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BACKGROUND: Anxiety disorders are among the most prevalent psychiatric conditions worldwide, and the incidence of anxiety disorders among adults in the U.S. have increased over the last decade. Anxiety disorders can have debilitating effects on multiple areas of functioning and quality of life. Recently, social isolation has emerged as an important public health problem associated with worse health and well-being outcomes. Research on the connection between social isolation and mental health has found that multiple dimensions of social isolation may negatively impact mental health, but few inquiries have focused on the association between social isolation and anxiety. This study examined the relationships between multiple dimensions of social isolation and anxiety disorders in a nationally representative sample of adults aged 18 and older. METHODS: The sample includes 6082 individuals from the National Survey of American Life. This study examined whether three different dimensions of social isolation-subjective, interpersonal, and structural-were associated with 12-month and lifetime anxiety disorders (any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were used to test the associations between the three social isolation variables and the anxiety outcomes. RESULTS: This study found that of the three dimensions of social isolation, subjective isolation was most consistently related to both lifetime and 12-month anxiety disorders. Those who were subjectively isolated had increased odds of meeting criteria for any anxiety disorder, PTSD, GAD, PD, and AG over the past 12 months and throughout their lifetimes. Structural isolation was negatively associated with lifetime and 12-month AG. CONCLUSIONS: Public health approaches should include mental health and primary care providers and need to target social isolation, especially subjective isolation, which may be key in preventing anxiety disorders and the worsening of anxiety disorders. Future public health research is needed on how and in what ways the differing dimensions of social isolation impact mental health.
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Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos , Adulto , Humanos , Estados Unidos/epidemiologia , Transtornos de Ansiedade/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Saúde Mental , Isolamento Social , ComorbidadeRESUMO
In this editorial, we consider the current state of loneliness and social isolation research around the world, including knowledge gaps in the empirical literature.
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Solidão , Isolamento Social , HumanosRESUMO
OBJECTIVES: This study examines associations between social isolation and depressive symptoms among Hong Kong Chinese adults aged 65 and older by investigating the distinct effects of individual indicators, cumulative index, and typologies of social isolation during the Covid-19 pandemic. METHODS: We used a sample of 260 older adults from a cross-sectional, city-wide online survey targeting 1,109 aged 45+ adults through purposive sampling. Seven indicators of social isolation (not married; living alone; not engaging in social/organizational activities; no social contact with friends or families; lack of family and friends networks; loneliness) using Cornwell & Waite's framework were selected to construct three unique types of social isolation measures. We used latent class analysis (LCA) and regression models to examine the effects of varied typologies of social isolation on depressive symptoms. RESULTS: Individual model of social isolation showed that lack of social contact and feeling lonely were significant predictors of depressive symptoms. A strong linear-trend gradient effect of cumulative social isolation on depressive symptoms was also observed. The LCA model identified four typologies of social isolation (socially isolated; living alone but socially engaged; married but lacking social ties, and not socially isolated); those in the 'socially isolated' and 'married but lacking social ties' groups had the most depressive symptoms. CONCLUSION: Three operationalizations of social isolation demonstrated different utilities and implications in assessing the impacts of social isolation on depressive symptoms. Social contacts and loneliness, rather than living status or other characteristics of isolation, were the factors most strongly associated with depressive symptoms. Support programs should target lonely older adults who lack social engagement opportunities, as they are at increased risk of depression.
