The Relationship of Social Isolation with Mental Distress Among Older Korean Americans: The Role of Positive Social Environment

Background and Purpose:

Social isolation has been associated with poor physical and mental health outcomes. The detrimental effects of social isolation may be greater for older immigrants who do not have protective social environment (e.g., quality of family interactions and perceived community cohesion). The purpose of this study was to investigate the relationship of different dimensions of social isolation with mental distress and to examine the interactive role of social environment. We hypothesized that social isolation would be associated with greater mental distress and that positive social environment would buffer the influence of social isolation on mental distress.

Methods:

Data were drawn from the Study of Older Korean Americans (SOKA), which included 2,150 older Korean Americans aged 60 or over in five states (California, New York, Texas, Hawaii, and Florida). Data collection took place at multiple sites and community events during 2017−2018. In hierarchical regression models, mental distress was regressed on four blocks of variables: (1) socio-demographic (age, gender, education, perceived financial status, and number of years in the U.S.); (2) health (chronic medical conditions and functional disability); (3) social isolation (living alone, marginal family ties, marginal friend ties); and (4) social environment (family cohesion and community cohesion). In the final step, interaction terms (family/community cohesion with marginal family ties and marginal friend ties) were included to the direct effect models.

Results:

About one-third of the sample lived alone, 20% had marginal family ties, and 19% had marginal friend ties. All dimensions of social isolation were associated with poorer medical conditions and functional disability, lower family cohesion, and higher levels of mental distress. In the final direct effect model, female gender, lower perceived financial status, more chronic medical conditions, greater functional disability, marginal family ties, marginal friend ties, and lower levels of family and community cohesion were significant risk factors to mental distress. When interaction terms were considered, family cohesion buffered the negative effects of marginal ties to family and friends on mental distress.

Conclusions and Implications:

The results support the direct effects of social isolation on mental distress and interactive effects of family cohesion with marginal ties to family and friends. It is disconcerting that significant proportions of older Korean immigrants were socially isolated and that those isolated were at risk of unsupportive social environment and mental distress. The significant role of positive social environment should be considered when addressing the needs of older immigrants who are socially isolated. Implications for social work practice with older immigrants are suggested.