"I Feel Trapped": The Tension Between Personal and Structural Factors of Social Isolation and the Desire for Social Integration Among Older Residents of a High-Crime Neighborhood.
OBJECTIVE
The aim of this study was to examine the factors contributing to the social isolation of older residents of a high-crime neighborhood through the in-depth examination of their lived experiences. A deeper understanding of factors contributing to social isolation can allow policymakers and health care providers to create policies and programs to alleviate the social isolation of these vulnerable and understudied individuals.


METHODS
Participants were recruited through the support of the Housing Authority and Police and Fire Departments of Richmond, California, a town with a high-crime rate. Fifty-nine ethnographic interviews were conducted with 20 individuals of 58-95 years of age. Transcripts and fieldnotes were analyzed with a focus on the specific factors contributing the social isolation of participants.


RESULTS
An overarching theme of tension between personal and structural factors of social isolation and desire for social integration emerged from qualitative content analysis. A tension emerged between a longing to participate in society and the immersion in a reality so dense with obstacles that made participation in society difficult to attain. Four specific themes also emerged. Three themes demonstrated underlying factors of social isolation stemming from the personal sphere and the physical and social environment. The fourth theme illustrated participants' desire for social integration.


CONCLUSIONS
Findings demonstrate the salience of interventions and programs to make neighborhoods safe and accessible to older residents. Findings also suggest a need to reframe the conceptual framework for social isolation to better measure and alleviate this public health problem.
Institute for Health and Aging, University of California-San Francisco.|Institute for the Study of Societal Issues, University of California-Berkeley.
Elena
E
Portacolone
Division of Geriatric Medicine, School of Medicine, University of California-San Francisco.
Carla
C
Perissinotto
Department of Social and Behavioral Sciences, University of California-San Francisco.
Jarmin Christine
JC
Yeh
Division of Geriatrics, Department of Medicine, Penn University, Philadelphia.
S Ryan
SR
Greysen
D000368:Aged; D003415:Crime / Q000517:prevention & control / Q000523:psychology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D020380:Needs Assessment; D011634:Public Health / Q000379:methods; D011640:Public Policy; D012111:Residence Characteristics / Q000145:classification*; D064890:Social Determinants of Health / Q000706:statistics & numerical data*; D012931:Social Environment; D012934:Social Isolation / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
Crime; Disparities (health racial); Environment (ergonomics); Gerontology; Health care policy; Public policy; Social isolation; Sociology of aging/social; Urban