Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences

Julie L Locher, Christine S Ritchie, David L Roth, Patricia Sawyer Baker, Eric V Bodner, Richard M Allman, Julie L Locher, Christine S Ritchie, David L Roth, Patricia Sawyer Baker, Eric V Bodner, Richard M Allman

Abstract

This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital. For all ethnic-gender groups, greater restriction in independent life-space (an indicator of social isolation) was associated with increased nutritional risk. For black women and white men, not having adequate transportation (also an indicator of social isolation) was associated with increased nutritional risk. Additionally, for black and white women and white men, lower income was associated with increased nutritional risk. For white women only, the perception of a low level of social support was associated with increased nutritional risk. For black men, not being married (an indicator of social support) and not attending religious services regularly, restricting activities for fear of being attacked, and perceived discrimination (indicators of social capital) were associated with increased nutritional risk. Black females had the greatest risk of poor nutritional health, however more indicators of social isolation, support, and capital were associated with nutritional risk for black men. Additionally, the indicators of social support and capital adversely affecting nutritional risk for black men differed from those associated with nutritional risk in other ethnic-gender groups. This research has implications for nutritional policies directed towards older adults.

References

    1. Arcury TA, Quandt SA, Bell RA, McDonald J, Vitolins MZ. Barriers to nutritional well-beingfor rural elders: Community experts’ perceptions. The Gerontologist. 1998;38:490–498.
    1. Baker PS, Bodner EV, Allman RM. Measuring life–space mobility in community-dwelling older adults. Journal of the American Geriatrics Society. 2003;51(11):1610–1614.
    1. Bourdieu P. Forms of social capital. In: Richardson JH, editor. Handbook of theory and research for the sociology of education. Greenwood; New York: 19831991. pp. 241–258.
    1. Bourdieu P, Wacquant L. Invitation to reflexive sociology. University of Chicago Press; Chicago: 1992.
    1. Burt MR. Hunger among the elderly: Local and national comparisons. Urban Institute; Washington, DC: 1993.
    1. Cape E. Aging women in rural settings. In: Marshall V, editor. Aging in Canada: Social perspectives. wnd ed. Fitzhenry and Whiteside; Toronto: 1987. pp. 84–89.
    1. Chernoff R. Nutrition and health promotion in older adults. Journal of Gerontology: Series A. 2001;56A(Special Issue II):47–53.
    1. Clemente F, Kleiman MB. Fear of crime in the United States: A multivariate analysis. Social Forces. 1977;56:331–518.
    1. Cohen BE, Burt MR, Schulte MM. Hunger and food insecurity among the elderly. The Urban Institute; Washington, DC: 1993.
    1. Coleman JS. Social capital in the creation of human capital. American Journal of Sociology. 1988;94(Suppl):S95–S120.
    1. Coulston AM, Craig L, Voss AC. Meals-on-wheels applicants are a population at risk for poor nutritional status. Journal of the American Dietetic Association. 1996;96(6):570–573.
    1. Crockett EG, Clancy KI, Bowering J. Comparingthe cost of a thrifty food plan market basket in three areas of New York state. Journal of Nutrition Education. 1992;24:72S–79S.
    1. Davies L. Nutrition in the elderly: Identifyingthose at risk. Proceedings of the Nutrition Society (London) 1984;43:295–302.
    1. Davis MA, Randall E, Forthofer RN, Lee ES, Margen S. Living arrangements and dietary patterns of older adults in the United States. Journal of Gerontology. 1985;40:434–442.
    1. Davis MA, Murphy SP, Neuhaus JM, Gee L, Quiroga SS. Living arrangements affect dietary quality for US adults aged 50 years and older: NHANES III 1988–1994. Journal of Nutrition. 2000;130:2256–2264.
    1. DeVault M. Feeding the family: The social organization of caring as gendered work. University of Chicago Press; Chicago: 1991.
    1. Ferraro K. Firm believers? Religion, body weight, and well-being. Review of Religious Research. 1998;39:224–244.
    1. Fried LP, Walston J. Frailty and failure to thrive. In: Ettinger WH, Halter JB, Ouslander JG, editors. Principles of geriatric medicine and gerontology. 4th ed. McGraw-Hill Health Professions Division; New York: 1999. pp. 1387–1402.
    1. Frongillo EA, Rauschebach BS, Roe DA, Williamson DF. Characteristics related to elderly person's not eating for 1 or more days: Implications for meal programs. American Journal of Public Health. 1992;82(4):600–602.
    1. Gordon MT, Riger S. The female fear: The social cost of rape. University of Illinois Press; Chicago: 1991.
    1. Hooyman NR, Kiyak H. Social gerontology. 6th ed. Allyn and Bacon; Boston: 2002.