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COVID-19 , Depressão , Humanos , Idoso , Depressão/epidemiologia , Estudos Transversais , Pandemias , COVID-19/epidemiologia , Isolamento Social , SolidãoRESUMO
OBJECTIVES: Discrimination is an urgent public health problem. A number of major cities and counties across the United States has declared racism a public health crisis. While there is a growing body of research on the discrimination-health connection, less is known regarding the social relational consequences of discrimination. The present study addresses this knowledge gap by investigating the relationship between discrimination, skin tone, and objective and subjective social isolation using a nationally representative sample of African Americans. METHOD: This analysis was based upon the African American subsample (N = 3,570) of the National Survey of American Life. Discrimination was assessed with the Everyday Discrimination Scale. Objective and subjective isolation differentiated between respondents who were (a) socially isolated from both family and friends, (b) socially isolated from friends only, (c) socially isolated from family only, and (d) not socially isolated. Skin tone was self-reported. Multinomial logistic regression analyses were used to test the study hypotheses. RESULTS: The analyses indicated that more frequent discriminatory experiences were associated with increased risk for subjective and objective social isolation. Skin tone moderated the association between discrimination and subjective isolation; the discrimination-isolation relationship was stronger among participants with darker skin tones. CONCLUSIONS: These findings shed light on African Americans' nuanced experiences with discrimination and colorism. Further, the data demonstrate heterogeneity in the vulnerability to the adverse effects of discrimination within the African American population; the relationship between discrimination and subjective isolation was stratified by skin tone. This underscores the well-documented and persistent racialized social stratification system in the United States (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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This study examined racial and ethnic differences in professional service use by older African Americans, Black Caribbeans, and Non-Hispanic Whites in response to a serious personal problem. The analytic sample (N = 862) was drawn from the National Survey of American Life. Findings indicated that African Americans and Black Caribbeans were less likely to use services than Whites. Type and race of providers seen varied by respondents' race and ethnicity. Among respondents who did not seek professional help, reasons for not seeking help varied by ethnicity. Study findings are discussed in relation to practice implications.
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Etnicidade/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Grupos Raciais/estatística & dados numéricos , Serviço Social/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Região do Caribe , Feminino , Nível de Saúde , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Saúde Mental/etnologia , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados UnidosRESUMO
There are many studies on loneliness among community-dwelling older adults; however, there is limited research examining the extent and correlates of loneliness among older adults who reside in senior housing communities. This study examines the extent and correlates of loneliness in three public senior housing communities in the St. Louis area. Data for this project was collected with survey questionnaires with a total sample size of 148 respondents. Loneliness was measured using the Hughes 3-item loneliness scale. Additionally, the questionnaire contained measures on socio-demographics, health/mental health, social engagement, and social support. Missing data for the hierarchical multivariate regression models were imputed using multiple imputation methods. Results showed approximately 30.8% of the sample was not lonely, 42.7% was moderately lonely, and 26.6% was severely lonely. In the multivariate analyses, loneliness was primarily associated with depressive symptoms. Contrary to popular opinion, our study found the prevalence of loneliness was high in senior housing communities. Nevertheless, senior housing communities could be ideal locations for reducing loneliness among older adults. Interventions should focus on concomitantly addressing both an individual's loneliness and mental health.
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Depressão/diagnóstico , Solidão/psicologia , Idoso , Idoso de 80 Anos ou mais , Depressão/psicologia , Feminino , Habitação/organização & administração , Habitação/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Projetos Piloto , Psicometria/instrumentação , Psicometria/métodos , Fatores de Risco , Centros Comunitários para Idosos/organização & administração , Centros Comunitários para Idosos/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study examined the relationship between informal social support from extended family and friends and suicidality among African Americans. METHODS: Logistic regression analysis was based on a nationally representative sample of African Americans from the National Survey of American Life (N = 3263). Subjective closeness and frequency of contact with extended family and friends and negative family interaction were examined in relation to lifetime suicide ideation and attempts. RESULTS: Subjective closeness to family and frequency of contact with friends were negatively associated with suicide ideation and attempts. Subjective closeness to friends and negative family interaction were positively associated with suicide ideation and attempts. Significant interactions between social support and negative interaction showed that social support buffers against the harmful effects of negative interaction on suicidality. CONCLUSIONS: Findings are discussed in relation to the functions of positive and negative social ties in suicidality.
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Negro ou Afro-Americano/estatística & dados numéricos , Família , Amigos , Relações Interpessoais , Apoio Social , Suicídio/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
Social isolation is a significant public health problem among many older adults; however, most of the empirical knowledge about isolation derives from community-based samples. There has been less attention given to isolation in senior housing communities. The objectives of this pilot study were to test two methods to identify socially isolated residents in low-income senior housing and compare findings about the extent of isolation from these two methods. The first method, self-report by residents, included 47 out of 135 residents who completed in-person interviews. To determine self-report isolation, residents completed the Lubben Social Network Scale 6 (LSNS-6). The second method involved a staff member who reported the extent of isolation on all 135 residents via an online survey. Results indicated that 26% of residents who were interviewed were deemed socially isolated by the LSNS-6. Staff members rated 12% of residents as having some or a lot of isolation. In comparing the two methods, staff members rated 2% of interviewed residents as having a lot of isolation. The combination of self-report and staff report could be more informative than just self-report alone, particularly when participation rates are low. However, researchers should be aware of the potential discrepancy between these two methods.
