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Loneliness is a global public health concern among older adults (SW Grand Challenges, 2016) and is associated with poorer physical health, poor mental well-being and morbidity. Increasingly research has focused on high-income countries; however, significantly less is known as to how loneliness varies by cultural context. Recent attention has been paid to the multiple challenges facing elders in Mexico yet no studies have explored predictors of loneliness in this population. Moreover violence (e.g., homicides, kidnapping, extortion etc.) is a critical problem in Mexico yet little or no research has considered its effects on the well-being of Mexican elders. Guided by Nicholson’s (2009; 2012) conceptual analysis and de Jong-Gierveld’s (1987, 2016) model of loneliness, we estimate the prevalence of loneliness and identify significant predictors among a nationally representative sample of Mexican elders.
Methods:
We drew data from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1 (2007-2010). The survey used a multistage, stratified clustered sample design. Household clusters were sampled to reflect age, sex, level of wealth/local economic development, and urban/rural status in the Mexico Census. Measures were standardized, well validated and widely used in world health surveys. Interviews included 1,973 adults aged ≥ 50 years. For our analysis, we conceptualized loneliness as dissatisfaction with community integration. We conducted logistic regression analyses to explore associations with: physical health (i.e. chronic health conditions, self-rated health); mental health (i.e., depression, affect); healthcare utilization (i.e., inpatient, outpatient); and violence (i.e., homicide rates, perceived safety, victimization) while controlling for important demographics (i.e., age, gender, income, marital status, education, living location).
Findings:
The mean age of this sample was 67 years (SD= 9) with 39% older than 70 years. About 60% were female, 25% were widowed, and 83% had 6 years of schooling or less. Approximately 25% of older adults in Mexico reported experiencing loneliness. Results from our logistic regression indicated individuals with good self-rated health (OR: .736, CI: .581, .935) and those living in the most violent states (OR: .674, CI:.466, .976) were significantly less likely to report loneliness. On the other hand individuals with diagnosed depression (OR: 1.659, CI: 1.215, 2.265), negative affect (OR: 2.03, CI: 1.536, 2.669) and individuals who reported being hospitalized during the past three years (OR: 1.463, CI: 1.102, 1.941) were more likely to report loneliness. Surprisingly, living in more violent states was a negative predictor of loneliness.
Conclusions and Implications:
Loneliness among older Mexicans is a critical social concern. Collaborations between the U.S. and Mexican health associations should: 1) explore supports and resources for training current practitioners in recognizing loneliness especially among hospitalized and recently hospitalized elders; 2) examine the effects of loneliness on important health outcomes among older Mexicans; 3) identify additional protective factors for elders at risk; and 4) engage in the development/implementation of interventions to both prevent and address loneliness through the current Mexican geriatric care system. In addition, future work should explore further the connection between violence and loneliness among Mexican elders to more fully understand the impact.