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Senior Men, Social Capital, and Social Policy Opportunities

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Senior Men, Social Capital, and Social Policy Opportunities Mitigating a Potential Mental Health Crisis among Aging Male Baby Boomers Peter Kellett MN RN Ph.D ... – PowerPoint PPT presentation

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Title: Senior Men, Social Capital, and Social Policy Opportunities


1
Senior Men, Social Capital, and Social Policy
Opportunities
  • Mitigating a Potential Mental Health Crisis among
    Aging Male Baby Boomers

Peter Kellett MN RN Ph.D. Student (Demography)
2
Authors
  • Peter Kellett MN, RN, Ph.D. Student
    (Demography), Instructor (Nursing), Faculty of
    Health Sciences, University of Lethbridge, ,
    Alberta, Canada.
  • Susan McDaniel Ph.D. , FRSC, Director of
    the Prentice Institute for Global Population
    Economy, Canada Research Chair in Global
    Population Life Course, Prentice Research
    Chair, Professor of Sociology, University of
    Lethbridge, Alberta, Canada.
  • Bradley Hagen Ph.D. (Nursing), RN ,
    R.Psych, Associate Professor Coordinator of
    Health Sciences Graduate Program, Faculty of
    Health Sciences, University of Lethbridge,
    Alberta, Canada.
  • Olu Awosoga Ph.D. (Statistics), Assistant
    Professor, Faculty of Health Sciences, University
    of Lethbridge, Alberta, Canada.
  • Cheryl Currie Ph.D., Assistant Professor (Public
    Health), AIHS Translational Health Chair in
    Aboriginal Health Wellness, Faculty of Health
    Sciences, University of Lethbridge, Alberta,
    Canada.

3
Shifting Socio-demographic Landscape
  • Aging Population

gt65 years 2009 14 2036 23-25
2061 24-28
(Statistics Canada, 2012a)
4
  • Increasing Divorce Rates Decreased Investment
    in Traditional Marriage

(Milan, 2013)
5
Transnational Trend of Living Alone
Men gt Women
Note. Figure created based on data supplied by
Jamieson Simpson (2013), p. 34
6
Men, Social Capital, Mental Illness
  • Social Support networks are a documented mediator
    of mental health outcomes (Conrad, 2010
    Keating,2009).
  • Systematic review (n14) individual social
    capital inverse relationship between cognitive
    social capital common mental disorders (De
    Silva, 2005)
  • Mens social support is generally inferior to
    womens (Conrad, 2010)
  • Female family members, wives, partners main
    source of emotional support for men (Conrad,
    2010)
  • Retirement or job loss may significantly reduce
    mens social capital (Oliffe et al., 2010,2013)
  • Older men may be more affected by a lack of
    informal social capital (Muckenhuber et al.,
    2013)

7
Depression in Men
  • Annual prevalence of major depression in Canadian
    men
  • 2.9 4 (Blackmore, et al., 2007 Patten, et
    al., 2006 Simpson, et al., 2012)
  • Statistics suggest that women experience
    depression approximately twice as much as men.
  • Surveys frequently use WMH-CIDI or CIDI-SF-MD
    (Kessler et al., 1998)
  • Diagnostic tools for major depression (90
    cut-point)
  • Do not capture all masculine presentations of
    depression
  • Many current estimates of depression in men may
    underestimate the prevalence of depression in men


  • (Oliffe Philips, 2008)

8
Masculinities Suicide
  • Paradox - despite lower reported rates of
    depression, men consistently have significantly
    higher rates of completed suicide (worldwide)
  • Western Societies female-to-male ratio at least
    12
  • WHO reports 13.5 (based on 58 countries)
  • U.S. Has highest ratio at 16
  • Men tend to use more dramatic lethal methods
    (e.g. hanging, firearms etc.)
  • Profoundly linked to the performance of
    masculinities

9
Suicide and Older Men
Note. Data from Statistics Canada (2012b),
CANSIM Table 102-0551
10
  • Purpose
  • To examine the impact of living alone on the
    availability of social support, the prevalence of
    depression, and the prevalence of suicidal
    ideation among older Canadian men
  • Research Questions
  • Do senior men exhibit higher rates of suicidal
    ideation and depression?
  • Does living alone contribute to higher risk for
    decreased social support, depression, and
    suicidal ideation in senior men?
  • Does education level influence the prevalence of
    depression and suicide in senior men?
  • Sample
  • 2010 Canadian Community Health Survey (CCHS)
    (n62 909)

