Health and Psychosocial Risks of Unengaged Residents in Low-Income Independent Living Communities

TL;DR

This study shows that unengaged older adults in low-income independent living communities face worse health and higher fall risks compared to their more socially engaged peers.

Contribution

The study provides empirical evidence linking low social engagement to poorer health outcomes in low-income older adults.

Findings

Unengaged residents scored significantly lower on physical functioning, vitality, and emotional well-being.

Unengaged residents had higher fall risk scores and were nearly three times more likely to report social isolation.

Trends showed unengaged residents had higher loneliness and healthcare utilization, though not statistically significant.

Abstract

Social engagement is a critical determinant of health in older adults, yet many residents of independent living communities remain unengaged despite available opportunities. We report baseline data from a longitudinal wellness program study of residents in low-income independent communities in Southwest Ohio. Assessments measured general health, quality of life, and psychosocial function. Participants (N = 119) were older adults (M = 73.5, SD = 8.6), primarily female (83.2%), African American (60.5%), and with annual incomes below $25,000 (86%). Quartile splits of the Social Engagement and Activities Questionnaire (SEAQ) were used to define engagement, with most participants (69.9%) classified as engaged. Compared to engaged peers, unengaged residents (31.1%) scored significantly lower on domains of physical functioning (M = –12.27, p = .020), vitality (–9.86, p = .016), and emotional well-being (–10.26, p = .013), on the SF–36 quality of life instrument, and had higher fall risk scores (M = 1.37, p = .035) on a fall risk assessment. Other SF-36 domains trended in the expected direction but were nonsignificant. Unengaged residents also showed nonsignificant trends toward greater loneliness scores (UCLA-3 Item) and healthcare utilization (annual hospital visits). Examining social isolations using the Lubben Social Network Scale (LSNS-6), unengaged residents were nearly three times more likely to report social isolation than engaged residents (32.4% vs. 12.2%; OR = 3.46, 95% CI [1.33–8.98]). Findings highlight the need to improve engagement in wellness programming of older low-income adults living independently.