB was only consistent for white women across the two crime indices after covariate adjustment. For Black women, the association between living in a high violent crime neighborhood and PTB is systematically underestimated across all models when the estimated crime rate is used. CONCLUSIONS There is evidence that model-estimated crime rates are not reliable proxies for crime in an urban area even when appropriate confounders are adjusted for.
Collapse
Affiliation(s)
- Ariana N Gobaud
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
| | - Michael R Kramer
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA
| | | | - Danielle F Haley
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
| |
Collapse
|
18
|
Portacolone E, Palmer NR, Lichtenberg P, Waters CM, Hill CV, Keiser S, Vest L, Maloof M, Tran T, Martinez P, Guerrero J, Johnson JK. Earning the Trust of African American Communities to Increase Representation in Dementia Research. Ethn Dis 2020; 30:719-734. [PMID: 33250619 DOI: 10.18865/ed.30.s2.719] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Black/African American populations are underrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to both historical and contemporary racism. Building on the Ford framework, the objective of our study was to examine factors that influence participation in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected during January 2019 and March 2020 from 10 focus groups with African American older adults (n=91), 5 focus groups with caregivers (n=44), and interviews with administrators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive content analysis was used to identify themes. The results identified an overall tension between distrust of researchers and a compelling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American communities becomes a systemic endeavor, with academic, state, and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.
Collapse
Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging; University of California San Francisco, CA
| | - Nynikka R Palmer
- Division of General Internal Medicine at Zuckerberg San Francisco General Hospital,University of California San Francisco, San Francisco, CA
| | - Peter Lichtenberg
- Department of Psychology, Institute of Gerontology, Michigan Center for Urban African American Research, Wayne State University, Detroit, MI
| | - Catherine M Waters
- School of Nursing, University of California San Francisco, San Francisco, CA
| | | | - Sahru Keiser
- Institute for Health & Aging; University of California San Francisco, CA
| | - Leah Vest
- Institute for Health & Aging; University of California San Francisco, CA
| | | | - Thi Tran
- Institute for Health & Aging; University of California San Francisco, CA
| | - Paula Martinez
- Institute for Health & Aging; University of California San Francisco, CA
| | - Javier Guerrero
- Institute for Health & Aging; University of California San Francisco, CA
| | - Julene K Johnson
- Institute for Health & Aging; University of California San Francisco, CA
| |
Collapse
|
19
|
Allison TA, Nápoles AM, Johnson JK, Stewart AL, Rodriguez-Salazar M, Peringer J, Sherman S, Ortez-Alfaro J, Villero O, Portacolone E. Multi-cultural perspectives on group singing among diverse older adults. Geriatr Nurs 2020; 41:1006-1012. [PMID: 32778434 PMCID: PMC7738424 DOI: 10.1016/j.gerinurse.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 11/28/2022]
Abstract
Group choir singing has been shown to have health benefits for older adults. However, because most studies have included predominantly white participants, it is unknown whether findings generalize to older adults from more diverse backgrounds. This multi-site qualitative study assessed perceived benefits of group singing for socioeconomically and racially/ethnically diverse older adults. We interviewed 31 choir participants, 6 music professionals and 6 administrators involved in a large, cluster-randomized trial. We used content analysis to identify themes. Psychosocial engagement was most commonly reported, with six components: emotional well-being, self-esteem, self-confidence, social connection and support, decreased loneliness, and cultural identity and multi-cultural appreciation. A few reported cognitive and physical benefits. They also suggest that group singing among ethnically diverse older adults can have multiple psychosocial benefits and enhance a sense of cultural identity and appreciation of other cultures. These findings can help in selecting structured outcome measures for choir interventions.
