Loneliness and mental health outcomes among South Asian older adult immigrants in the United States: a cross‐sectional study

Abstract

Background There is growing concern of mental health issues among South Asian immigrant populations, although limited disaggregated data on determinants of these issues exists. The aim of this study was to examine factors associated with mental health outcomes among South Asian older adult immigrants living in New York City (NYC). Methods Data were sourced from a needs assessment among self‐identified South Asians aged 60+ conducted by an NYC‐based frontline agency and nonprofit organization. Variables assessed included the 9‐item Patient Health Questionnaire, degree of difficulty experienced due to depression, loneliness, emotional distress, as well as sociodemographic, living situation, acculturation, general health, and financial related indicators. Results Among the 682 responses, 9.4% of participants displayed symptoms of mild or moderate depression (16% of Caribbean‐origin, 10% of Pakistani, 9% of Bangladeshi, and 8% of Indian participants). About a third of participants (29.9%) reported feeling lonely sometimes and 39.1% experienced any type of emotional distress. When compared to those with excellent or very good self‐rated health, having fair, poor, or terrible self‐rated health was associated with a greater adjusted odds ratio (AOR) of having mild or moderate depression (AOR: 8.42, 95% confidence interval [CI]: 22.09) and experiencing emotional distress (AOR: 3.03, 95% CI: 1.88–4.94). Those experiencing emotional distress were more likely to be younger (AOR: 0.97, 95% CI: 0.95–1.00) and live alone (AOR: 2.06, 95% CI: 1.21–3.53). Discussion Findings support the need for tailored mental health interventions targeting concerns, such as poor self‐rated health, among South Asian older adult immigrants, as well as specific subpopulations such as Indo‐Caribbeans who may be experiencing a disproportionate burden.

Social isolation and psychological well‐being among older Chinese Americans: Does resilience mediate the association?

“…38,39 Relevant findings also indicated that older immigrants are less engaged within communities, less likely to have access to mental health services, and are more likely to feel excluded due to language and cultural barriers. 19,40 The overall findings call attention to facilitating social connection and adaptation of older immigrants who are faced with multiple disadvantages and barriers.…”

Factors associated with loneliness in immigrant and Canadian-born older adults in Ontario, Canada: a population-based study

“…This finding supports results from previous studies that demonstrate the importance of quality over quantity of social interaction in protecting against loneliness [ 9 , 44 ]. Living alone was associated with increased loneliness only among Canadian-born older adults, although previous studies generally found that living alone increases risk of loneliness in both immigrants and Canadian-born individuals [ 33 , 44 , 45 ]. However, some immigrants choose to live alone to avoid being a burden to their children [ 46 ], and this personal choice may lead to protection against loneliness [ 47 ].…”

“…We found increased length of time in Canada to be associated with decreased odds of loneliness. Previous studies have found either no association or a positive association between length of time in the host country and loneliness [ 33 – 35 ]. Our finding is supported by qualitative research, in which increased time in the host country means more time to obtain resources (e.g., money, language skills) and build social support required for participation in many activities [ 36 ].…”

Loneliness and social isolation of ethnic minority/immigrant older adults: a scoping review

“…Victor et al (2012: 70) acknowledge the challenge of loneliness measurement translation from English to other languages as 'in some languages there is no single word that would differentiate between alone, and lonely'. Ali et al (2021) advocate for critical examination and comprehensive validation of loneliness or other mental health measurements in South Asian immigrant settings. Kong et al (2018) and ten Kate et al (2020) note the potential cultural desirability bias that leads to underreporting or don't-know answers to loneliness as immigrants may consider some questions too personal and sensitive to discuss.…”

“…Some examples of recommended intervention are educational programmes (e.g. job, financial literacy and English training; third-age universities) (Ng and Northcott, 2015;Cela and Fokkema, 2017;Ali et al, 2021;Koehn et al, 2022), counselling interventions (Wang and Dong, 2018;Liu et al, 2021), group activities (Creecy et al, 1983;Park et al, 2017;Pan et al, 2021), voluntary opportunities (Dong and Chen, 2017), home visits programmes (Kim, 1999b;Hinojosa et al, 2011;Ng and Northcott, 2015;Cela and Fokkema, 2017;Park et al, 2017;Berthold et al, 2018), peer support models (Ng and Northcott, 2015;Park et al, 2017;Berthold et al, 2018;Liu et al, 2021;Pan et al, 2021), internet-based social technology (Simon et al, 2014;Ng and Northcott, 2015;Byrne et al, 2021) and agefriendly communities (Weng, 2019).…”