Loneliness in older adults is a growing U.S. population health problem, especially among immigrants This research brief explores the impact of age at immigration on loneliness and considers factors such as health, socio-demographic characteristics, and engagement in volunteering on loneliness. Findings demonstrate the need for programs that promote social connection among older adult immigrants to combat feelings of loneliness

Wilmoth, Janet

Zemba, Stephanie

Syracuse University Research Facility and Collaborative Environment

1      Older Immigrants Are More Likely Than Older Nonimmigrants to Experience Loneliness  Stephanie Zemba and Janet Wilmoth  National data indicate that loneliness is a considerable public health problem among older adults,1 with approximately 20% of adults over the age of 60 reporting frequent loneliness.2 Certain groups of older adults, including immigrants, are more vulnerable to loneliness,1, 3 which may lead to negative health consequences such as depression, dementia, and mortality.1 The detrimental effects of loneliness on health may be part of the reason why the ‘healthy immigrant effect’ (where immigrants have better health than nonimmigrants) diminishes with age.4 Understanding and addressing loneliness among immigrant older adults is crucial, as immigrants will comprise nearly a quarter of the U.S. population over 65 by 2060.5   This brief examines patterns in reported loneliness for U.S.-born nonimmigrant older adults and older adults who immigrated as children, during early adulthood (ages 18-44) when careers and families are being established, and in middle-to-late life (ages 45 and older).   Immigrant Older Adults are at a Higher Risk for Loneliness than Non-Immigrants Immigrant older adults have a higher prevalence of loneliness compared to nonimmigrants. As shown by the orange bars in Figure 1, the probability of loneliness (on a scale of 0 to 1) is 0.15 for nonimmigrant older adults, 0.19 for childhood immigrants, 0.20 for early adulthood immigrants, and 0.23 for mid- to late-life immigrants. Compared to nonimmigrants, the likelihood of loneliness is 26% higher RESEARCH BRIEF #78 October 11, 2022    KEY FINDINGS  • Immigrant older adults are at a higher risk for loneliness than nonimmigrants. • Age at immigration matters: risk of loneliness is significantly higher for immigrants who arrived in the United States after age 18. • Factors such as socio-demographic characteristics, health, and engagement in volunteering partially explain immigrant older adults’ higher risk of loneliness.  • Programs that promote social connection are necessary to reduce loneliness among older adult immigrants.  2  among immigrants who arrived as children, 34% higher among immigrants who arrived in early adulthood, and 63% higher among immigrants who arrived in mid-to-late life.    Figure 1: Predicted Probabilities of Loneliness by Immigrant Status and Age at Immigration Data Source: Health and Retirement Study, 2018; N=14,786 Note: The adjusted model controls for: age, gender, educational attainment, race and ethnicity, living arrangements, marital status, income, self-rated health, chronic pain, days in bed during the past month, and involvement in volunteering.   Characteristics of Immigrant Groups Partially Explain Their Higher Risk of Loneliness The blue bars in Figure 1 show how accounting for socio-demographic characteristics (age, gender, education, race, living arrangements, marital status, income), health, and volunteering reduces the differences between nonimmigrants and immigrants. In our model that adjusts for these factors, the probability of loneliness is 0.12 for nonimmigrants, 0.13 for childhood immigrants, 0.14 for early adulthood immigrants, and 0.16 for mid- to late-life immigrants. Compared to nonimmigrants, childhood immigrants have a 12% greater likelihood of loneliness, but this is not a statistically significant difference. The likelihood of loneliness is 22% higher among immigrants who came to the U.S. in early adulthood and 45% higher among immigrants who arrived in mid- to late-life. These differences are statistically significant.    Additional analysis (not shown) indicates that living alone, having chronic pain, and reporting more days in bed per month increases the probability of loneliness. Higher income, better self-rated health, and volunteering decrease the probability of loneliness.  To summarize, those who immigrated in early adulthood or mid- to late-life are more likely to experience loneliness compared to nonimmigrants, even after taking these factors into account.    