The Effect of Chronic Illness on Psychological Distress: Perceived Neighborhood Social Cohesion as a Moderator

Older adults with chronic health conditions have greater chances of experiencing social participation restriction, which, in turn, increases their psychological distress.
Using the multiple-group path analysis approach, this study examined how this indirect relationship between chronic health conditions and psychological distress via social participation restriction was affected by perceived neighborhood social cohesion. Community-dwelling foreign-born older adults in the U.S. from the National Health Interview Survey (N=2,243) were analyzed. Perceived neighborhood social cohesion was tested as a group variable. After controlling for other covariates (e.g., marital status, English proficiency, and neighborhood tenure), suffering from chronic health conditions was associated with greater psychological distress through increased social participation restriction in both groups (significant mediation).
However, the indirect effects through social participation restriction were significantly smaller among those living in the high social cohesion neighborhood (p=0.035; significant moderated mediation). The results imply the importance of the neighborhood social environment in buffering the negative effects of chronic health conditions on psychological distress.