Stand by Me: Social Ties and Health in Real-Time.

Sociological research has documented myriad associations between individuals' overall social connectedness and health, but rarely considers the shorter-term dynamics of social life that may underlie these associations. We examine how being with others ("social accompaniment") is associated with momentary experiences of symptoms, drawing smartphone-based ecological momentary assessments (N=12,720) collected from 342 older adults from the Chicago Health and Activity in Real Time study. We find that patterns of social accompaniment are distinct from global measures of social integration such as network size. Older adults who are in the company of a friend or neighbor are significantly less likely to experience momentary fatigue and stress, even after accounting for overall measures of social integration. These results suggest that social accompaniment has unique implications for short-term health outcomes. New theoretical perspectives and empirical analyses are needed to better understand the dynamic nature of everyday social accompaniment and its longer-term implications for well-being.

Local Ties in the Social Networks of Older Adults.

OBJECTIVES: Family members and friends who live nearby may be especially well-positioned to provide social support and companionship for community-residing older adults, but prior research has not examined the distribution and characteristics of local ties in older adults' networks. We hypothesize that local ties are newer, more frequently accessed, and more embedded in the network, and that social disadvantage and neighborhood conditions structure older adults' access to local ties. METHODS: We use egocentric network data from 15,137 alters named by 3,735 older adults in Wave 3 of the National Social Life, Health, and Aging Project (NSHAP). We conduct dyadic analysis to compare characteristics of local and nonlocal ties. Logistic regression models estimate how personal and neighborhood characteristics are associated with naming local kin and local non-kin ties. RESULTS: Nearly half of the older adults named at least one local network tie, and about 60% of these local ties are non-kin. Local ties are newer, frequently accessed, and highly embedded in older adults' networks. Local kin ties are most common among socially disadvantaged older adults. Local non-kin ties are most common among white older adults and those who live in areas with high levels of collective efficacy, although local non-kin ties are also associated with residence in high-poverty neighborhoods. DISCUSSION: Local ties may bring unique benefits for community-residing older adults, but their availability is likely structured by residential mobility, neighborhood context, disparities in resources, and support needs. Future research should consider their implications for health and well-being.

Neighborhood Disorder and Distress in Real Time: Evidence from a Smartphone-Based Study of Older Adults.

Socioeconomic disadvantage and disorder in the residential neighborhood have been linked to multiple health risks, but less is known about the relevance of other spaces of daily life. This article considers whether disadvantage and disorder in the immediate context-within or outside of the residential neighborhood-is associated with physiological symptoms indicative of stress and strain. We use data from a study of 61 older adults in four New York City neighborhoods. Participants carried smartphones to capture GPS locations and ecological momentary assessments during the study week. We find that instantaneous exposure to disorder is associated with momentary spikes in pain and fatigue. This is not explained by cumulative exposure to disorder or concurrent stress or fear. Rather, disordered spaces may be physically and cognitively taxing for older adults in real time. We urge further research on short- and long-term health consequences of activity spaces.

Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis.

BACKGROUND: Research indicates that social isolation and loneliness increase the risk of mental disorders, but less is known about the distinct contributions of different aspects of isolation. We aimed to distinguish the pathways through which social disconnectedness (eg, small social network, infrequent social interaction) and perceptions of social isolation (eg, loneliness, perceived lack of support) contribute to anxiety and depression symptom severity in community-residing older adults aged 57-85 years at baseline. METHODS: We did a longitudinal mediation analysis with data from the National Social Life, Health, and Aging Project (NSHAP). The study included individuals from the USA born between 1920 and 1947. Validated measures on social disconnectedness, perceived isolation, and depression and anxiety symptoms were used. Structural equation modelling was used to construct complete longitudinal path models. FINDINGS: Using data from 3005 adults aged 57-85 years, we identified two significant longitudinal mediation patterns with symptoms of depression, and two with anxiety symptoms. Overall, social disconnectedness predicted higher subsequent perceived isolation (ß=0·09; p<0·0001), which in turn predicted higher depression symptoms (ß=0·12; p<0·0001) and anxiety symptoms (ß=0·12; p<0·0001). The reverse pathways were statistically supported as well, suggesting bi-directional influences. INTERPRETATION: Social network structure and function are strongly intertwined with anxiety and depression symptoms in the general population of older adults. Public health initiatives could reduce perceived isolation by facilitating social network integration and participation in community activities, thereby protecting against the development of affective disorders. FUNDING: Nordea-fonden.