0.000.050.100.150.200.25Nonimmigrants ChildhoodImmigrantsEarly AdulthoodImmigrantsMid to Late LifeImmigrantsProbabilityUnadjusted Adjusted3  How Can We Address Loneliness Among Older Immigrants? Age at immigration matters for risk of loneliness among older adults. The likelihood of loneliness is highest among immigrants who arrived in mid- or late-life. This group is more likely to face language and cultural barriers that can hinder efforts at social integration.6 Research indicates that many late-life immigrants come to the U.S. using family reunification visas. These older adults tend to abstain from the labor force, take on caregiving duties, and have a family-centered social network.7,8  Programs that promote social connections, particularly those that recognize cultural and linguistic diversity, are needed to reduce loneliness among immigrant older adults. The goals of such programs can include social network expansion, continuation of cultural or religious traditions, and assistance with adjustment to life in the U.S. Strategies may include enhanced funding through the Older Americans Act for programs that encourage older immigrants to volunteer, connect them with local ethnic or religious communities, and provide low- or no-cost English as a Second Language (ESL) classes.  ______________________________________________________________________________                               4  Data and Methods This study used the 2018 Health and Retirement Study (HRS), which is a nationally representative longitudinal panel study of older adults ages 50+.8 The HRS measures immigrant status with a question that asks whether the respondent is U.S. born or foreign born, with a follow-up question about age at immigration. The results in Figure 1 are based on two logistic regression models. The unadjusted bivariate model included only immigrant status and the adjusted multivariate model included socio-demographic, health, and volunteering characteristics.   References 1. National Academies of Sciences, Engineering, and Medicine (NASEM). (2020). Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press.  2. Hawkley, L. C., M. Kozloski, & J. Wong. (2017). A profile of social connectedness in older adults. https://connect2affect.org/wp-content/uploads/2020/06/A-Profile-of-Social-Connectedness-1-1.pdf 3. Fokkema, T., & Ciobanu, R. O. (2021). Older migrants and loneliness: scanning the field and looking forward. European journal of ageing, 18(3), 291-297. 4. Markides, K. S., & Rote, S. (2019). The healthy immigrant effect and aging in the United States and other western countries. The Gerontologist, 59(2), 205-214. 5. Mizoguchi, N., Walker, L., Trevelyan, E., & Ahmed, B. (2019). The older foreign-born population in the United States: 2012–2016. American Community Survey Reports. ACS-42.  6. Leach, M. (2008). America's older immigrants: A profile. Generations, 32(4), 34-39. 7. Rote, S., & Markides, K. (2014). Aging, social relationships, and health among older immigrants. Generations, 38(1), 51-57. 8. Fisher, G. G., & Ryan, L. H. (2018). Overview of the health and retirement study and introduction to the special issue. Work, aging and retirement, 4(1), 1-9.  Acknowledgements The authors are affiliates of the Center for Aging and Policy Studies, which receives funding from the National Institute on Aging (grant # 1P30AG066583).   Recommended Citation Zemba, Stephanie; and Wilmoth, Janet, “Older Immigrants Are More Likely Than Older Nonimmigrants to Experience Loneliness” (2022). Population Health Research Brief Series. 194. https://surface.syr.edu/lerner/194   About the Authors Stephanie Zemba (szemba@syr.edu) is a PhD student in the Department of Sociology and a Graduate Research Associate in the Aging Studies Institute at Syracuse University. Janet Wilmoth (jwilmoth@syr.edu) is Professor and Chair of Sociology and Director of the Aging Studies Institute at Syracuse University.SYRACUSE UNIVERSITY LERNER CENTER FOR PUBLIC HEALTH PROMOTION & POPULATION HEALTH RESEARCH BRIEF SERIES  Series Editor - Shannon M. Monnat 426 Eggers Hall | Syracuse | New York | 13244 syracuse.edu | lernercenter.syr.edu  To access all our briefs, visit: https://surface.syr.edu/lerner/  The mission of the Syracuse University Lerner Center for Public Health Promotion & Population Health is to improve population and community health through research, education, and outreach focused on the social, spatial, and structural determinants of physical, mental, and behavioral health and health disparities.  

Older Immigrants Are More Likely Than Older Nonimmigrants to Experience Loneliness

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Older Immigrants Are More Likely Than Older Nonimmigrants to Experience Loneliness

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