The Impact of Social Relationships on Depressive Symptoms among Older Barbadian Women

Introduction Two models have been proposed to explain the relationship between social ties and mental health (Kawachi & Berkman, 2001) – Main effect model – Stress buffering model Social ties (Berkman & Glass, 2000) – positive effects on health behaviors and psychological states or – by promoting access to a greater variety of types of support

Introduction Stress process that leads to depression – Physical limitations (Yang & George, 2005) – Economy insecurity (Krause, 1987) Women report higher depression (Wethington, McLoed, Kessler, 1987) – Married women display similar or higher prevalence of depression compare to single women (Bebbington, 1999)

Introduction By the year 2000, 6 Caribbean countries had already found more than 10 % of their populations over the age of 60 years By 2025, Barbados and Cuba are projected to be the first countries in the Caribbean with 25% of their population to be over age 60 On a general note, not much is known of the lives of women over age 60 in the Caribbean

Specific Aims 1.Examine how social relationships acts as buffers in the presence of life stressors 2.Examine how social support affect older Barbadian women’s depressive symptomology across types of living conditions

Methods Survey on Health and Well-Being of Elders – Seven cities in Latin America and Caribbean Bridgetown, Barbados – The national electoral registry, which is updated periodically, was used to calculate the sample – Response rate 85% – Female = 924/ Male = 888 Measurements – Abbreviated Geriatric Depression Scale – Self Reported Health

Methods MMSE score of 6 (N = 867) Outcome variable: Geriatric Depression Scale – Cut-off point 6/7 Independent variable: Functional social network Control variables: age, levels of education, ethnicity,

Table 1. Sample Characteristics of Barbadian Older Women N (%)µ (sd) Age GroupN = (8.6) 60 to 69 years309 (42.2) 70 to 79 years320 (34.6) 80 and older214 (23.1) Ethnic BackgroundN = 924 White49 (5.4) Black738 (80.9) Mulatto112 (12.3) Other13 (1.4) Levels of EducationN = (3.2) None21 (2.3) Primary714 (77.7) Secondary148 (16.1) Higher36 (3.9) Born in BarbadosN = 924 Yes807 (87.3) No117 (12.7)

Table 2. Characteristics of Social Network Structure of Older Barbadian Women Marital StatusN = 913 % Single Married or cohabiting Widowed Separated or divorced Living arrangementN = 924 Alone With someone Living arrangement of childrenN = 910 Yes No434.7 Does not know91

Table 3. Health Status % Self-rated health N = 924 Excellent232.5 Very good to Good Fair to Poor Does not know40.4 HypertensionN = 923 Yes Type-2 DiabetesN = 920 Yes CancerN = 922 Yes323.5 Chronic Lung DiseaseN = 922 Yes434.7 Heart ConditionN = 923 Yes Cerebral EmbolismN = 917 Yes596.4 ArthritisN = 923 Yes Fallen in the last 12 monthsN = 918 Yes

Table 4. Odds Ratios and 95% CI obtained from Logistic Regression Analysis for Depressive Symptoms by Social Network Structure and Characteristics Independent VariableβSEOR (95%CI)p-value Age (0.939 – 1.061)0.954 Race Black1.0 (ref) Non-Black (0.320 – 6.486)0.227 Education (0.823 – 1.148)0.738 Marital Status Married1.0 (ref) Single (0.453 – )0.201 Not Married (0886 – )0.064 Widowed (1.556 – )0.018 Living arrangement Alone1.0 (ref) With someone (0.215 – 2.780).694

Conclusion Women less likely to be married but more likely to live with someone (i.e., children) Women appear to benefit from having some of their children living inside the home Social relationships have important buffering properties Public health implications: interventions that are family-focused Future research: Links to reciprocity between provider and recipients

Acknowledge Samatha Pittman, BS Diana Arellego Ayumi Irie, BS