Collapse
Affiliation(s)
- Theresa A Allison
- Division of Geriatrics, Department of Medicine and Department of Family & Community Medicine, University of California, 4150 Clement Street, Box 181-G, San Francisco, CA 94121, United States.
| | - Anna M Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 9000 Rockville Pike, Building 3, Floor 5, Room E08, Bethesda, MD 20892, United States
| | - Julene K Johnson
- Institute for Health & Aging, School of Nursing, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, United States
| | - Anita L Stewart
- Institute for Health & Aging, School of Nursing, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, United States
| | | | - Jennifer Peringer
- San Francisco Community Music Center, 544 Capp Street, San Francisco, CA 94110, United States
| | - Sylvia Sherman
- San Francisco Community Music Center, 544 Capp Street, San Francisco, CA 94110, United States
| | - Jessica Ortez-Alfaro
- Institute for Health & Aging, School of Nursing, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, United States
| | - Ofelia Villero
- Institute for Health & Aging, School of Nursing, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, United States
| | - Elena Portacolone
- Institute for Health & Aging, School of Nursing, University of California San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, United States
| |
Collapse
|
20
|
Portacolone E, Covinsky KE, Johnson JK, Halpern J. Expectations and Concerns of Older Adults With Cognitive Impairment About Their Relationship With Medical Providers: A Call for Therapeutic Alliances. QUALITATIVE HEALTH RESEARCH 2020; 30:1584-1595. [PMID: 32564681 PMCID: PMC7398607 DOI: 10.1177/1049732320925796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
We sought to understand the expectations and concerns of older adults with cognitive impairment with regard to their relationship with medical providers. In particular, we observed whether study participants were involved in therapeutic alliances. Medical providers and patients create therapeutic alliances when they agree on the goals of the treatment and share a personal bond. Whereas such alliances have been studied in cancer research, little is known about therapeutic alliances in dementia research. Data were gathered in a qualitative study of 27 older adults with cognitive impairment and analyzed with narrative analysis. We introduce four case studies that illustrate the effects of having or missing a therapeutic alliance. Whereas the participant in the first case benefited from a therapeutic alliance, the other cases are marked by different experiences of abandonment. Findings suggest that interventions should concentrate on ways to enhance the relationship between medical providers and patients with cognitive impairment.
Collapse
Affiliation(s)
- Elena Portacolone
- University of California San Francisco, San Francisco, California, USA
| | | | - Julene K. Johnson
- University of California San Francisco, San Francisco, California, USA
| | - Jodi Halpern
- University of California, Berkeley, Berkeley, California, USA
| |
Collapse
|
21
|
Burholt V, Winter B, Aartsen M, Constantinou C, Dahlberg L, Feliciano V, De Jong Gierveld J, Van Regenmortel S, Waldegrave C. A critical review and development of a conceptual model of exclusion from social relations for older people. Eur J Ageing 2020; 17:3-19. [PMID: 32158368 PMCID: PMC7040153 DOI: 10.1007/s10433-019-00506-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Social exclusion is complex and dynamic, and it leads to the non-realization of social, economic, political or cultural rights or participation within a society. This critical review takes stock of the literature on exclusion of social relations. Social relations are defined as comprising social resources, social connections and social networks. An evidence review group undertook a critical review which integrates, interprets and synthesizes information across studies to develop a conceptual model of exclusion from social relations. The resulting model is a subjective interpretation of the literature and is intended to be the starting point for further evaluations. The conceptual model identifies individual risks for exclusion from social relations (personal attributes, biological and neurological risk, retirement, socio-economic status, exclusion from material resources and migration). It incorporates the evaluation of social relations, and the influence of psychosocial resources and socio-emotional processes, sociocultural, social-structural, environmental and policy contextual influences on exclusion from social relations. It includes distal outcomes of exclusion from social relations, that is, individual well-being, health and functioning, social opportunities and social cohesion. The dynamic relationships between elements of the model are also reported. We conclude that the model provides a subjective interpretation of the data and an excellent starting point for further phases of conceptual development and systematic evaluation(s). Future research needs to consider the use of sophisticated analytical tools and an interdisciplinary approach in order to understand the underlying biological and ecopsychosocial associations that contribute to individual and dynamic differences in the experience of exclusion from social relations.
