Senior Men, Social Capital, and Social Policy Opportunities

1. Senior Men, Social Capital, and Social Policy Opportunities Mitigating a Potential Mental Health Crisis among Aging Male “Baby Boomers” Peter Kellett MN RN Ph.D. Student (Demography)

2. Authors Peter Kellett MN, RN, Ph.D. Student (Demography), Instructor (Nursing), Faculty of Health Sciences, University of Lethbridge, , Alberta, Canada. Susan McDaniel Ph.D. , FRSC, Director of the Prentice Institute for Global Population & Economy, Canada Research Chair in Global Population & Life Course, Prentice Research Chair, & Professor of Sociology, University of Lethbridge, Alberta, Canada. Bradley Hagen Ph.D. (Nursing), RN , R.Psych, Associate Professor & Coordinator of Health Sciences Graduate Program, Faculty of Health Sciences, University of Lethbridge, Alberta, Canada. Olu Awosoga Ph.D. (Statistics), Assistant Professor, Faculty of Health Sciences, University of Lethbridge, Alberta, Canada. Cheryl Currie Ph.D., Assistant Professor (Public Health), AIHS Translational Health Chair in Aboriginal Health & Wellness, Faculty of Health Sciences, University of Lethbridge, Alberta, Canada.

3. Shifting Socio-demographic Landscape • >65 years 2009 – 14% • 2036 – 23-25% • 2061 – 24-28% Aging Population (Statistics Canada, 2012a)

4. Increasing Divorce Rates & Decreased Investment in Traditional Marriage (Milan, 2013)

5. Transnational Trend of Living Alone Men > Women Note. Figure created based on data supplied by Jamieson & Simpson (2013), p. 34

6. Men, Social Capital, & Mental Illness • Social Support networks are a documented mediator of mental health outcomes(Conrad, 2010; Keating,2009). • Systematic review (n=14) individual social capital: inverse relationship between cognitive social capital & common mental disorders(De Silva, 2005) • Men’s social support is generally inferior to women’s (Conrad, 2010) • Female family members, wives, partners main source of emotional support for men(Conrad, 2010) • Retirement or job loss may significantly reduce men’s social capital (Oliffe et al., 2010,2013) • Older men may be more affected by a lack of informal social capital (Muckenhuber et al., 2013)

7. Depression in Men • Annual prevalence of major depression in Canadian men: 2.9 – 4% (Blackmore, et al., 2007; Patten, et al., 2006; Simpson, et al., 2012) • Statistics suggest that women experience depression approximately twice as much as men. • Surveys frequently use WMH-CIDI or CIDI-SF-MD (Kessler et al., 1998) • Diagnostic tools for major depression (90% cut-point) • Do not capture all masculine presentations of depression • Many current estimates of depression in men may underestimate the prevalence of depression in men (Oliffe & Philips, 2008)

8. Masculinities & Suicide • Paradox - despite lower reported rates of depression, men consistently have significantly higher rates of completed suicide (worldwide) • Western Societies: female-to-male ratio at least 1:2 • WHO reports 1:3.5 (based on 58 countries) • U.S. Has highest ratio at 1:6 • Men tend to use more dramatic & lethal methods (e.g. hanging, firearms etc.) • Profoundly linked to the performance of masculinities

9. Suicide and Older Men Note. Data from Statistics Canada (2012b), CANSIM Table 102-0551

10. Purpose To examine the impact of living alone on the availability of social support, the prevalence of depression, and the prevalence of suicidal ideation among older Canadian men Research Questions • Do senior men exhibit higher rates of suicidal ideation and depression? • Does living alone contribute to higher risk for decreased social support, depression, and suicidal ideation in senior men? • Does education level influence the prevalence of depression and suicide in senior men? Sample 2010 Canadian Community Health Survey (CCHS) (n=62 909)

11. Findings 2010 Annual Prevalence of Depression Men: 4.1% (approximately 302 000) Women: 6.4%

12. Suicidal Ideation (Past 12 months) When men were asked if they had seriously considered suicide in the past 12 months Depressed men, over 65 years-old had a significantly higher odds of suicidal ideation OR=14.9 (95% CI:13.3, 16.6)

13. The Impact of Living Alone • More unattached older men (65+), who lived alone, experienced major depression than older men living with a spouse or partner (χ2 (1, N=7791560)=85.4, p<.001), OR= 1.2 (95% CI: 1.1, 1.2) • More unattached Men 65+, who lived alone, reported suicidal ideation in the past 12 months when compared to those, who lived with a spouse or partner, χ2 (1, N=137437) = 1824.4, p<.001, OR=2.4 (95% CI: 2.3, 2.5) • However, residing with others does not always result in less depression for unattached older men, since both unattached older men who lived alone, and older men who lived with a spouse/partner, were significantly more likely to be classified as not depressed (Bonferroni corrected z-test of column proportions).

14. Medical Outcomes Study (MOS) Social Support Scores by Living Arrangement for Men Older than 65 years All post hoc pairwise Mann-Whitney U comparisons indicated significant differences between all living arrangements for each subscale (p<.001) (Sherbourne & Stewart, 1991)

15. Effect of Education Level on Major Depression and Suicidal Ideation in the Past 12 months among Men 65 years +

16. Social Policy Opportunities National/Provincial Level • Governments must target social policy investment to facilitate the development and maintenance of social support networks beyond the traditional nuclear/biological family • Broaden the legal definition of family • Consider the use of tax mechanisms (deductions) to encourage collaborative and informal caregiving relationships between individuals that are not biologically related or formally partnered • Invest in social programming that provides resources to support informal caregivers and informal social support networks • Particularly target investment for seniors that may be informal caregivers for other seniors • Invest in programming that provides seniors resources for managing mental health issues

17. Social Policy Opportunities Local/Community Level • Promote new housing/living options that encourages collaborative living between individuals that live alone • Create programs to facilitate intergenerational connection/exchange between biologically/formally unrelated individuals • Create social spaces to build social capital among “solo” older men, or men who have lost social networks due to retirement (Actual/Virtual) • e.g. Men Sheds, virtual communities

18. Contact Information peter.kellett@uleth.ca Gender and Population Studies (GAPS) in Health www.gapsinhealth.com @GAPSinHealth

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