There Is No Community Here: Living Alone, Place, and Older Peoples' Risk of Social Isolation

Abstract Existing research has identified significant risk factors for experiencing social isolation in later life including chronic health conditions, mobility impairments, and living alone among others. Although many older people who live alone maintain active social lives, living alone remains a top predictor of social isolation. Less is known about other types of risk factors, such as place-based risks and social exclusion. Despite calls to examine the role of place and social exclusion in social isolation risk, few studies have investigated the links. Models of isolation risk have often omitted place-based factors and social exclusion and focused largely on individual-level risks. In order to address these gaps, this paper presents the findings of 17 in-depth, qualitative interviews with community-dwelling older people who live alone (aged 65-93). Participants were recruited using a theoretical sampling strategy to ensure that a diverse range of neighbourhood types were represented among the participants (e.g., walkable vs. car-dependent neighbourhoods). Interview transcripts were analyzed using a constructivist grounded approach resulting in several major themes. Participants described aspects of their local environments as shaping their risk of isolation including infrastructure and amenities delivered in place, and neighbourhood makeup, among others. These themes are further examined through the lens of place-based exclusion and used to conceptualize how dimensions of both place and social exclusion fit into the model of known isolation risk factors. An adapted model of risk is presented to guide future research and intervention planning.

emotional problems in spouse/child, financial strain, housing problems, and close relationships in others) mediate the association between loneliness and depressive symptoms.In addition, the perceived negative strain from family moderated the mediating effect of health problems and housing problems in the relationship between loneliness and depressive symptoms.Discussion: This study suggests that negative relationships with family may increase upsetting in stress appraisals on health and housing problems, which turn in increased depressive symptoms for lonely older immigrants.Practitioners need to assess older immigrants' stressors and family relationships to understand their loneliness and depressive symptoms.Objective: This study examined the prevalence of social isolation and cigarette smoking in a national sample of community-dwelling older adults, and assessed the role of social isolation on the risk of cigarette smoking.Methods: Using data from 8,044 participants (age 65+ years) across two waves of the National Health and Aging Trends Study (NHATS), we analyzed the prevalence of social isolation in older adults and as a risk factor for cigarette smoking.Social isolation was measured across 4 relationship domains (Cudjoe, 2018) on a scale of 0 to 4, using objective measures of social interactions.Descriptive and logistic regression analyses were conducted to assess how social isolation is associated with smoking.Results: Preliminary results showed that 18.2% of older adults were socially isolated (3.5% severely isolated) and 7.1% of participants reported current smoking.We found that both social isolation (OR = 2.5, p<.001) and severe isolation (OR = 5.9, p<.001) increased the odds of smoking.Also, older adults with depression (OR = 1.6, p<.01) and dual-eligible beneficiaries (Medicare and Medicaid) with TRICARE coverage (OR = 4.6, p<.05) had greater odds of smoking.However, we did not find evidence that the odds of smoking varied significantly by the number of chronic conditions.Conclusion: Social isolation is associated with an increased risk of cigarette smoking among older adults.Smoking may be an important behavior in the pathway between social isolation and its association with morbidity and mortality.

THERE IS NO COMMUNITY HERE: LIVING ALONE, PLACE, AND OLDER PEOPLES' RISK OF SOCIAL ISOLATION Rachel Weldrick, Simon Fraser University, Vancouver, British Columbia, Canada
Existing research has identified significant risk factors for experiencing social isolation in later life including chronic health conditions, mobility impairments, and living alone among others.Although many older people who live alone maintain active social lives, living alone remains a top predictor of social isolation.Less is known about other types of risk factors, such as place-based risks and social exclusion.
Despite calls to examine the role of place and social exclusion in social isolation risk, few studies have investigated the links.Models of isolation risk have often omitted placebased factors and social exclusion and focused largely on individual-level risks.In order to address these gaps, this paper presents the findings of 17 in-depth, qualitative interviews with community-dwelling older people who live alone (aged 65-93).Participants were recruited using a theoretical sampling strategy to ensure that a diverse range of neighbourhood types were represented among the participants (e.g., walkable vs. car-dependent neighbourhoods).Interview transcripts were analyzed using a constructivist grounded approach resulting in several major themes.Participants described aspects of their local environments as shaping their risk of isolation including infrastructure and amenities delivered in place, and neighbourhood makeup, among others.These themes are further examined through the lens of place-based exclusion and used to conceptualize how dimensions of both place and social exclusion fit into the model of known isolation risk factors.An adapted model of risk is presented to guide future research and intervention planning.

