Chinese and non-Hispanic White differences in social activity, social support and mental health among community-dwelling older adults in Massachusetts, USA

OBJECTIVES: This study aimed to assess differences in social activity, social support, and mental health among Chinese and non-Hispanic White (NHW) older adults, and to evaluate if the differences in mental health are mediated by social activity and/or social support. METHOD: The study enrolled 604 community-dwelling older adults (470 NHW and 134 Chinese) aged 65-95 y in Massachusetts, USA (2018-2023). Mental health, including anxiety, depressive symptoms, perceived stress and resilience. Multivariable linear regression models were used to estimate differences in these outcomes by race. Structural equation models were used to examine if social activity and/or social support mediated the Chinese-NHW differences in mental health, while adjusting for sociodemographic variables, physical health, functional status, lifestyle behaviors. RESULTS: Compared to NHW, Chinese had lower levels of social activity, social support and resilience, experienced higher levels of anxiety and perceived stress. No significant differences were found in depressive symptoms. Social activity partially mediated Chinese-NHW differences in anxiety symptoms and perceived stress. Social support also partially mediated Chinese-NHW differences in anxiety symptoms and resilience. CONCLUSION: Chinese participants had less social activity and support than NHW. Increasing social activity or social support in Chinese could help improve mental health outcomes.