Social Connections and Health among Older Adults Living in Low-income Housing

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Project Summary/Abstract Social isolation exists when one has limited social connections. Approximately 1 in 4 older adults are socially isolated. Social isolation is a risk factor for morbidity and mortality comparable to well-established risk factors including smoking, hypertension, and a sedentary lifestyle. Older adults with limited social connections account for an estimated additional $6.7 billion dollars in annual Medicare spending. Low income older adults have two times the odds of experiencing social isolation compared to those with higher incomes. Amidst current aging projections and reports that the current cohort of older Americans have high debt and insufficient savings, the demand for low income housing has increased. Despite epidemiologic evidence demonstrating the deleterious effects of limited social connections on health, gaps exist in our knowledge regarding the best solutions to address this problem. Focusing on social connections to improve the physical and mental health of older adults who live in low income housing is an important area of study. We will use qualitative and quantitative methods to increase our understanding of the factors that affect the social connections of this population. We propose the following specific aims: Aim 1A. To characterize the social connections of older adults who live in low income housing, utilizing social network inventory interviews. We will identify the frequency, function, and relationships that can be targeted in an intervention that focuses on social connections to improve the physical and mental health of older adults who live in low income housing. Aim 1B. To explore the perspectives of older adults who live in low income housing regarding their preferences for social connections, the factors that influence their social connections and its impact on physical and mental health. We will conduct semi- structured interviews to explore the following perspectives: 1) preferences for social connections, 2) facilitators and barriers to social connections, 3) resources that impact social connections, 4) perceptions regarding social connections impact on physical and mental health, and 5) perspectives regarding the acceptability of different interventions. Aim 2. To explore the perspectives of local low income housing stakeholders on social connections and the feasibility of an intervention to improve the social connections of older adults. We will convene 3-4 focus groups with low income housing stakeholders (e.g. service coordinators) to explore perspectives regarding existing approaches to identify and address social isolation in this population and elicit reactions on the feasibility of several community based intervention ideas. Accomplishing these aims will provide the foundation for future work that advances our understanding of the health of older adults who live in low income housing and facilitate the development of an intervention that focuses on social connections to improve the physical and mental health. This proposal will support the career development of the candidate, who aims to become an independent clinician investigator focused on developing, implementing, and evaluating community based interventions that improve the health of low income older adults.