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Psicometria/estatística & dados numéricos , Isolamento Social/psicologia , Feminino , Humanos , Solidão/psicologia , Masculino , Projetos Piloto , Psicometria/instrumentação , Psicometria/métodos , Autorrelato , Estados UnidosRESUMO
OBJECTIVES: Guided by the theory of stress proliferation, our study examined whether loneliness, citizenship status, and English proficiency were associated with psychological distress among older adults, and if citizenship status and English proficiency moderated these relationships. METHODS: Using the older adult subsample (65+ years) of the 2019-2020 California Health Interview Survey (N = 15,210), we assessed cross-sectional associations between loneliness, citizenship status, and English proficiency on psychological distress by conducting multivariable linear regression models. Interaction terms were included in subsequent models to determine if citizenship status and English proficiency moderated the relationship between loneliness and psychological distress. RESULTS: In unadjusted models, greater loneliness was associated with higher distress. Both naturalized citizens and noncitizens, and those with limited English proficiency (LEP) exhibited greater distress than US born citizens and those who speak English only (EO). After adjusting for sociodemographic and health covariables, loneliness remained significant for distress although the relationships between citizenship status and English proficiency became attenuated. With the inclusion of interactions, the magnitude of the relationship between loneliness and distress was stronger for naturalized citizens and those with LEP than native-born citizens and those who speak EO, respectively. DISCUSSION: Loneliness was the most consistent stressor affecting multiple life domains. However, our findings demonstrate that stress proliferation is occurring among older immigrant adults and the interplay between loneliness, citizenship status, and English proficiency is contributing to heightened distress. Further attention is needed in understanding the role of multiple stressors influencing mental health among immigrant older adults.
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Emigrantes e Imigrantes , Angústia Psicológica , Humanos , Idoso , Solidão , Estudos Transversais , CidadaniaRESUMO
Social isolation is associated with worse health; however, few studies have examined the health effects of isolation among African Americans. The purpose of this study is to evaluate associations between social isolation and self-rated physical and oral health from the National Survey of American Life, a nationally representative sample of African Americans. Social isolation was operationalized to reflect both objective isolation (lack of contact) and subjective isolation (lack of emotional closeness). Self-rated physical and oral health were regressed on objective and subjective isolation while controlling for marital status, gender, age, family income, education, and health behaviors. Poorer self-rated physical health was associated with objective isolation, while poorer self-rated oral health was associated with subjective isolation. This study contributes to the small literature of the impact of social isolation on health among African Americans; furthermore, it is the first to examine the relationship between isolation and self-rated oral health in this population.
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Negro ou Afro-Americano , Nível de Saúde , Saúde Bucal , Isolamento Social , Humanos , Negro ou Afro-Americano/psicologia , Negro ou Afro-Americano/estatística & dados numéricos , Masculino , Saúde Bucal/etnologia , Feminino , Isolamento Social/psicologia , Pessoa de Meia-Idade , Adulto , Estados Unidos , Idoso , Adulto Jovem , Adolescente , Autorrelato , Inquéritos Epidemiológicos , Fatores SocioeconômicosRESUMO
Background and Objectives: Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education. Research Design and Methods: Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014-2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson-Holm-Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness. Results: In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education. Discussion and Implications: Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness.
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Objective: This study examined racial and ethnic differences in the receipt and provision of instrumental family support. Background: Extended families provide significant levels of emotional and instrumental support across the life course. Despite their importance, extended family relationships and the assistance they provide are largely neglected in the literature. Further, questions remain concerning cultural variation in family support relationships and inconsistent findings on racial differences in family support in prior investigations. Method: This study relied on data from the National Survey of American Life-Reinterview (n=3,483) to investigate the provision and receipt of instrumental support from extended family among African Americans, Black Caribbeans, and non-Latino Whites and within high- and low-income categories for each group. Eight key measures of instrumental family support are examined: receiving and providing transportation, help with chores, financial assistance, and help during an illness. Results: African Americans and Black Caribbeans share similar profiles of providing and receiving instrumental family support. Both populations receive and provide assistance more frequently than do non-Latino Whites. Similarly, analyses stratified by income indicated that for low-income and high-income groups, African American and Black Caribbeans are similar to one another, and at each income category, both groups received and provided support more frequently than non-Latino Whites. Conclusion: Study findings are discussed in relation to conceptual and methodological differences in assessing Black-White differences across studies of family support. Attention to these issues and the specific contexts for receiving/providing family support (emergency vs. routine; intergenerational vs. extended) will help clarify inconsistent findings across studies.