Collapse
Affiliation(s)
- Vanessa Burholt
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
| | - Bethan Winter
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
| | - Marja Aartsen
- Centre for Welfare and Labour Research, OsloMet Oslo Metropolitan University, Oslo, Norway
| | | | - Lena Dahlberg
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Aging Research Center, Karolinska Institute, Solna, Sweden
| | - Villar Feliciano
- Department of Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Jenny De Jong Gierveld
- Faculty of Social Science, VU University Amsterdam, Amsterdam, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
| | - Sofie Van Regenmortel
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - The Working Group on Exclusion from Social Relations, part of the COST-financed Research Network ‘Reducing Old-Age Exclusion: Collaborations in Research and Policy’ (ROSENet)
- Centre for Innovative Ageing, Swansea University, Swansea, Wales UK
- Centre for Welfare and Labour Research, OsloMet Oslo Metropolitan University, Oslo, Norway
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
- Aging Research Center, Karolinska Institute, Solna, Sweden
- Department of Development and Educational Psychology, University of Barcelona, Barcelona, Spain
- Faculty of Social Science, VU University Amsterdam, Amsterdam, The Netherlands
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands
- Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Family Centre Social Policy Research Unit, Lower Hutt, New Zealand
| |
Collapse
|
22
|
Portacolone E, Johnson JK, Halpern J, Kotwal A. Seeking a Sense of Belonging. GENERATIONS (SAN FRANCISCO, CALIF.) 2020; 44:1-8. [PMID: 37583626 PMCID: PMC10426317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
This article draws on investigations by its authors, and from American and Italian interventions to provide recommendations for decreasing social isolation in older adults for policy makers, researchers, and other professionals committed to supporting the improved social integration of older adults. The article argues that to mitigate social isolation it is critical to foster a sense of belonging (personal involvement in a system or environment so people feel they are an integral part of that system or environment). Suggestions are provided on how to leverage systematic interventions to foster isolated older adults' sense of belonging to their communities.
Collapse
Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging University of California San Francisco (UCSF), USA
| | - Julene K Johnson
- Institute for Health & Aging Center for Aging in Diverse Communities University of California San Francisco, San Francisco, CA, USA
| | - Jodi Halpern
- Professor of Bioethics and Medical Humanities UCB-UCSF Joint Medical Program University of California Berkeley, Berkeley, CA, USA
| | - Ashwin Kotwal
- Medicine, Division of Geriatric Medicine University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
23
|
Portacolone E, Halpern J, Luxenberg J, Harrison KL, Covinsky KE. Ethical Issues Raised by the Introduction of Artificial Companions to Older Adults with Cognitive Impairment: A Call for Interdisciplinary Collaborations. J Alzheimers Dis 2020; 76:445-455. [PMID: 32250295 PMCID: PMC7437496 DOI: 10.3233/jad-190952] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Due to the high costs of providing long-term care to older adults with cognitive impairment, artificial companions are increasingly considered as a cost-efficient way to provide support. Artificial companions can comfort, entertain, and inform, and even induce a sense of being in a close relationship. Sensors and algorithms are increasingly leading to applications that exude a life-like feel. We focus on a case study of an artificial companion for people with cognitive impairment. This companion is an avatar on an electronic tablet that is displayed as a dog or a cat. Whereas artificial intelligence guides most artificial companions, this application also relies on technicians "behind" the on-screen avatar, who via surveillance, interact with users. This case is notable because it particularly illustrates the tension between the endless opportunities offered by technology and the ethical issues stemming from limited regulations. Reviewing the case through the lens of biomedical ethics, concerns of deception, monitoring and tracking, as well as informed consent and social isolation are raised by the introduction of this technology to users with cognitive impairment. We provide a detailed description of the case, review the main ethical issues and present two theoretical frameworks, the "human-driven technology" platform and the emancipatory gerontology framework, to inform the design of future applications.
