Neighborhood social cohesion and psychological distress among caregiving spouses with or without a nearby social support network

Background Caregiving spouses often experience substantial physical and emotional strain, placing them at elevated risk for psychological distress. While nearby social support networks and neighborhood social cohesion have each been linked to caregiver well-being, neighborhood social cohesion may serve as a complementary resource, particularly for those without nearby social support. However, little is known about whether the association between neighborhood social cohesion and psychological distress varies depending on the availability of nearby social support among caregiving spouses. Methods Using data from the 2006–2012 waves of the Health and Retirement Study, this study examined associations between perceived neighborhood social cohesion and psychological distress among caregiving spouses of older adults ( N = 1,375), stratified by nearby social support network status. Regression models were estimated to assess associations of neighborhood social cohesion with anxiety, hopelessness, and depressive symptoms, adjusting for sociodemographic characteristics and caregiving intensity. Results Approximately 13.0% of caregiving spouses reported having no nearby social support network. Caregivers without nearby social support reported higher levels of anxiety, hopelessness, and depressive symptoms compared with those who had nearby social support networks. Across all outcomes, higher neighborhood social cohesion was significantly associated with lower psychological distress in both groups. However, associations were consistently stronger among caregivers lacking nearby social support networks (anxiety: b = −0.12, p < 0.001; hopelessness: b = −0.42, p < 0.001; depressive symptoms: b = −0.26, p < 0.05) than among those with nearby social support networks (anxiety: b = −0.05, p < 0.01; hopelessness: b = −0.16, p < 0.001; depressive symptoms: b = −0.12, p < 0.01). Conclusion These findings highlight the importance of neighborhood-level social environments as a potential resource for caregiver mental health, particularly for caregivers with limited proximate social support. They further suggest that community-based efforts to strengthen social cohesion may complement caregiver support strategies and enhance psychological well-being among caregiving spouses.