TEACHING ANTI-RACISM IN GERONTOLOGY: AN INTERACTIVE PROGRAM OF RECOGNITION, SELF-WORK, PEDAGOGY, AND ACTION
Chair: Althea Pestine-Stevens Discussant: Tina K. Newsham Older adults with intersecting identities as persons of color experience disparities in health and well-being due to racism in individual and structural spheres, which have been amplified by health, economic, and social consequences of COVID-19.We can begin the work to reduce these inequities by training scholars and practitioners to disrupt the systems within which we work that relegate advantages and disadvantages throughout the life course and in later life by racial groups.This interactive symposium presents resources on anti-racist gerontological education and provides an opportunity to engage critically with peers in all stages of their careers and anti-racism journeys who are interested in integrating anti-racism into their teaching.The first presenter introduces conversations to begin anti-racist pedagogy and assumptions to dismantle.The second presenter describes cultural humility as an essential step towards self-awareness and critical self-reflection for educators and practitioners.The third presenter presents how anti-racist pedagogy, a teaching approach that combines racial content, pedagogy, and organizing, may be applied to gerontology education.Fourth, an example will be presented from an online course module developed to guide Master of Social Work students toward recognizing racial disparities in aging services systems and identifying concrete suggestions for improvement.Finally, strategies for curriculum design will be presented with examples from Public Health education.This symposium is designed to include ample time for group discussion on this critical and under-addressed area of teaching in gerontology across disciplines, such that participants can better connect with others to build awareness, competency, and resources.

TEACHING ANTI-RACISM IN AN AGING SERVICES COURSE: LESSONS DEVELOPED AND LESSONS LEARNED
Althea Pestine-Stevens, 1 and Emily Greenfield, 2 1. Rutgers Social Work, New Brunswick, New Jersey, United States, 2. Rutgers, The State University of New Jersey, New Brunswick, New Jersey, United States Despite high levels of racial disparities in health and well-being among older adults, curricula addressing how aging services systems contribute to or work to ameliorate these disparities are scarce.This paper introduces a module on inequalities and anti-racism in aging developed for an online course on aging services within a Master of Social Work program.First, materials that help students identify and understand racial inequalities in aging and in the programs that serve older adults are presented.Next, students are introduced to the applied context of how COVID-19 has exacerbated these inequalities.Finally, students critically engage in reflections and assessments of the available resources within aging services and advocacy organizations, providing recommendations for how these systems may better incorporate anti-racist practices.Challenges and opportunities will be discussed, including piloting this module in a virtual, asynchronous environment.

THE MASTER'S TOOLS WILL NEVER DISMANTLE THE MASTER'S HOUSE: THE ROLE OF DIVERSITY IN ANTI-RACIST EDUCATION Karen Lincoln, University of Southern California, Los Angeles, California, United States
Diversity is a strange fruit that requires critical analysis to understand its meaning, value and impact on education.Depending on the era, diversity has been defined in a number of different ways and has a variety of meanings across a range of contexts.The lack of shared meaning and understanding of diversity and who controls the diversity narrative have significant implications for the development of anti-racist pedagogy in gerontological education.This presentation will discuss the history and evolution of the "diversity discourse" and how mainstream notions of diversity impact diversity initiatives, curriculum design and anti-racist pedagogy.Strategies for engaging in an historical analysis of diversity and how this process relates to the design, leadership and ownership of anti-racist curriculum will be discussed, as well as the role of gerontology in leading these efforts.

CULTURAL HUMILITY: THE BIAS CHECKER
Natalie Moore-Bembry, Rutgers, The State University of New Jersey, Camden, New Jersey, United States Historically we have been taught to understand and embrace cultural competency, however, this focus has often led to a superficial understanding of others and seldom required one to better understand themselves.Cultural humility is based on one's ability to engage in individual accountability and institutional accountability.Individual accountability is based on critical self-reflection and critique, lifelong learning, and the challenging of power imbalances.Institutional accountability requires one to challenge structural power.This session will: (1) explore ways to engage in critical self-reflection and critique; (2) describe how values and beliefs impact the interactions of our personal and professional lives; and Gilbert Gimm, 1 Mary Lou Pomeroy, 2 and Thomas Cudjoe, 3 1.George Mason University, Vienna, Virginia, United States, 2. George Mason University, George Mason University, Virginia, United States, 3. Johns Hopkins University School of Medicine, Baltimore, Maryland, United States