Collapse
Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging, University of California San Francisco, San Francisco, CA, USA
| | - Jodi Halpern
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | | | - Krista L. Harrison
- Division of Geriatric Medicine, University of California San Francisco, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
| | - Kenneth E. Covinsky
- Division of Geriatric Medicine, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
24
|
Affiliation(s)
- Rachel Pruchno
- New Jersey Institute for Successful Aging, Rowan University School of Osteopathic Medicine, Stratford
| |
Collapse
|
25
|
Fritz H, Cutchin MP, Cummins ER. Loss of Trust in the Neighborhood: The Experience of Older African Americans in Detroit. J Gerontol B Psychol Sci Soc Sci 2018; 73:e108-e119. [PMID: 29471366 PMCID: PMC6454554 DOI: 10.1093/geronb/gby019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 02/18/2018] [Indexed: 12/20/2022] Open
Abstract
Objective Although evidence suggests that neighborhood conditions are related to stress and health, the processes connecting neighborhood conditions and stress for older minorities is little explored. The purpose of this analysis is to contribute new insights into this issue. Method We conducted a qualitative analysis as part of a larger mixed methods study of 100 African Americans aged 55 years and older living in neighborhoods of varying quality in Detroit, Michigan. A subsample of (n = 20) older adults took photographs of bothersome aspects of their neighborhoods and participated in in-depth photo-elicitation interviews. Data were analyzed using a grounded theory approach. Results "Loss of trust in the neighborhood" emerged as the core category to explain how older African Americans in our sample experienced neighborhood stressors in their daily lives. Loss of trust in physical, social, and institutional dimensions of the neighborhood contributed to the core category. Discussion The life course of neighborhoods and the trust placed in them appears to be intimately connected to the well-being of older African Americans. We therefore hypothesize that a fundamental pathway through which neighborhood stressors are experienced for older African Americans in United States "Rust Belt" cities is the multifaceted loss of trust in the neighborhood.
Collapse
Affiliation(s)
- Heather Fritz
- Health Care Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan
- Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Malcolm P Cutchin
- Health Care Sciences, Institute of Gerontology, Wayne State University, Detroit, Michigan
| | - Emily R Cummins
- Center for Urban and Global Studies, Trinity College, Hartford, Connecticut
| |
Collapse
|
26
|
Portacolone E. Structural Factors of Elders' Isolation in a High-Crime Neighborhood: An In-Depth Perspective. THE PUBLIC POLICY AND AGING REPORT 2018; 27:152-155. [PMID: 29576722 DOI: 10.1093/ppar/prx025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging, University of California San Francisco
| |
Collapse
|
27
|
Holt-Lunstad J. Why Social Relationships Are Important for Physical Health: A Systems Approach to Understanding and Modifying Risk and Protection. Annu Rev Psychol 2018; 69:437-458. [DOI: 10.1146/annurev-psych-122216-011902] [Citation(s) in RCA: 296] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Julianne Holt-Lunstad
- Departments of Psychology and Neuroscience, Brigham Young University, Provo, Utah 84602
| |
Collapse
|
28
|
Abramson CM, Portacolone E. What is new with old? What old age teaches us about inequality and stratification. SOCIOLOGY COMPASS 2017; 11:e12450. [PMID: 29861782 PMCID: PMC5983354 DOI: 10.1111/soc4.12450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 12/05/2016] [Indexed: 06/08/2023]
Abstract
Aging is remarkably unequal. Who survives to grow old in America and the circumstances they face once there reflect durable racial, socioeconomic, and gender inequalities that structure our lives from birth. Yet within the field of social stratification and mainstream sociology proper, examinations of the rapidly growing population of older Americans are often relegated to a "gerontological" periphery. This essay posits that the failure to place aging as a core concern in stratification and inequality is a missed opportunity. We argue for the importance of reintegrating studies on the stratification of aging and explain why such a move is necessary. Specifically, we posit that (a) examining the aging population is necessary for understanding American inequality because aging is an outcome that is ubiquitous yet highly stratified; (b) aging and being seen as "old" in a youth-focused society are stratifying processes in their own right; and (c) later life provides for analytical comparisons that are illustrative of how key mechanisms of inequality structure and stratify. After examining insights provided by a new wave of research on the aging U.S. population, we revisit the implications for understanding inequality and stratification in a graying and unequal America.
Collapse
|