Beach Brian, Willis Paul, Powell Jillian, Vickery Alex, Smith Randall, Cameron Ailsa
Research Department of Epidemiology and Public Health, University College London, London, UK.
School for Policy Studies, University of Bristol, Bristol, UK.
Innov Aging. 2022 Sep 29;6(7):igac061. doi: 10.1093/geroni/igac061. eCollection 2022.
Housing with care is often lauded as a way to combat loneliness and social isolation in later life. This study examined whether housing with care created better outcomes for residents in terms of loneliness and social isolation than they might expect if they were living in the community.
A survey was distributed to residents of housing with care as part of the Diversity in Care Environments project. It was designed to enable comparison with the English Longitudinal Study of Ageing. Propensity score matching was applied to identify the effect of housing with care residence on loneliness and social isolation.
People living in housing with care had lower levels of loneliness than would be expected if they lived in the general community, with an average treatment effect on the treated (ATT) of -0.407 (95% CI = -0.601, -0.214). In contrast, social isolation was found to be slightly higher for residents than would be expected if they were in the community (ATT = 0.134 [95% CI = 0.022, 0.247]). Higher social isolation appears driven by less frequent contact with friends and reduced organizational membership rather than any difference in contact with family and children.
Our research has shown a positive impact on subjective social experiences from housing with care residence, despite a slight increase in objective social isolation. The findings underscore the importance of looking at loneliness and social isolation as distinct concepts as well as the effectiveness of housing with care at improving later-life outcomes.
有照护的住房常被誉为应对晚年孤独和社会隔离的一种方式。本研究考察了有照护的住房相较于居民若居住在社区中可能预期的情况,是否能为居民带来更好的孤独感和社会隔离方面的结果。
作为“照护环境多样性”项目的一部分,向有照护的住房的居民发放了一份调查问卷。其设计目的是便于与英国老龄化纵向研究进行比较。采用倾向得分匹配法来确定有照护的住房居住对孤独感和社会隔离的影响。
居住在有照护的住房中的人孤独感水平低于若居住在普通社区中预期的水平,处理组平均处理效应(ATT)为 -0.407(95%置信区间 = -0.601,-0.214)。相比之下,发现居民的社会隔离程度略高于若他们处于社区中预期的水平(ATT = 0.134 [95%置信区间 = 0.022,0.247])。社会隔离程度较高似乎是由于与朋友的联系频率较低以及组织成员身份减少,而非与家人和子女的联系存在任何差异。
我们的研究表明,尽管客观社会隔离略有增加,但有照护的住房居住对主观社会体验有积极影响。研究结果强调了将孤独感和社会隔离视为不同概念的重要性,以及有照护的住房在改善晚年生活结果方面的有效性。