Neighborhood Matters – Association Between Neighborhood Cohesion and Self-Neglect in Chinese American Older Adults

Newswise — Chicago, IL, Oct 19— Increasing neighborhood cohesion may enhance self-neglect prevention and intervention in U.S. Chinese older adults, suggested by a new study published in Journal of the American Geriatrics Society 17 OCT 2017 online.

Self-neglect is defined as inability to perform essential self-care tasks. It is the most common form of elder mistreatment related to greater risk of medical comorbidities and mortality in older adults. U.S. Chinese older adults have higher prevalence of self-neglect than Black and White older adults. Understanding associated factors of self-neglect is necessary to prevent and intervene the harmful behaviors. Although individual-level characteristics and health conditions have been linked with self-neglect, the relationship between neighborhood-level factors and self-neglect is still unknown in this population.

Neighborhood context plays important roles in residents’ health behaviors and outcomes, especially among older adults. “Since self-neglect is about living and self-care, we want to see if neighborhood context, especially neighborhood cohesion, the positive neighborhood characteristics, may be associated with self-neglect including the severity and phenotypes,” said by Dr. XinQi Dong, MD, MPH, the expert in the field of elder mistreatment with more than 200 publications and wrote a state-of-science text book on elder abuse.

Neighborhood cohesion includes the elements of trust, solidarity, connectedness, shared values, and support between neighbors, and reflects the level of social integration and availability of resources and services in the neighborhood. It represents a sense of belonging and attachment, and was found to be associated with positive health outcomes.

In this study, more than 3,000 Chinese older adults aged 60 and above were interviewed. Five phenotypes of self-neglect including hoarding, poor personal hygiene, need for home repair, unsanitary conditions, and inadequate utilities; and measured neighborhood cohesion were assessed. The main findings from this study:

• Greater neighborhood cohesion was associated with lower risk of overall self-neglect, especially moderate to severe self-neglect.
• With respect to the phenotypes of self-neglect, greater neighborhood cohesion was associated with lower risk of poor personal hygiene and need for home repair but not of hoarding, unsanitary conditions, and inadequate utilities

Dr. Ailian Hei, Co-investigator of this study, said “since policymakers have considered place-based strategies for health promotion, our findings can support policymakers and community organizations in shaping future self-neglect prevention and intervention strategies.” He continues, “based on the findings, improving neighborhood cohesion through increasing neighbors’ connections and community services such as comprehensive community initiatives and neighborhood meetings may be helpful to prevent self-neglect, and to intervene some phenotypes of self-neglect in Chinese older adults.”