Factors Impacting Perceived Control and Depression in Older Adults of Different Racial/Ethnic Groups

Background and Purpose: While there has been substantial research on risk and protective factors that impact older adult health and well-being, current research has only begun to understand complexities regarding racial and ethnic group differences in health outcomes.  The purpose of this study was to examine 1) racial and ethnic group difference in social support, transportation and neighborhood issues, depression and perceived control among older adults; 2) the effect of social support, transportation and neighborhood issues on depression and perceived control among older adults; and 3) racial and ethnic group differences in the hypothesized relationship between the variables.

Methods: This study was a secondary analysis of data collected from the Well Elderly 2 study. The original study was a four-year (2004-2008) longitudinal, multi-site study that tested the effectiveness and cost of an occupational therapy on older adults ages 60-95. A convenience sampling design was utilized. The current study is a cross-sectional study of survey data gathered at the baseline measurement before any treatment was given. There were a total of 460 participants: 66% female, 39.3% Caucasian, 32.9% African American, and 21.5% Hispanic. Self-report measures of social support, neighborhood and transportation issues, depression, and perceived control were utilized. Neighborhood and transportation issues assessed how much perceived stress participants felt due to their neighborhood environment and transportation services. Each transportation and neighborhood issue measure consisted of 3 questions on a 5-point Likert scale; a total score ranged between 3-15. Lubben Social Network Scale (Lubben, 1988) and the Center of Epidemiologic Studies Depression Scale (Radloff, 1977) were used. Perceived control was assessed by 8 questions on a 4-point Likert scale; a total score ranged between 8-32. A series of one-way ANOVA and multiple linear regression analyses was conducted. The regression models were tested with the total sample first and subsequently, with each racial and ethnic group. Education, age and income were entered as covariates in the regression models. 

Results: Overall, significant racial and ethnic group differences were observed. The results from the one-way ANOVA tests revealed Caucasians had significantly lower transportation issues than African Americans, while African Americans had significantly higher neighborhood issues than Caucasians. Caucasians had significantly lower transportation issues than both groups and significantly lower social support than African Americans. The results from the regression analyses revealed that transportation issues predicted higher levels of depression and lower levels of perceived control among all racial/ethnic groups. Racial and ethnic group differences emerged in predicting depression. Social support was a significant predictor of depression among African Americans and Caucasians, but not for Hispanics. Additionally, neighborhood issue was a significant predictor of depression only for Caucasians.

Implications: Findings suggest that more interventions and funds should focus on improving transportation options for older adults, particularly in California, to improve their overall health. Increasing opportunities for African American and Caucasian older adults to socialize with others and interact with their community may also improve depressive symptoms. Interventions should be customized in order to address the different risk and protective factors of health outcomes among racial/ethnic groups.