Loneliness amongst Low-Socioeconomic Status Elderly Singaporeans and its Association with Perceptions of the Neighbourhood Environment

Abstract

In Singapore, a densely urbanised Asian city state, more than 80% of the population stays in public housing estates and the majority (90%) own their own homes. For the needy who cannot afford home ownership, public rental flats are available. We were interested in exploring social-environmental factors that are associated with loneliness among elderly residents of public rental housing in Singapore. We surveyed residents aged ≥60 in two Singapore public housing precincts in 2016. Loneliness was measured using a three-item scale. Sociodemographic information was obtained via standardised questionnaires. We used chi-square to identify associations between loneliness and sociodemographic characteristics, as well as neighbourhood perceptions (safety, convenience and the physical environment), on univariate analysis; and logistic regression for multivariate analysis. The response rate was 62.1% (528/800). On multivariate analysis, staying in a rental flat block was independently associated with loneliness (adjusted odds ratio, aOR = 2.10, 95% confidence interval (CI) = 1.32–3.36), as was staying in a poorer physical environment (aOR = 1.92, 95% CI = 1.15–3.22). Although needy Singapore residents share the same built environment as more well-to-do neighbours, differences in the impact of loneliness do exist.

Age differences in associations of different indicators of socioeconomic status with social isolation: A cross-sectional study

“…Housing type, a proxy of household SES in Singapore, was found to be associated with social isolation in middle-aged and older adults in this study with those residing in HDB 1-and 2-room flats having higher probability of social isolation, even after adjusted for other SES indicators. This is consistent with a Singapore study which reported that older adults residing in HDB 3-room flat or smaller had significantly higher risk of loneliness [6]. This suggests that housing type is a sensitive SES indicator that can be used to estimate the SES effect on social isolation in middle-aged and older adults.…”

“…Second, we used housing type as a proxy of household SES, however, the ownership of the property or wealth was not captured. This may affect our findings as a small portion of participants were tenants or lived in HDB rental flats and staying in a rental flat was found to be associated with loneliness [6]. Third, the authors tried to disentangle each SES indicator's independent impact on social isolation by adjusting for other indicators.…”

“…Evidence suggests that people around the world are more socially isolated now than ever before [2][3][4][5]. In Singapore, population ageing and shift towards nuclear families increases the likelihood of social isolation [6]. Social isolation has increasingly recognized as a global social issue that casts significant and growing influence on people's health across life course [7], including but not limit to physical and psychological health [8][9][10], morbidity [11], and mortality [12,13].…”

Social and physical neighbourhood characteristics and loneliness among older adults: results from the MINDMAP project

“…In GLOBE, the scale score ranged from 6 to 30 and tertiles were defined as low (score=6-9), medium (score=10-12), and high (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Scores were calculated for respondents with data on at least five items.…”

“…8 9 Previous studies show, for instance, that lower levels of perceived neighbourhood walkability, safety and attachment are associated with a higher level of loneliness among older adults. [10][11][12][13][14] Research on the association between objectively measured neighbourhood characteristics and loneliness in older adults is, however, lacking. The results of such studies may provide additional guidance for urban planners and policymakers in designing more appropriate and contextualised strategies for interventions to prevent or reduce loneliness.…”