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As baby boomers reach retirement age, accessible, evidence-based programs to promote healthy aging and prevent or delay onset of chronic conditions in communities will be essential. New York City, one of the most racially/ethnically, culturally and economically diverse cities in the world, is expecting a 44% increase in the older adult (65 +) population over the next 25 years. The Healthy Indicators Project (HIP) is an initiative to design, deliver, and evaluate effective programs for older adults that support personal choice and communal interdependence. The 3-year study uses representative survey data to design and implement evidence based practices, and evaluate their effectiveness. The first year consisted of a survey of a representative sample of senior center participants' functional, social, health, demographic and socioeconomic characteristics for baseline measurement and to design targeted, evidence-based interventions. This paper presents an analysis of the relationships between ethnic and racial diversity of senior centers and social support reported by participants.
Methods:
The citywide survey employed a stratified random sample technique; the first stratum consisted of geography (borough) and the second stratum size of the senior center. Fifty-six senior centers were selected. Within each senior center, a systematic random sample (every third participant) was invited to participate. The 76.7% response rate resulted in 1,870 in-person interviews from April through November 2008. Standardized questionnaires were administered in five languages (Chinese, English, Italian, Russian and Spanish), and included items from validated measures of functional status, mental and physical health status, co-morbidities, social networks, perceptions about neighborhoods, cancer screenings, as well as several demographic and socioeconomic status variables.
Bivariate and multivariate analyses explored predictive ability of cultural diversity on social support. Analysis of variance examined the relationship between social support and health and t-tests examined differences in social support between more or less diverse senior centers. Ordinal regression (ordered logit model) was performed to identify predictors of social support. Independent variables included gender, living alone, diversity of the senior center, and white/non-white identification of the participant.
Results: Findings support existing evidence of the positive relationship between social support and self-reported health (F = 3.63, p < .01). However, social support among older adults who attend senior centers with more ethnically and racially diverse populations was found to be significantly lower than support among participants in more homogeneous centers (t = -3.46, p < .01). Results from an ordinal regression of social support (low, medium, high) suggest that when controlling for race/ethnicity, gender, and living alone status, the diversity of the senior center is a significant predictor of lower levels of social support. Lower levels of social support were also predicted by living alone and being male.
Conclusions and Implications: This first of its kind study using a representative sample of senior center participants provides a rigorous methodological approach to designing and implementing targeted evidence-based interventions in community-based settings serving older adults. The findings support the need to design and target interventions for building social support mechanisms within ethnically and racially diverse environments.