Contexts That Exclude: Loneliness in North America, Europe, and Africa

Abstract Loneliness is a key indicator of exclusion from social relations. Its prevalence among older people is of increasing global concern given the powerful impact of loneliness on health and wellbeing. To date, empirical and theoretical advancements in understanding loneliness have been focused on the micro contexts of networks of social relationships surrounding older people. Yet these relationships occur within broader socio-cultural, political and geographical settings that may help us better understand the experiences and manifestations of loneliness. In this presentation we draw on our research on loneliness on three continents. Findings from Canada show how ageing in a foreign land can truncate social connections. Research across Europe reveals differences in values and expectations about social connections. South African findings illustrate the long-term impact of dislocation resulting from political ideologies. We draw together these findings to create an ecological model of contexts that may lead to cumulative disadvantage in social relations.


NEW PERSPECTIVES ON LONELINESS: FROM MICRO QUALITATIVE TO MACRO QUANTITATIVE CROSS-NATIONAL COMPARISONS Chair: Marja Aartsen
Longitudinal research revealed a number of micro-level drivers of loneliness, such as widowhood, exclusion from the wider society, ill health and migrant status, but a number of questions are still unanswered. For example, the prevalence of loneliness varies substantially across countries, but we do not know precisely what causes these differences. It may be due to differences in the composition of the populations, it may also be caused by macro-level drivers, or by variations in the impact of risk factors between countries. For example, losing a spouse may be loneliness provoking in countries where living with a partner is the norm, but less so in countries where living alone is more valued. Also how early childhood and events over the life course affect the level of loneliness in later life is still under-researched. The aim of our symposium is to address this gap by presenting different perspectives on loneliness and social isolation. The first presenter interprets five-year follow-up information from qualitative interviews with a life course perspective. The second investigates the role of trust as factor producing social integration, which leads to variations in loneliness. The third compares and discusses loneliness in three different continents, based on an ecological model of contexts. The forth presenter critically discusses ways to measure loneliness in societies that are culturally distinct from western cultures. The last presenter discusses the dynamics between loneliness and material deprivation in Europe. The findings provide a new lens through which we can understand loneliness and inform about effective prevention.

EARLY-LIFE CIRCUMSTANCES AND LATE-LIFE LONELINESS: FINDINGS FROM IN-DEPTH INTERVIEWS Elisa Tiilikainen, University of Eastern Finland, Kuopio, Finland
This case study examines loneliness from the perspective of two older men, who were interviewed three times as part of a five-year qualitative longitudinal study on loneliness in later life. Both interviewees self-identified as feeling lonely "often" or "all the time" and had experienced loneliness also in previous life phases. The interviews revealed trajectories of long-term loneliness which were impacted by life events and circumstances in early life, childhood and youth. Two critical experiences were identified: childhood bereavement and sexual abuse. These factors contributed to emotional insecurities and impacted the ways the interviewees perceived their selves and their relations with others. The acknowledgement of past life experiences is important for the theoretical and conceptual understanding of loneliness and the development of different intervention strategies. However, more longitudinal analysis is needed on the cumulative disadvantages making people vulnerable to long-term loneliness. Loneliness in later life is two times more prevalent in Eastern and Southern European countries than in Northern and Western European countries. One explanation that is put forth is the difference in expectations about social relations. We examine a not often evaluated role of trust in society as factor contributing to the country differences in loneliness. We adopt the trust-as-antecedent model of social integration, and assume that social integration is associated with loneliness. We use data of respondents aged 65 and over participating in the European Social Survey and conduct a latent factors path analysis to examine the effect of trust in the system and trust in people on social capital and loneliness. Loneliness is two times more prevalent in Eastern Europe than the rest of Europe (26% vs 10%), levels of trust are substantially lower in Eastern European countries, which in turn is associated with higher levels of loneliness.

