SOCIAL ISOLATION AMONG OLDER JAPANESE: DO REGIONAL ATTRIBUTES MATTER?

摘要

Although social isolation (SI) has shown to impede health and well-being, there is little knowledge about regional factors affecting SI. While urban life may hinder close contact with neighbors, advance in public transportation can make contact with friends and relatives easier. This study examined how the two aspects of urbanization affect SI among older adults when ADL declines. Data came from the National Survey of Japanese Elderly, a nationwide longitudinal study of Japanese older adults aged 60 and older. We analyzed 3132 respondents who lived in 192 municipalities (regions) and responded to 2–5 waves’ interviews between 1996 and 2012, through hierarchical generalized linear models (three-level model). SI was defined as having less contact than once a week with anyone outside the household. Regional level explanatory variables were “close-knit neighborhood” represented as median number of neighbors with whom one has close contact among respondents in the region, and availability of public transportation assessed by interviewers. Key individual time-varying or baseline attributes included gender, age, ADL/IADL, family/financial status, and number of close neighbors. Results showed that living in regions with close-knit neighborhood lowered probability of SI even after controlling for the individual characteristics, while availability of public transportation did not. Functional decline increased the probability of SI, but this negative impact was buffered by living in regions with higher availability of public transportation. Our findings indicate that urbanization does not necessarily promote SI, and that various resources are required to prevent SI according to phases of functional decline in later life.