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There is increasing evidence suggesting the influence social isolation has on health outcomes and mental well-being. Chronic medical conditions, such as pain, have been shown to impact social relationships and isolation among majority populations, but there is little evidence documenting this relationship among African Americans. To address this lack of scholarly work, the current study aimed to examine subjective and objective social isolation, pain interference with daily life, and problems with pain in a sample of African American adults 18 + years of age. Taken from the National Survey of American Life: Coping with Stress in the 21st Century (NSAL), results showed that participants who were objectively isolated from family only were more likely to have a chronic health problem that was associated with increased pain. Data further showed that those reporting subjective isolation from both family and friends experienced greater interference from pain than those who were not isolated from family and friends. Findings from this study acknowledge a larger issue that addresses the impact social isolation has on health, quality of life, and general well-being. Recognizing the influence of such may allow systems to acknowledge the determinants that perpetuate social isolation, while still recognizing the needs of marginalized groups.
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Negro ou Afro-Americano , Qualidade de Vida , Adaptação Psicológica , Adulto , Doença Crônica , Humanos , Dor , Isolamento SocialRESUMO
Objective: This study sought to determine whether religious involvement is associated with sleep quality in a nationally representative sample of older African Americans. Methods: The analytic sample included African American respondents aged 55+ from the National Survey of American Life-Reinterview (N = 459). Religious involvement variables included service attendance, reading religious texts, watching religious television programs, listening to religious radio programs, prayer, and subjective religiosity. Sleep outcomes were restless sleep and sleep satisfaction. Multiple linear regression analysis was used. Results: Watching religious television programs was associated with more restless sleep. Respondents who attended religious services less than once a year, at least once a week, or nearly every day reported greater sleep satisfaction than respondents who never attended religious services. Subjective religiosity was associated with lower sleep satisfaction. Discussion: The findings demonstrate the importance of examining a variety of religious involvement domains, which could point to different explanatory pathways between religious involvement and sleep.
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Negro ou Afro-Americano , Transtornos Mentais , Humanos , Satisfação Pessoal , Religião , Sono , Estados UnidosRESUMO
BACKGROUND: Research documents the adverse health effects of systemic inflammation. Overall, older Black Americans tend to have higher inflammation than older non-Hispanic White adults. Given that inflammation is related to a range of chronic health problems that disproportionately affect Blacks compared to Whites, this racial disparity in inflammation may contribute to racial disparities in particular chronic health problems. Thus, a better understanding of its determinants in the older Black population is of critical importance. This analysis examined the association between neighborhood characteristics and inflammation in a national sample of older non-Hispanic Black Americans. An additional aim of this study was to determine whether hopelessness and pessimism moderate the association between neighborhood characteristics and inflammation. METHODS: A sample of older non-Hispanic Black Americans aged 60+ were drawn from the Health and Retirement Study (N = 1004). Neighborhood characteristics included neighborhood physical disadvantage and neighborhood social cohesion. Inflammation was assessed by C-reactive protein. RESULTS: The analyses indicated that neighborhood physical disadvantage and social cohesion were not associated with C-reactive protein. Hopelessness and pessimism moderated the association between neighborhood physical disadvantage and C-reactive protein. CONCLUSIONS: Knowledge regarding the role of hopelessness and pessimism as moderator in the neighborhood-inflammation association can inform cognitive-behavioral interventions targeted at changes in cognition patterns.