11
Findings
  • 2010 Annual Prevalence of Depression
  • Men 4.1 (approximately 302 000)
  • Women 6.4

Age Cohort Frequency Proportion of Men with Major Depression
Teenagers 12-19 28 400 3.4
Young Adults 20 -44 155 000 5.2
Mid-age Adults (Boomers) 45-64 106 300 4.4
Older Adults 65 11 700 1.1
12
  • Suicidal Ideation (Past 12 months)
  • When men were asked if they had seriously
    considered suicide in the past 12 months

Answer Percent per Age Cohort Percent per Age Cohort Percent per Age Cohort
Answer Young Adults 20-44 Mid-age Adults 45-64 Older Adults 65
Yes 1.9 2.1 .9
No 5.3 6.9 3.4
Not Applicable 89.2 86.8 85
Not Stated 3.6 4.2 10.8
Depressed men, over 65 years-old had a
significantly higher odds of suicidal ideation
OR14.9 (95 CI13.3, 16.6)
13
The Impact of Living Alone
  • More unattached older men (65), who lived alone,
    experienced major depression than older men
    living with a spouse or partner (?2 (1,
    N7791560)85.4, plt.001), OR 1.2 (95 CI 1.1,
    1.2)
  • More unattached Men 65, who lived alone,
    reported suicidal ideation in the past 12 months
    when compared to those, who lived with a spouse
    or partner, ?2 (1, N137437) 1824.4, plt.001,
    OR2.4 (95 CI 2.3, 2.5)
  • However, residing with others does not always
    result in less depression for unattached older
    men, since both unattached older men who lived
    alone, and older men who lived with a
    spouse/partner, were significantly more likely to
    be classified as not depressed (Bonferroni
    corrected z-test of column proportions).

14
Medical Outcomes Study (MOS) Social Support
Scores by Living Arrangement for Men Older than
65 years
Living Arrangement Tangible Social Support- MOS subscale index (0-16) M (SD) Affection MOS subscale index (0-12) M (SD) Positive Social Interaction MOS subscale index (0-16) M (SD) Emotional and Informational Support MOS subscale index (0-32) M (SD)
Unattached Individual Living Alone 10.6 (5.0) 8.0 (3.7) 10.5 (5.0) 21.6 (9.1)
Unattached Individual Living with Others 13.2 (2.7) 8.7 (2.7) 12.5 (3.4) 23.5 (7.5)
Living with Spouse/Partner 14.6 (2.4) 11.2 (1.7) 14.5 (2.6) 28.0 (6.1)
Kruskal-Wallis Test Statistic ?2 (2, N646 339) 107 241.9, plt.001 ?2 (2, N650 099) 149 527, plt.001 ?2 (2, N646 892) 107 547.7, plt.001 ?2 (2, N632 184) 75 198.4, plt.001
All post hoc pairwise Mann-Whitney U comparisons
indicated significant differences between all
living arrangements for each subscale (plt.001)
(Sherbourne Stewart, 1991)
15
Effect of Education Level on Major Depression and
Suicidal Ideation in the Past 12 months among Men
65 years
Education Level Living Arrangement Depression OR (95 CI) Suicidal Ideation OR (95 CI)
Secondary School or Less Unattached Living Alone 1.46 (1.37, 1.53) .35 (.30, .40)
Secondary School or Less Living with Spouse Partner .988 (.987, .990) 1.05 (1.05, 1.06)
Some Post-secondary to Post-secondary Graduation Unattached Living Alone .922 (.884, .962) 3.80 (3.63, 3.98)
Some Post-secondary to Post-secondary Graduation Living with Spouse Partner 1.002(1.001, 1.003) .84 (.83, .84)
16
Social Policy Opportunities
  • National/Provincial Level
  • Governments must target social policy investment
    to facilitate the development and maintenance of
    social support networks beyond the traditional
    nuclear/biological family
  • Broaden the legal definition of family
  • Consider the use of tax mechanisms (deductions)
    to encourage collaborative and informal
    caregiving relationships between individuals that
    are not biologically related or formally
    partnered
  • Invest in social programming that provides
    resources to support informal caregivers and
    informal social support networks
  • Particularly target investment for seniors that
    may be informal caregivers for other seniors
  • Invest in programming that provides seniors
    resources for managing mental health issues

17
Social Policy Opportunities
  • Local/Community Level
  • Promote new housing/living options that
    encourages collaborative living between
    individuals that live alone
  • Create programs to facilitate intergenerational
    connection/exchange between biologically/formally
    unrelated individuals
  • Create social spaces to build social capital
    among solo older men, or men who have lost
    social networks due to retirement
    (Actual/Virtual)
  • e.g. Men Sheds, virtual communities

18
Contact Information
peter.kellett_at_uleth.ca Gender and Population
Studies (GAPS) in Health www.gapsinhealth.com _at_G
APSinHealth
19
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