Longitudinal Relationships between Neighboring Behavior and Depressive Symptoms in Hispanic Older Adults in Miami, Florida.

Although many studies have shown that supportive interactions with friends and family can have beneficial effects for older adults’ mental health (e.g., Bisconti & Bergeman, 1999; Seeman, 2000; Zunzunegui, Alvarado, Del Ser, & Otero, 2003), relatively few studies have examined the potentially salutary effects of elders’ interactions with, and support from, neighbors (Brown et al., 2009; Wethington & Kavey, 2000). Neighboring behavior, defined as positive social interactions and exchanges of support with one’s neighbors for their mutual benefit, may be particularly important for older adults over age 70, who spend much of their time at home, in their neighborhoods (Horgas, Wilms, & Baltes, 1998). The proximity of neighbors provides opportunities for social functions that other members of an elder’s social network may not fulfill, such as having frequent face-to-face visits and chats with nearby residents, sense of community, and sense of mutual aid. Neighboring behavior can, therefore, improve the safety and health of elders by greater access to critical goods and services (i.e., grocery shopping, medical care, and household maintenance) as well as providing a monitoring or “watching” function over the elder in his or her home (Wethington & Kavey, 2000). These prosocial behaviors may, therefore, increase older residents’ independence, social involvement, and well-being (Shaw, 2005; Wethington & Kavey, 2000), including their psychological well-being (Berghorn, Schafer, Steere, & Wiseman, 1978; Cantor, 1979; Rosow, 1967; Unger & Wandersman, 1982; Young, Russell, & Powers, 2004). In addition, the perception that others are available to provide support when needed has been associated with reduced psychological distress in elders (Krause, 1997; Wethington & Kessler, 1986). To our knowledge, there have been relatively few studies examining the longitudinal relationship between neighboring behaviors and mental health over time. Furthermore, we are not aware of any studies that have examined neighborhood climate or social interactions with neighbors as a predictor of health and well-being in Hispanic elders. Hispanic Americans are now the largest minority group in the United States (U.S. Census Bureau, 2008) and will comprise 7.8 million Hispanic adults aged 65 and older by the year 2030 (Day, 1996). At the same time, little is known about the unique health challenges facing Hispanic elders, many of whom may be vulnerable to poor health outcomes, including depressive symptoms, due to a variety of factors including limited financial circumstances, low literacy, social isolation, and residence in inner-city urban neighborhoods (e.g., Black et al., 1999; Espino, Lichtenstein, Palmer, & Hazuda, 2001; Falcon & Tucker, 2000; Perrino, Brown, Mason, & Szapocznik, 2009; Stewart & Napoles-Springer, 2000). This study, therefore, examines the longitudinal relationships between neighboring behavior and depressive symptoms in an understudied population: Hispanic older adults, who may be at particularly high risk of depressive symptomatology, when compared with non-Hispanic Whites (Black, Markides, & Miller, 1998; Falcon & Tucker, 2000; Perrino et al., 2009; Stewart & Napoles-Springer, 2000). We theorize that neighboring behavior may impact elders’ depressive symptoms over time, that is, having more positive and supportive interactions with neighbors over time may lead to reduced depressive symptomatology in Hispanic elders. Neighboring Behavior and Elders’ Mental Health Prior cross-sectional research suggests that positive neighborhood social environments and related neighboring behaviors are an important correlate of psychological well-being in older adults (cf., Brown et al., 2009). Magaziner and Cadigan (1989) reported that neighbors were a significant community resource for older women who lived alone (see also Stoller and Pugliesi, 1988). Moreover, positive associations between participative interactions with neighbors and psychological well-being of elders have been obtained by Roach and O’Brien (1982) and Beck and Page (1988). Similarly, Berghorn et al. (1978) found that neighboring behavior was a significant component of the psychological well-being of older people, particularly for women. Furthermore, substantial evidence indicates that an active, engaged lifestyle, involving participation in social activities with members of one’s social network, which may include interactions with neighbors, may be associated with better mental and physical health outcomes in later adulthood (Rowe & Kahn, 1997). Longitudinal Studies of Neighboring Behavior and Mental Health In contrast, few studies have examined longitudinal changes in elders’ interactions and social support from neighbors over time and how these neighboring behaviors impact elders’ mental health over time (cf., Barnes, 2003; Fratiglioni, Wang, Ericsson, Maytan, & Winblad, 2000; Glass, Mendes de Leon, Seeman, & Berkman, 1997). Some studies have found that social isolation can lead to psychological distress over time (e.g., Bassuk, Glass, & Berkman, 1999; Roberts, Kaplan, Shema, & Strawbridge, 1997). Moreover, Thomese, Van Tilburg, and Knipscheer (2003) found, using data from a longitudinal study among Dutch adults in later life on their relationships with neighbors, that friendly relationships with neighbors can provide security and a sense of integration. More recently, Herrero and Gracia (2007) used structural equation modeling to test the cross-lagged relationships of perceived community support, which included integration with and participation in the community, and depressive symptoms over a 6-month period in Spanish adults ages 18 and older (mean age of 42). We found it interesting that there was a relationship between perceived community support and depressive symptoms over time, but only in that earlier community support predicts later depressive symptoms, not vice versa (Herrero & Gracia, 2007). However, this study did not focus specifically on older adults. Thus, recent longitudinal findings (Herrero & Gracia, 2007; Thomese et al., 2003) may exemplify Cowen’s (2000) theories about the importance of informal sources of support in the community, including neighbors, for mental health, but these relationships require more study in independently living older adults. However, other studies suggest the reverse causality: Depression may lead to less neighboring behavior over time. For instance, changes in depressive symptoms in older adults have been shown to predict declines in social participation over time (Beekman et al., 2002). Similarly, depressed older individuals have been found to report smaller increases in emotional support and greater increases in negative interactions with network members including neighbors, over time, when compared with older individuals without depression (Gurung, Taylor, & Seeman, 2003). It is possible that depressed older adults may withdraw from, or have difficulty managing, the discretionary elements of their networks over time, including interactions with neighbors (Beekman et al., 2002; Gurung et al., 2003). A further, related view is that high levels of depressive symptoms may cause individuals to rate their social interactions and social support, including support from neighbors, more negatively (cf., Maher, Mora, & Leventhal, 2006). Alternatively, older individuals with high levels of distress may cause members of their social network such as neighbors to withdraw from them and resist further social interaction (Gurung et al., 2003; Vaerum & McCabe, 2001). The Present Investigation The present study therefore examines the relationships between neighboring behavior and depressive symptoms over a 3-year period in a population-based sample of Miami Hispanic elders, in whom we previously documented a high rate of clinically relevant depressive symptoms (Perrino et al., 2009). More specifically, this study examines whether neighboring behavior predicts elders’ subsequent depressive symptoms, or whether depressive symptoms predict elders’ subsequent perceptions of neighboring behavior. To our knowledge, this is the first study that has examined possible reciprocal relationships between neighboring behavior and depressive symptoms over time in community-dwelling Hispanic elders, and it does so over four timepoints (i.e., baseline and 12-, 24-, and 36-month post-baseline).