Neighborhood Social Cohesion and Subjective Well-Being: Gender Differences Among Chinese Older Adults

Background

Although neighborhood social cohesion (nSC) has been linked to improved individual well-being (Kim et al., 2020), little is known about whether this association may vary by gender among Chinese older adults. This study aims to determine the relationship between nSC and subjective well-being among community-dwelling older adults in China and identify the potential moderating effects of gender.

Methods

The person-in-environment framework guides our understanding of the association between nSC and subjective well-being (Bronfenbrenner, 1977). In 2013, a cross-sectional study was conducted with older adults aged 60 years and above in the Anhui province of China. A two-stage stratified random sampling method was used to get a representative sample (n=3,045) from four urban and four rural communities. Life satisfaction, self-rated health, and psychological health were measured to reflect the participants’ subjective well-being. Psychological health was evaluated using the 12-item Chinese version of the General Health Questionnaire (GHQ-12).

The independent variable was nSC measured by four items: 1) people in this neighborhood can be trusted; 2) this is a close-knit neighborhood; 3) people are helping each other; 4) I feel being a part of this neighborhood. Each item was rated on a five-point scale, from 1 (Very Dissatisfied) to 5 (Very Satisfied). nSC is the sum of four response options, ranging from 4 to 20 as a continuous variable and categorized into high (≥16) and low level (<16) from its median. Multiple binary logistic regression was performed with an interaction term of gender and nSC. Models were also conducted for stratified samples to compare gender differences. The logistic models showed odds ratio (OR) results at the 95% confidence interval. Based on previous literature, the results in all models were adjusted with twelve potential confounders (e.g., age, marital status, education, chronic diseases, social support, and financial difficulty).

Results

Among 3,045 study participants, 66.7% reported high life satisfaction, 52.3% reported high self-rated health, and 11.6% reported having mental disorders. The average score of nSC was 15.0±2.1, and 50.2% reported high nSC. The models with the categorical variable of nSC indicated that high nSC was positively associated with increased life satisfaction (OR=2.26, 95% CI: 1.92-2.66) and improved self-rated health (OR=1.29, 95% CI: 1.10-1.50) but negatively associated with mental disorders (OR=0.73, 95% CI: 0.57-0.93). The models with nSC as a continuous variable confirmed the impact of nSC on subjective well-being. Gender may only moderate the association beween nSC and psychological health. Further, modeling on the stratified samples showed that high nSC was negatively associated with having mental disorders (OR=0.41, 95% CI: 0.27-0.62) for male sample only.

Conclusions/Implications

This study reveals the positive impact of nSC on subjective well-being and the moderating effects of gender on the relationship between nSC and psychological health. The findings provide evidence for social workers to better understand how the environment impacts older adults’ health and well-being. In addition, social workers can design programs to enhance nSC for improving subjective well-being and promoting health equity, particularly for male older adults.