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机构、邻里和生活压力源对老年人孤独感的影响

Institutional, neighborhood, and life stressors on loneliness among older adults.

作者信息

Tsuchiya Kazumi, Thierry Amy Danielle, Taylor Harry Owen

机构信息

Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada.

Department of Public Health Sciences, Xavier University of Louisiana, 1 Drexel Drive, New Orelans, LA, 70125, USA.

出版信息

BMC Public Health. 2025 Jan 29;25(1):363. doi: 10.1186/s12889-025-21463-7.

Abstract

BACKGROUND

Loneliness is a public health epidemic in the United States (US), with older adults being vulnerable to experiencing loneliness. Predictors of loneliness are less understood among racial/ethnic groups of US older adults, and few studies have included perceived institutional discrimination (PID), stressful life events (SLE), and perceived neighborhood characteristics (PNC) as antecedent stressors of loneliness in diverse older adult samples. Our study assessed the relationship between these stressors and loneliness among specific racial/ethnic groups of older adults.

METHODS

We used the Health and Retirement Study data (n = 9,904) to examine whether PID, SLE, and PNC were associated with loneliness. Loneliness was measured using the 11-item UCLA Loneliness Scale. PID included unfairly not hired for a job, unfairly prevented from moving into a neighborhood, and unfairly treated by the police. SLE included moving to a worse neighborhood/residence, being robbed or burglarized, and unemployed/looking for a job. PNC were measured as discohesion and disorder. Lagged multivariate linear regression models regressed loneliness (2014/2016 HRS waves) on PID, SLE and PNC (2010/2012 HRS waves) measured as cumulative totals and individual items. Models were stratified by Black (BOAs), Hispanic/Latinx (HOAs), and White (WOAs) older adults.

RESULTS

Cumulative totals of PID, SLE, and neighborhood discohesion were associated with loneliness among BOAs while only discohesion was associated with loneliness among HOAs. Cumulative totals for PID, SLE, and PNC were associated with loneliness among WOAs. Individual stressors predicting loneliness for BOAs were moving to a worse residence and being robbed/burglarized. For HOAs, being prevented from moving to a neighborhood was associated with greater loneliness while being robbed/burglarized was associated with less loneliness. Individual stressors predicting greater loneliness for WOAs were being unfairly not hired for a job, receiving unfair treatment during police encounters, and moving to a worse residence.

CONCLUSIONS

Our study finds racial/ethnic variation in psychosocial stressors predicting loneliness four years later. Nevertheless, neighborhood discohesion was the most salient stressor and was associated with greater loneliness across all racial/ethnic groups. Future research and interventions should consider the differing stress appraisal processes across groups and to support the development of resources and policies to ameliorate loneliness among diverse older adults.

摘要

背景

在美国,孤独是一种公共卫生流行病,老年人更容易感到孤独。在美国老年人群体的种族/族裔群体中,孤独的预测因素鲜为人知,很少有研究将感知到的制度歧视(PID)、压力性生活事件(SLE)和感知到的邻里特征(PNC)作为不同老年样本中孤独的先行压力源。我们的研究评估了这些压力源与特定种族/族裔老年人群体中孤独感之间的关系。

方法

我们使用健康与退休研究数据(n = 9904)来检验PID、SLE和PNC是否与孤独感相关。孤独感使用11项加州大学洛杉矶分校孤独量表进行测量。PID包括求职时被不公平地拒绝录用、被不公平地阻止迁入某个社区以及受到警察的不公平对待。SLE包括搬到更差的社区/住所、遭遇抢劫或入室盗窃以及失业/正在找工作。PNC被测量为凝聚力缺失和无序。滞后多元线性回归模型将孤独感(2014/2016年健康与退休研究波次)对PID、SLE和PNC(2010/2012年健康与退休研究波次)进行回归,这些因素以累计总和及单个项目进行测量。模型按黑人(非裔美国人)、西班牙裔/拉丁裔(西班牙裔美国人)和白人(白人美国人)老年人进行分层。

结果

PID、SLE和邻里凝聚力缺失的累计总和与非裔美国人中的孤独感相关,而在西班牙裔美国人中只有凝聚力缺失与孤独感相关。PID、SLE和PNC的累计总和与白人美国人中的孤独感相关。预测非裔美国人孤独感的个体压力源是搬到更差的住所和遭遇抢劫/入室盗窃。对于西班牙裔美国人,被阻止迁入某个社区与更高的孤独感相关,而遭遇抢劫/入室盗窃与较低的孤独感相关。预测白人美国人孤独感增加的个体压力源是求职时被不公平地拒绝录用、在与警察接触时受到不公平对待以及搬到更差的住所。

结论

我们的研究发现,在预测四年后的孤独感方面,心理社会压力源存在种族/族裔差异然而,邻里凝聚力缺失是最突出的压力源,并且在所有种族/族裔群体中都与更高的孤独感相关。未来的研究和干预措施应考虑不同群体之间不同的压力评估过程,并支持开发资源和政策以改善不同老年人群体中的孤独感。

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Risk factors for loneliness: A literature review.孤独的风险因素:文献综述。
Soc Sci Med. 2023 Oct;334:116163. doi: 10.1016/j.socscimed.2023.116163. Epub 2023 Aug 9.

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