Older Adults' Loneliness and Health Disparities across States: Promoting Safe and Interactive Environment

Background and Purpose: Social disconnectedness, perceived isolation, and feelings of loneliness are important factors affecting older adults’ physical and mental health. In particular, older adults’ disengagement from their communities is likely to affect their loneliness. The CIHDR model from the University of Chicago's Center for Interdisciplinary Health Disparities Research explains the downward causal chain from social environment factors, such as neighborhood crime, to individual health. Based on the CIHDR model, this study explored the relationship between older adults’ individual factors, state crime rates, and older adults’ self-rated health. The purpose of the study was to examine the association between older adults’ feelings of loneliness and health and how older adults’ feelings of loneliness can be affected by risky environment. The study hypothesized that 1) older adults’ self-rated health varies across states after accounting for race and age; 2) the state crime rate affects older adults’ self-rated health; and 3) the magnitude of the relationship between older adults’ perceived loneliness and self-rated health varies across states.

Methods: Hierarchical linear models were employed to test the study hypotheses. The individual data were attained from the fifth wave of the American’s Changing Lives Survey collected in 2011. The group-level data on states’ crime rates came from the Disaster Center. All of the variables of interest were grand-mean centered.

Results: A total of 1592 older adults aged 60 and older were included for study analyses. The mean age of the respondents was 70.02 (SE=7.41). First, there was evidence of significant variation in self-rated health across states after including the level-1 predictors, age and race (χ2 = 74.06, p=0.01). Secondly, there was evidence of significant residual state variation in self-rated health (χ2 = 68.48, p<0.05), and approximately 12.4% of the residual variance in self-rated health across states was explained by state crime rates. When every one unit increases in state crime rates, self-rated health is poorer by approximately 0.001 unit, after controlling for the others. Lastly, fixed effects indicated that perceived loneliness was associated with self-rated health after controlling for age and race. There was evidence of variation in the effect of loneliness across states (χ2 = 67.53, p=0.01). Older adults’ perceived loneliness moderates the relationship between states’ crime rates and their self-rated health.

Conclusions and Implications: An extensive body of research has identified environmental factors affecting older adults’ health to develop effective social work interventions. As life expectancy has increased, there has been growing interest in “aging in place” in academia as well as in practice. However, it often generates concerns that older adults are likely to have fewer options and become isolated in their own home. Referring to the CIHDR model, individuals are likely to feel isolated and depressed in broken communities. It is critical to develop safe and interactive communities where older adults can actively participate in social activities. Moreover, State-level efforts are required to protect older adults from all kinds of crimes including crimes specifically targeting older populations. Enjoyable and reliable environment will help minimize feelings of loneliness among older populations.