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Using data from the Health and Retirement Study (HRS) 2010 wave, this research examined depression among community-dwelling, African American women, age 50 and over. Depression among this population was examined in relation to age, social support, religion, caregiving, and physical health. Intersectionality and social construction were used as theoretical frameworks for the study.-- Abstract.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
ABSTRACT: Although social support variables have long been associated with psychological well-being, and in particular, depressive symptoms, few studies have examined the causal association between social support and depressive symptoms. The present study examined two basic hypotheses: do levels of social support predict later depressive symptoms, or conversely, do depressive symptoms predict subsequent declines in social support? Depression is the most frequent cause of emotional suffering in older adults, and thus identifying contributors to depressive symptoms among older adults has important implications for developing treatment for depressive symptoms. Two hypotheses regarding the causal relation between the association between social support and depression were identified. Lewinsohn's social skills model of depression posits that social skills deficits lead to reduced social support, which in turn produces depression. In contrast, Coyne's interpersonal theory of depression (1976), proposed that depressed individuals interact with others in a manner that is aversive and lacking in social skills (Coyne, 1976), which serves to reduce social support. In the current study, the influence of three dimensions of social support on subsequent depressive symptoms was examined. In a modified test of the first hypothesis (low social support predicts depression), the present study examined the influence of the three dimensions of social support (i.e., emotional social support, instrumental support and size of social network), on subsequent depressive symptoms in a sample of older adults. The second hypothesis examined whether depressive symptoms negatively impacted subsequent levels of social support, that is, whether initial levels of baseline (time 1) depressive symptoms had a negative impact on indices of social support. It should be noted these were only partial test of Coyne and Lewinsohns's theories, as social skills was not measure in the current study. A longitudinal study design based on data obtained from the Duke EPESE was employed to examine the association between dimensions of social support and depressive symptoms over a six-year period in a sample of older adults (N=2100). The three dimensions of social support were identified based on a factor analysis of survey items included in the EPESE study. These social support measures tapped aspects of both the quality and quantity of social support. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). A test of the first hypothesis, that social support deficits would predict subsequent depressive symptoms among older adults was not supported. Inconsistent with Lewinsohn's theory, as quality of instrumental support increased, depression increased. Therefore, it appears that individuals with more difficulty are receiving more instrumental support from family and friends. In a test of the second hypothesis, based on Coyne's theory of depression, baseline (time 1) depressive symptoms were examined to see if they predicted any of the social support measures. Depressive symptoms measured at time 1 did not predict any of the social support measures assessed at time 2. However, there was a sex and depression interaction in the prediction of size of social networks. As depression decreased the size of social networks increased, but it increased more for men than women. Maintaining a large network of support may be more important to men than for women. However, in partial support of a Coyne's modified theory results showed that a change in depressive symptoms did predict a change in emotional social support such that as depression decreased emotional support increased. Similarly, a change in depressive symptoms predicted a change in social network support such that as depression decreased social network support increased. Thus, these results are consistent with the modified Coyne's theory that suggests that depressed individuals have aversive styles of functioning and therefore are more likely to lower both the quality and quantity of social support. In light of these findings, special attention should be paid to the status of social networks. Elderly individuals with fewer friends and family and less social may be at risk for developing depressive symptoms and further erosion of support networks. In addition, older adults, particularly those with depression, may benefit from interventions designed to maintain or even enhance social networks.
Social Support, Life Events, and Depression describes a research program that looked into the social process of mental health. This research program provided an arena for opportunities to explore many topics concerning the relationships among social support, life events, and mental health (primarily depressive symptoms). The volume is organized into six parts. Part I sets the background and scope of the study. Part II focuses on the dependent variable (depression), one of the two independent variables (life events], and the key control variable [psychological resources). Part III describes the measurement of social support. Part IV examines the basic models involving social support, life events, psychological resources, and depression. Part V proceeds to examine the reduced basic model in terms of a number of factors, such as age, sex, marital status, social class, and history of prior illness. Part VI discusses several specific issues regarding the dynamics of social support. This book is intended primarily for researchers, scientists, professionals, and instructors who are interested in examining both conceptual and methodological issues regarding social factors in mental health. Thus, those working in the area of public health, social and behavioral sciences, and medical professions may find this book useful. Because of the way the chapters are organized, it is possible for researchers and practitioners alike to select and read chapters pertinent to their specific interests.
Depression is responsible for widespread functional impairment and disability in 16 million individuals across the United States, as well as societal costs that exceed $36 billion. There are numerous risk factors for depression, such as female gender, ethnic minority status, poverty, incarceration, and comorbid substance use disorders. Thus, low-income, criminal-justice-involved African American women in recovery from substance use problems represent a population that is particularly vulnerable to depression. Social support has been established as a protective factor against depression; however, the relationship between social support and depression has been understudied in such high-risk African American populations. The present study examined the relationship between social support and depression among low-income, criminal-justice-involved African American women in recovery, through the lens of Coyne's interactional theory of depression and Lewinsohn's behavioral theory of depression. The relationship between social support and depression was assessed via a cross-lagged path model. The mediational impact of social support on the relationship between Oxford House sober-living home residence and depression was also be explored. Policy and treatment implications will be discussed, along with suggestions for future research.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.