Friend Connection Predicting Overall Health and Quality of Life Among Asian Older Adults in Affordable Housing

BACKGROUND/PURPOSE

Studies show older-adults and persons with disabilities (OA/PD) that are poor are at greater risk of worse health outcomes. Barriers to health and social services (H/SS) can lead to housing instability and hospitalization. Using a social determinants of health lens, several H/SS agencies formed the Housing with Services (HWS) project to provide comprehensive and culturally-specific services to low-income OA/PD residing in affordable housing in Portland, Oregon.

This study tests the associations of demographic, economic and social factors on health and quality of life (QoL) among low-income seniors. We focus on potential impacts of social connection among culturally diverse seniors when housing stability is assumed (i.e., residing in affordable housing). It is hypothesized seniors residing in properties where social connection is promoted report better outcome variables. Findings highlight potential intervention strategies for low-income seniors.

METHODS

All 1400+ residents of 10 affordable housing properties were invited to participate in a government-funded longitudinal evaluation of the effectiveness of HWS, but our initial data was comprised of 541 residents. To control for age and residential effects, residents ages 62+ were only selected from properties where Asian-language speaking participants were residing. Our final sample comprised 298 seniors (69 Asian-language, 217 non-Asian language speaking, 12 unknown).

Self-reported overall health, experiencing depression or anxiety, and QoL were measured as outcome variables. Social connection was measure with two constructs: family and friend connection, by 3-item questions per each (reliability=.85, .95 respectively). Sex, income, and living-alone were included as predictors.

Preliminary analysis was conducted to compare Asian-speaking vs. non-Asian speaking seniors on study variables. OLS regression was followed to explore causal explanation of study variables on outcome variables separately.         

RESULTS

Compared to non-Asian language speaking, Asian-speaking seniors were less likely to be living alone, experiencing depression/anxiety, and more likely to be poor and have family connection.

Only two regression models were significant with overall health and QoL, and only friend connection was a consistently significant predictor. When language-spoken was controlled, predictive power of friend connection remained significant, but surprisingly only with Asian-speaking seniors.

Post-hoc analysis revealed all Asian-language speaking were foreign-born except three (2 unknown; 1 in US), and more likely living in same properties. Among foreign-born Asian-speaking seniors, Chinese were living in three properties (n=40/1/1), Koreans in three (n=8/3/1), Vietnamese in three (n=4/4/1), and Filipinos in one (n=3). But, only 11% (n=24) of non-Asian speaking were foreign-born from 13 different countries, and living in eight different properties.

CONCLUSIONS/IMPLICATIONS

Asian-Americans are the fastest growing US population, and experience longer life expectancy. Nearly half of Asian-American seniors live alone and are below the poverty line. To our best knowledge, this is the first comprehensive study to examine the effects of social determinants of health among culturally diverse seniors residing in affordable housing. Interestingly, only friend connection matters only among Asian-language speaking seniors for health and QoL. Findings inform how to improve culturally-specific health programs for Asian-American low-income older adults by promoting social connection. Longitudinal study for stronger causality and qualitative study for deeper understanding of social connections are encouraged.