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Negro ou Afro-Americano , Pessimismo , Proteína C-Reativa , Humanos , Inflamação , Características da Vizinhança , Características de ResidênciaRESUMO
Social isolation and loneliness are significant risks to health among older adults. Previous studies have found a significant association between social isolation and loneliness; however, few studies examined the association between social isolation and loneliness in a multivariate context and how specific types of social isolation influence loneliness. This study fills this gap by examining social isolation's overall influence on loneliness and how specific social isolation indicators influence loneliness. Data comes from 2014 Wave of the Health and Retirement Study, a nationally representative study of adults aged 50 and older. Social isolation was operationalized using seven indicators as social isolation from: 1) adult children, 2) other family members, 3) friends, 4) living alone, 5) being unmarried, and 6) not participating in social groups or 7) religious activities. Loneliness was operationalized by the Hughes 3-item loneliness scale. Loneliness was regressed on social isolation and key socio-demographic factors. Results found when social isolation indicators were combined into an index, every unit increase in overall social isolation was associated with an increase in loneliness. Furthermore older adults who were isolated from other family members and from friends, lived alone, were single, and did not participate in social groups or religious activities reported greater loneliness. Study findings demonstrate that greater overall social isolation and specific social isolation indicators are associated with greater loneliness. Clinical practice with older adults can be enhanced by understanding the connections between social isolation and loneliness and which forms of social isolation are more meaningful for perceived loneliness.
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The concept of "double jeopardy"-being both older and Black-describes how racism and ageism together shape higher risks for coronavirus exposure, COVID-19 disease, and poor health outcomes for older Black adults. Black people and older adults are the two groups most affected by COVID-19 morbidity and mortality. Double jeopardy, as a race- and age-informed analysis, demonstrates how Black race and older age are associated with practices and policies that shape key life circumstances (e.g., racial residential segregation, family and household composition) and resources in ways that embody elevated risk for COVID-19. The concept of double jeopardy underscores long-standing race- and age-based inequities and social vulnerabilities that produce devastating COVID-19 related deaths and injuries for older Black adults. Developing policies and actions that address race- and age-based inequities and social vulnerabilities can lower risks and enhance protective factors to ensure the health of older Black Americans during the COVID-19 pandemic.
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Negro ou Afro-Americano/estatística & dados numéricos , Infecções por Coronavirus/etnologia , Disparidades nos Níveis de Saúde , Pneumonia Viral/etnologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , COVID-19 , Infecções por Coronavirus/mortalidade , Instituição de Longa Permanência para Idosos/normas , Humanos , Masculino , Pessoa de Meia-Idade , Casas de Saúde/normas , Pandemias , Pneumonia Viral/mortalidade , Religião , SARS-CoV-2 , Isolamento Social , Segregação Social/tendências , Fatores SocioeconômicosRESUMO
Social isolation is a major problem in the United States that has adverse impacts on health and well-being. However, few studies investigate social isolation among African Americans or the impact of social isolation on psychiatric disorders. This study addresses this gap by investigating the impact of objective (absence of contact with others) and subjective (lacking feelings of closeness to others) social isolation on psychiatric disorders among African Americans. The sample includes 3,570 African Americans from the National Survey of American Life. Regression models were used to test the impact of objective and subjective isolation on 12-month MDD, any 12-month DSM disorder and number of 12-month DSM disorders. Analyses indicated that subjective isolation from family only, friends only, and both groups were associated with greater odds of meeting criteria for 12-month MDD, any 12-month disorder and number of 12-month DSM disorders. However, objective isolation was unrelated to either measure of psychiatric disorder. Study findings indicate that affective characteristics of social isolation (feelings of closeness with family and friends) are more significant for psychiatric disorders than are objective features (social contact). Our discussion notes that the connections between subjective and objective social isolation and psychiatric disorders are complex and potentially reciprocally associated with one another. Clinical practice should focus on both possible associations.
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Social isolation is a significant social problem in the United States that many health and welfare organizations have begun to acknowledge and address. Unfortunately, extremely little research focuses on social isolation among ethnic minority populations. This study investigated the association between social isolation from family and friends and the mental health of African Americans and Black Caribbeans. Using data from the National Survey of American Life (2001-2003), we explore 2 indicators of mental health: depressive symptoms (CES-D) and serious psychological distress (Kessler 6). The negative binomial regression analysis examined both objective isolation (infrequent contact) and subjective isolation (lack of emotional closeness) from family and friends. Overall study findings indicated that infrequent contact (objective social isolation) and diminished emotional closeness (subjective social isolation) from family and friends were associated with higher levels of depressive symptoms and serious psychological distress for both African Americans and Black Caribbeans. The addition of subjective social isolation to regression models attenuated the association between objective social isolation and depressive symptoms for both groups. However, the addition of subjective social isolation attenuated the association between serious psychological distress for African Americans but not for Black Caribbeans. These findings contribute to the very limited, but growing body of research on the negative association between social isolation and the mental and physical health of ethnic minorities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).