The Role of Neighborhood Social Cohesion in Older Adults' Loneliness during the COVID-19 Pandemic

Background and Purpose: Loneliness among older adults is recognized as a significant issue that affects physical and mental health, particularly exacerbated by the COVID-19 pandemic. While existing research has focused on individual-level factors such as marital status, living arrangements, social isolation, and health, there remains a gap in understanding the role of neighborhood-level factors in influencing loneliness. Neighborhood social cohesion, which refers to the sense of connection and solidarity within a community, is considered a crucial aspect of social environments that can enhance psychological well-being. In this study, we aim to investigate the association between neighborhood social cohesion and loneliness among older adults, focusing on during the COVID-19 pandemic, when loneliness was particularly pronounced. We will also investigate how this association may vary by race/ethnicity.

Methods: Data was obtained from the Health and Retirement Study for 2016 and 2020. Our analytic sample includes respondents aged 50 years and older who completed the Psychosocial and Lifestyle Questionnaire in 2020 (N=2,998). Loneliness (0=not lonely; 1=lonely) was measured using the UCLA 3-item Loneliness Scale. Neighborhood social cohesion was measured using a widely used 4-item scale that was previously validated. Logistic regression was employed with loneliness in 2020 as the outcome variable and neighborhood social cohesion in 2020 as the exposure. We included a comprehensive set of covariates, including sociodemographic variables (age, sex, marital status, race/ethnicity, education, and household income), health status indicators (self-rated health, chronic diseases, and depression), COVID-19-related factors (financial concerns and concerns about getting help due COVID-19), and informal networks, all measured in 2020. Loneliness measured in 2016 was also included as a covariate. In addition to the direct association, we tested whether race/ethnicity moderates the association between neighborhood social cohesion and loneliness.

Results: We found that 28% of the study participants experienced loneliness. Logistic regression models showed that higher levels of neighborhood social cohesion were associated with a lower likelihood of loneliness (OR=0.96, 95% CI=0.94-0.98, p < 0.001). Moreover, we observed a significant moderating effect of race/ethnicity, indicating that the association between neighborhood social cohesion and loneliness varied across different racial and ethnic groups. Specifically, greater neighborhood social cohesion is significantly associated with a lower likelihood of loneliness among non-Hispanic Black adults (OR=0.90, 95% CI=0.87-0.95, p < 0.001) and White adults (OR=0.97, 95% CI=0.95-1.00, p < 0.05). However, this association was insignificant among Hispanic adults (OR=1.01, 95% CI=0.92-1.12, p < 0.001). Further, we found that the association was significantly stronger for non-Hispanic Black adults compared to non-Hispanic White adults (p < 0.05).

Conclusions and Implications: Our findings highlight the importance of neighborhood social cohesion in mitigating loneliness among older adults, especially among non-Hispanic Black adults. This suggests the need for community-level interventions aimed at fostering social connectedness with a focus on predominantly Black communities. Given the long-term effects of loneliness and its associated psychological burden among older adults, future studies need to employ longitudinal designs to understand how neighborhood social cohesion impacts loneliness.