CONTEXTS THAT EXCLUDE: LONELINESS IN NORTH AMERICA, EUROPE, AND AFRICA
Norah Keating, 1 and Vera Roos, 2 1. Swansea University,Summerland,British Columbia,Canada,2. Optentia Research Focus Area,Vanderbijlpark,South Africa Loneliness is a key indicator of exclusion from social relations. Its prevalence among older people is of increasing global concern given the powerful impact of loneliness on health and wellbeing. To date, empirical and theoretical advancements in understanding loneliness have been focused on the micro contexts of networks of social relationships surrounding older people. Yet these relationships occur within broader socio-cultural, political and geographical settings that may help us better understand the experiences and manifestations of loneliness. In this presentation we draw on our research on loneliness on three continents. Findings from Canada show how ageing in a foreign land can truncate social connections. Research across Europe reveals differences in values and expectations about social connections. South African findings illustrate the long-term impact of dislocation resulting from political ideologies. We draw together these findings to create an ecological model of contexts that may lead to cumulative disadvantage in social relations. The growing international evidence on the impacts of social isolation and loneliness has profound implications for positive health status and wellbeing (Holt-Lunstad et. al. 2015). This raises important questions about how we measure loneliness, particularly in extended family cultures where loneliness may be experienced differently from western more individualistic cultures. In this research, key questions around loneliness and social isolation were co-created with Māori Elders and responses were compared with a standard international loneliness scale (De Jong Gierveld Loneliness Scale) to help identify universal aspects of loneliness and Māori specific aspects. The results demonstrated significant correlations between the co-created questions and the international scale. However, they also demonstrated substantial expressions of loneliness among older Māori that are not captured by standard scales showing the need for Māori specific scales which are more inclusive of their cultural norms and can provide more precise data for constructive policy making and service provision.

TWO DIMENSIONS OF SOCIAL EXCLUSION: ECONOMIC DEPRIVATION AND DYNAMICS OF LONELINESS DURING LATER LIFE IN EUROPE
Michal Myck, 1 Charles Waldegrave, 2 and Lena Dahlberg, 3 1. Centre for Economic Analysis,CenEA,Szczecin,Zachodniopomorskie,Poland,2. Family Centre Social Policy Research Unit,Lower Hutt,Wellington,New Zealand,3. Aging Research Center,Karolinska Institutet,Solna,Stockholms Lan,Sweden We contribute to the discussion on social exclusion by examining the relationship between material conditions and loneliness in a sample of individuals aged 50+ in the Survey of Health Ageing and Retirement in Europe (SHARE). In its 5th wave, the survey was extended to include specific items related to economic and social deprivation. We use this extended information on material conditions and examine how it correlates with the level and dynamics of a composite loneliness measure at the time of wave 5 and between wave 5 and 6 of the survey (undertaken in 2013 and 2015, respectively). In order to isolate the effect of material deprivation on loneliness, regression analyses include an extensive set of control variables. The analyses show a strong and significant relationship between material deprivation and both the level of loneliness and deterioration in the loneliness status.

OLDER LGBTQ WOMEN MATTER: AN EXAMINATION OF DISTINCTIVE HISTORIES, END-OF-LIFE NEEDS, AND SUPPORT Chair: Korijna Valenti
LGBTQ (lesbian, gay, bisexual, transgender, and queer) aging research has reached a point at which in depth examination of the heterogenous experiences of identity, social life, and health is needed in order to better understand the distinct life courses and service needs of diverse subgroups. Older LGBTQ women have diverse life experiences and areas of need in terms of professional, social, and health-related supports and systems. As emerging literature addresses the depth of these distinctions, issues of identity development, social isolation, social networks, and end of life (EOL) planning and expectations require further study as well as the use of varied methods of data collection and analysis to enhance empirical understanding. This symposium includes findings from three studies. In a qualitative study, Valenti and colleagues examined experiences of LGB women over60 who had recently lost a spouse or partner and explored issues related to preparation and expectations at the EOL. In a discourse analysis of personal aging narratives published in the Bi Women's Quarterly newsletter (including poetry, personal reflections, and short stories), Jen and colleagues examined how bisexuality is experienced and constructed through language use in context. Rowan and colleagues provide insights from interprofessional research with a specific focus on lesbian women in later life. All three presentations in this symposium illustrate how language, individual preferences and needs, and social support issues meet to inform the needs of LGBTQ older women as well as providing implications for future aging research, theory development, and interventions in practice.

WE'RE LESBIAN PIONEERS-WE CAN MANIFEST GOOD DEATH: EOL EXPERIENCES OF OLDER LGB WOMEN WHO HAVE LOST A SPOUSE OR PARTNER
Korijna Valenti, 1 and Leah Janssen, 2 1. Miami University,Oxford,Ohio,United States,2. Miami University,Hamilton,Ohio,United States Preparing for end-of-life (EOL) and identifying support systems are ways older lesbian, gay, and bisexual women (LGB) women can assert agency over EOL. This paper presents qualitative data from a sample of older LGB women 60+ who have lost a spouse or partner. Thematic analysis revealed four main categories of concern: 1) advance care documents and wills; 2) interactions with healthcare professionals; 3) discussions about EOL; and 4) social network support. The work also analyzed participants' discussions of how they have changed since losing a loved one and how they now view preparation for EOL. Findings reveal the need for better communication between healthcare professionals and LGB women, better understanding of care options (e.g. hospice, palliative care) and deeper EOL conversations among loved ones. This work critically engages queer gerontology, providing an important foundation of how to better understand how older LGB women perceive needs and preferences for their EOL.