Aging in Activity Space: Results From Smartphone-Based GPS-Tracking of Urban Seniors.

OBJECTIVES: Prior research emphasizes the importance of the residential neighborhood context during later life but little attention has been afforded to other areas that older adults encounter as they move beyond their residential environments for daily activities and social interactions. This study examines the predominance of the residential context within older adults' everyday lives. METHOD: We provided 60 older adults in four New York City neighborhoods with iPhones, which captured Global Positioning Systems (GPS) locations at 5-min intervals over 1 week (n = 55,561) and 17 ecological momentary assessments (EMAs) over 4 days (n = 757) to assess real-time activities. RESULTS: Older adults in our sample spent nearly 40% of their time outside of their residential tracts and they visited 28 other tracts, on average. Exercising, shopping, socializing, and social activities were especially likely to take place outside of residential tracts. Differences in residential and nonresidential poverty exposure vary across gender, race/ethnicity, education, car ownership, and residential areas. DISCUSSION: Measuring activity space, rather than relying on residential tracts, allows examination of the social environments that are relevant for older adults' everyday lives. Variation in characteristics of activity spaces may be an underexplored source of differences in health and well-being during later life.

Racial and Social Disparities in Bystander Support During Medical Emergencies on US Streets.

OBJECTIVES: To examine rates at which people suffering medical emergencies on public streets receive help from bystanders, that is, laypersons who first arrive on the scene, and how this varies across patient race and incident locations. METHODS: We analyzed data on 22 487 patients from the 2011 National Emergency Medical Services Information System, which we linked to characteristics of counties where the incidents occurred. RESULTS: Bystanders provided help to patients suffering a wide range of medical emergencies, but only about 1 in 39 patients (2.57%) received bystander support. Black patients were significantly less likely to receive bystander support (odds ratio = 0.42; 95% confidence interval = 0.35, 0.50). Bystander support and county socioeconomic status have a curvilinear relationship; patients in the most disadvantaged counties are least likely to receive bystander support. CONCLUSIONS: Help from bystanders is rare and less likely among Black patients and those in the poorest counties.

Assessment of neighborhood context in a nationally representative study.

OBJECTIVES: This paper introduces new measures of neighborhood context that are included in the second wave of the National Social Life, Health, and Aging Project (NSHAP). We describe the use of field interviewer ratings of respondents' neighborhood conditions, as well as the adaptation of existing measures for the assessment of neighborhood social context among urban and nonurban older adults. METHOD: We construct scales of neighborhood problems, neighborhood social cohesion, neighborhood social ties, and perceived neighborhood danger, and assess their reliability and validity. We then calculate descriptive statistics for measures of neighborhood context across respondent age, gender, and racial/ethnic background, and across low-, moderate-, and high-density residential blocks. RESULTS: We find that older women report greater neighborhood cohesion and more neighborhood ties than older men, but women also perceive more neighborhood danger. Black and Hispanic older adults reside in neighborhoods with more problems, lower cohesion, fewer social ties, and greater perceived danger. Neighborhood characteristics also vary across residential densities. Neighborhood problems and perceived danger increase with block-level density, but neighborhood social cohesion and social ties were lowest among residents of moderate-density blocks. DISCUSSION: The inclusion of neighborhood context measures in the second wave of NSHAP provides a unique opportunity to explore associations among neighborhood context, social connectedness, and indicators of health and function among older adults. We discuss limitations of the measures and provide recommendations for their use.

Social resources and disordered living conditions: evidence from a national sample of community-residing older adults.

For older adults aging in the community, living conditions can promote health, enhance coping, and reduce disablement--but they can also create stress and increase risks of illness, accidents, and decline. Although socioeconomic disparities in housing likely contribute to inequalities in interior conditions, I argue that living conditions are also shaped by social resources such as coresidential relationships, social network ties, and social support. In this article, I examine the distribution of a set of risky or stressful physical and ambient living conditions including structural disrepair, clutter, lack of cleanliness, noise, and odor. Using data from the National Social Life, Health, and Aging Project (NSHAP), I find that low-income and African American older adults have more disordered living conditions as do those with poorer physical and mental health. In addition, older adults who have a coresident partner, more nonresidential network ties, and more sources of instrumental support are exposed to fewer risky or harmful living conditions. This suggests that living conditions are an important, though overlooked, mechanism through which household composition, social networks, and social support affect health and well-being in later life.