Asian Neighborhoods and the Mental Health of Older Asian Americans: A Mixed-Methods Study

Study Aim: Applications of social capital theories with Asian Americans show social connections can improve health and mental health outcomes.  Little research has extended the theories to older Asian Americans, who have many health, mental health, and social vulnerabilities.  This study applied community-based participatory research methods to examine the relationship between social capital and perceived social discrimination on the depressive symptoms of community-dwelling  older Asian Americans. 

Methods:  This study utilized a cross-sectional, mixed method design.  In partnership with community-based agencies the study was administered as a randomized phone interview, and individually with senior-center attendees.   A semi-structured interview was used to elicit responses to questions about housing, health and mental health, and service use.  Descriptive statistics were used to explore relationships in the data.    These procedures yielded 120 completed surveys. 

Open ended items were analyzed qualitatively by two independent coders. 

In order to account for missing values, missing imputation with bootstrapping methods were used to test a multiple regression model that examined the effect of neighborhoods, social capital, and discrimination on Patient Health Questionnaire – 9 scores.

Results: The results reveal the separate and unique contributions of two dimensions of neighborhood relationships.  Elders living in non-Asian neighborhoods endorsed more depression symptoms (B=4.9). Meanwhile, higher levels of social capital were associated with lower levels of depression (B=-.64).  The deleterious effects of discrimination are tempered by the benefits of neighborhood social connections (B=.66). 

Four major themes were emerged from the qualitative analysis: characteristics of neighbors, physical environment, convenience, and safety. Elders living in Asian neighborhoods expressed less satisfaction with their neighbors, and more uncertainty about their surroundings, but they recognized convenient living conditions including transportation and local ethnic supermarkets.  Conversely, elders in non-Asian neighborhoods reported positive experiences with their neighbors, while noting the distance to ethnic services.

Conclusion: The social environment, role of aging in place and naturally occurring retirement communities (NORC) are vitally important for elders, irrespective of the demographic composition of the surrounding neighborhood.  These findings underscore the tradeoffs that Asian elders face when living in different neighborhoods.  Implications for elder housing policies, social capital theories and mental health promotion will be discussed.