    1. House JS, Umberson D, Landis K. Social relationships and health. Science. 1988;241:540–545.
    1. Institute of Medicine . The role of nutrition in maintaining health in the nation's elderly. National Academy Press; Washington, DC: 2000.
    1. Joseph HM, Rogers BL, Houser RF, Scharf J, Millen BE, Balsam AL. Evaluation of the use of the nutrition screening initiative. Tufts University; Medford, MA: 1997. (AARP Andrus Foundation Final Report)
    1. Kawachi I, Berkman L F. Social cohesion, social capital, and health. In: Berkman LF, Kawachi I, editors. Social epidemiology. Oxford University Press; New York: 2000.
    1. Kington R, Reuben D, Rogowski J, Lillard L. Socio-demographic and health factors in driving patterns after 50 years of age. American Journal of Public Health. 1994;84:1327–1329.
    1. Klinenberg E. Denaturalizing disaster: A social autopsy of the 1995 Chicago heat wave. Theory and Society. 1999;28:239–295.
    1. Klinenberg E. Alone in the City? An Intellectual History of Social Isolation. Institute for Policy Research Working Paper. 2002a. .
    1. Klinenberg E. Heat wave: A social autopsy of disaster in Chicago. University of Chicago Press; Chicago: 2002b.
    1. Kopec JA. Concepts of disability: The activity space model. Social Science & Medicine. 1995;40(5):649–656.
    1. Krause N. Neighborhood deterioration and social isolation in later life. International Journal of Aging and Human Development. 1993;36:9–38.
    1. Krout JA. An overview of older rural populations and community-based services. In: Krout JH, editor. Providing community-based services to the rural elderly. Sage Publications; Thousand Oaks, CA: 1994. pp. 3–18.
    1. Lee JS, Frongillo EA. Factors associated with food insecurity amongUS elderly persons: Importance of functional impairments. Journal of Gerontology: Social Sciences. 2001;56(2):S94–S99. (B)
    1. Locher JL, Burgio KL, Yoels WC, Ritchie CS. The social significance of food and eating in the lives of older recipients of meals on wheels. Journal of Nutrition for the Elderly. 1997;17(2):15–33.
    1. Lochner K, Kawachi I, Kennedy B. Social capital: A guide to its measurement. Health and Place. 1999;5:259–270.
    1. Macinko J, Starfield B. The utility of social capital in research on health determinants. The Milbank Quarterly. 2001;79(3):387–427.
    1. Madriz E. Nothing bad happens to good girls: Fear of crime in women's lives. University of California Press; Berkeley, CA: 1997.
    1. Marottoli RA, Ostfeld AM, Merrill SS, Perlman GD, Foley DJ, Cooney LM. Drivingcessation and changes in mileage driven among elderly individuals. Journal of Gerontology: Social Sciences. 1993;48:S255–S260.
    1. McIntosh WA, Shifflett PA. Influence of social support systems on dietary intake of the elderly. Journal of Nutrition for the Elderly. 1984;4(1):5–18.
    1. McIntosh WA, Shifflett PA, Picou JS. Social support, stressful events, strain, dietary intake, and the elderly. Medical Care. 1989;27:140–153.
    1. Meenan RF, Mason JH, Anderson JJ, Guccione AA, Kazis LE. The content and properties of a revised and expanded arthritis impact measurement scales health status questionnaire. Arthritis and Rheumatology. 1992;35:1–10.
    1. Millen BE, Ohls JC, Ponza M, McCool AC. The elderly nutrition program: An effective national framework for preventive nutrition interventions. Journal of the American Dietetics Association. 2002;102:234.
    1. Mirowsky J, Ross C. Education, personal control, lifestyle, and health: A human capital hypothesis. Research on Aging. 1998;20(4):415–449.
    1. Mirowsky J, Ross CE, Reynolds J. In: Handbook of medical sociology. 5th ed. Bird CE, Conrad P, Fremont AM, editors. Prentice-Hall; Upper Saddle River, NJ: 2000. pp. 47–67.
    1. Morris PM, Bellinger M, Haas E. Higher prices, fewer choices: Shopping for food in rural America. Public Voice for Food and Health Policy; Washington, DC: 1990.
    1. Fetzer Institute/National Institute on Aging Working Group . Multidimensional measurement of religiousness/spirituality for use in health research: A report of the Fetzer Institute/National Institute on aging working group. Fetzer Institute; Kalamazoo, MI: 1999.
    1. Nutrition Screening Initiative: Determine Your Nutritional Health Checklist. American Academy of Family Physicians; 2004. .
    1. Paxton P. Social capital and democracy: An interdependent relationship. American Sociological Review. 2002;67:254–277.
    1. Ponza M, Ohls JC, Millen BE. Serving elders at risk: The Older Americans act nutrition programs, national evaluation of the Elderly Nutrition Program, 1993–1995. Mathematica Policy Research; Princeton, NJ: 1996.
    1. Portes A. Social capital: Its origins and applications in modern sociology. Annual Review of Sociology. 1998;24:1–24.
    1. Posner BMM, Jette AM, Smith KW, Miller DR. Nutrition and health risks in the elderly: The nutrition screening initiative. American Journal of Public Health. 1993;83:972–978.
    1. Putnam R. Bowling alone: The collapse and revival of American community. Simon and Schuster; New York: 2000.
    1. Putnam R, Leonardi R, Nanetti R. Making democracy work: Civic traditions in modern Italy. Princeton University Press; Princeton, NJ: 1993.
    1. Quandt S, Chao D. Gender differences in nutritional risk in among older rural adults. Journal of Applied Gerontology. 2000;19(2):138–150.
    1. Quandt S, Rao P. Hunger and food security among older adults in a rural community. Human Organization. 1999;58(1):28–35.
    1. Quandt SA, Popyach JB, DeWalt KM. Home gardening and food preservation practices of the elderly in rural Kentucky. Ecology of Food and Nutrition. 1994;31:183–199.
    1. Quandt SA, McDonald J, Arcury TA, Bell RA, Vitolins MZ. Nutritional self-management of elderly widows in rural communities. The Gerontologist. 2000;40:86–96.
    1. Rabin DL, Barry OP. Community options for elderly patients. In: Reichel W, editor. Care of the elderly. Clinical aspects of aging. 4th ed. Williams and Wilkins; Baltimore, MD: 1995. pp. 521–528.
    1. Riger S, Gordon MT. The fear of rape. A study in social control. Journal of Social Issues. 1991;37:71–92.
    1. Roe D. In-home nutritional assessment of inner-city elderly. Journal of Nutrition. 1990;120:1538–1543.
    1. Ross CE, Reynolds JR, Geis KJ. The contingent meaning of neighborhood stability for residents’ psychological well-being. American Sociological Review. 2000;65:581–597.
    1. Ryan AS, Craig LD, Finn SC. Nutrient intakes and dietary patterns of older Americans: A national study. Journal of Gerontology. 1992;47:M145–M150.
    1. Ryan KC, Bower ME. Relationship of socioeconomic status in livingarrangements to nutritional intake of the older person. Journal of the American Dietetic Association. 1989;89:1805–1807.
    1. Sharkey JR. The interrelationship of nutritional risk factors, indicators of nutritional risk, and severity of disability among home-delivered meal participants. The Gerontologist. 2002;42(3):373–380.
    1. Sharkey JR, Haines PS. Black/White differences in nutritional risk amongrural older adults: The Home-Delivered Meals Program. Journal of Nutrition for the Elderly. 2001;20(3):13–27.
    1. Sharkey JR, Haines PS, Zohoori N. Community-based screening: Association between nutritional risk status and severe functional disability amoung rural home-delivered nutrition participants. Journal of Nutrition for the Elderly. 2000;20(1):1–15.
    1. Siegel J. Aging into the 21st Century (HHS Publication no. 100-95-0017) Administration on Aging, US Department of Health and Human Services; Washington, DC: 1996.
    1. Skogan W. The impact of victimization on fear. Crime and Delinquency. 1987;33:135–154.
    1. Spangler AA, Eigenbrod JS. Field trial affirms value of DETERMINE-ingnutrition-related problems of free-living elderly. Journal of the American Dietetics Association. 1995;95(4):489–490.
    1. Thoits PA. Stress, coping, and social support processes: Where are we? What next? Journal of Health and Social Behavior (Extra Issue) 1995:53–79.
    1. Torres CC, McIntosh WA, Kubena KS. Social network and social background characteristics of elderly who live and eat alone. Journal of Aging and Health. 1992;4:564–578.
    1. Unosson M, Ek A, Bjurulf P, Larsson J. Demographical, sociomedical and physical characteristics in relation to malnutrition in geriatric patients. Journal of Advanced Nursing. 1991;16:1406–1412.
    1. Vailas L, Nitzke SA, Becker M, Gast J. Risk indicators for malnutrition are associated inversely with quality of life for participants in meal programs for older adults. Journal of the American Dietetic Association. 1998;98(5):548–553.
    1. Veenstra G. Social capital, SES and health: An individual-level analysis. Social Science & Medicine. 2000;50:619–629.
    1. Weimer J. Affecting nutrient intake of the elderly. USDA, Economic Research Service, Food, and Rural Economics Division; Washington, DC: 1998. (Agricultural Economic Report No. 769)
    1. Wellman NS. Nutrition 2030. The Elderly Nutrition Program: Contributing to the health and independence of older adults. A white paper on lessons from Federal Nutrition Assistance Programs. National Policy and Resource Center on Nutrition and Aging; 1999.
    1. Wellman NS, Rosenzweig LY, Lloyd JL. Thirty years of the older Americans nutrition program. Journal of the American Dietetic Association. 2002;102:348–354.
    1. Williams DR. Race, socioeconomic status, and health: The added effects of racism and discrimination. Annals New York Academy of Science. 2000:173–188.

Source: PubMed

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