Unveiling the missing pieces: Addressing research gaps in tackling loneliness among older migrants

Abstract

Older migrants have long been an overlooked population (Fokkema & Ciobanu, 2021). While gerontological research has a rather colour-blind history, migration research has predominantly focused on younger migrant populations (e.g., recent newcomers and second-generation). Especially in longstanding immigration countries, older migrants today represent a substantial segment of the ageing population (OECD/European Union, 2023), and their numbers are expected to increase significantly in the near future (Apt, 2018; also see Fargues this issue). There is also growing awareness of the specific vulnerabilities of older migrants arising from the intersection of ageing and migration (Ciobanu et al., 2017). As a result, research on older migrants has gained momentum in recent years, encompassing a wide array of topics (see Torres and Hunter (2023) and the commentary in this issue for a nice illustration of this).

One of the vulnerabilities faced by older migrants is loneliness – the perceived discrepancy between the quality and/or quantity of an individual's actual and desired social relationships (Peplau & Perlman, 1982). Quantitative studies to date show, almost without exception, that older migrants on average report substantially higher levels of loneliness compared with their native-born counterparts (Dolberg et al., 2016; Fokkema & Naderi, 2013; Lin et al., 2016; Uysal-Bozkir et al., 2017; van Tilburg & Fokkema, 2021; Wu & Penning, 2015). When older migrants are further differentiated by ethnicity, those from countries of origin with greater cultural and linguistic distance are particularly prone to experiencing above-average levels of loneliness. In Great Britain, for instance, older migrants from India showed a loneliness prevalence similar to that of the native-born (8% versus 9%), whereas it was much higher for older migrants from the Caribbean (24%) and even more so for those from Bangladesh (40%), China (40%), Pakistan (50%), and Africa (50%) (Victor et al., 2012). In Canada, older migrants are on average lonelier than their native-born age peers, except for those who migrated from Britain or France (de Jong Gierveld et al., 2015) and identify themselves as British or French (Wu & Penning, 2015).

Addressing loneliness, especially when it becomes chronic, is paramount due to its detrimental effects on physical and mental health. Prolonged loneliness increases the risk of health issues such as cardiovascular disease, accelerated cognitive decline, dementia, depression, anxiety disorders, and even premature all-cause mortality (Cachón-Alonso et al., 2023; Holt-Lunstad et al., 2015; Holwerda et al., 2014; Park et al., 2020). Loneliness may also lead to unhealthy coping mechanisms such as excessive alcohol consumption or smoking, further jeopardising health (Wootton et al., 2021). Moreover, loneliness has consequences for society at large, including higher healthcare expenses and undermining of social cohesion and community connectedness (Massihzadegan & Stokes, 2023; Meisters et al., 2021).

So far, research on loneliness among older migrants has mainly focused on the underlying causes of their higher average levels of loneliness as individuals, resulting in three sets of potential explanations (Fokkema, 2023; Victor et al., 2021). First, older migrants are more exposed to known risk factors for loneliness, such as poor health, low socioeconomic status, more homogeneous social network, low level of social participation and low mastery. Second, migrant-specific risk factors such as limited host language proficiency and experienced ethnic discrimination can put older migrants at increased risk of loneliness. Third, cultural factors might play a role. Most older migrants come from collectivistic cultures that are often characterised by high expectations of social relationships, with a strong emphasis on mutual support, loyalty, and harmony within the family and community. When expectations are exceptionally high, there is an enhanced likelihood that these may not or hardly be met, possibly leading to feelings of disappointment and rejection. When these feelings are not shared for the sake of keeping harmony and avoiding conflict, it results in less fulfilling relationships, and thus feelings of loneliness.

Knowledge about the root causes of loneliness among older migrants at the individual level is certainly relevant, yet by no means sufficient to effectively address their loneliness. Several gaps persist that warrant further inquiry. In the following, without pretending to be exhaustive, I will discuss four main gaps.

First, there is an urgent need for more insight into the variation in the manifestations and causes of loneliness within the group of older migrants. They are not a homogenous group: there is substantial diversity in backgrounds (e.g., cultural, migration history, religious, linguistic), pre- and post-migration experiences, and personal characteristics (e.g., age, gender, socioeconomic status, health). The intersection of these multiple identities can significantly influence how loneliness manifests and its contributing factors. Without grasping these nuances, loneliness interventions may fail to adequately meet the diverse needs of different risk groups of older migrants. Indeed, an intervention can only be effective if it aligns with the underlying cause of loneliness. Just like with other population groups, there is no one-size-fits-all approach to address loneliness among older migrants.

Second, while existing research has shed light on individual-level factors that contribute to older migrants' loneliness (see above), the impact of the environmental (meso) and societal (macro) context has hardly been investigated (Kemppainen et al., 2023). That is a major omission, as loneliness is not solely an individual challenge but also a collective responsibility. Factors at the meso level that might play a significant role in shaping experiences of loneliness include ethnic diversity in the neighbourhood and the availability of services tailored to the needs of older migrants. Factors at the macro level potentially influencing older migrants' loneliness include type of welfare state, migration policies, and attitudes towards migrants. Taking into account these contextual factors and their interaction with individual factors allows for a more holistic understanding of loneliness among older migrants and identification of intervention leverage points at multiple levels of society.

By addressing these first two research gaps, the field of loneliness interventions will receive a significant boost. Although numerous interventions have been developed to prevent or reduce loneliness among older adults (de Jong Gierveld & Fokkema, 2015; Fakoya et al., 2020), only a handful have been designed or adapted specifically for older migrants (Salway et al., 2020). In addition to expanding the number of tailored interventions for older migrants through the new knowledge, the variety of interventions will significantly widen. The existing interventions for older migrants are primarily aimed at creating social meeting places (e.g., social and cultural activities in community or religious centres; Li & Southcott, 2012; Patzelt, 2017; Zhang & Zhan, 2009) under the assumption that “once among people and making new contacts, loneliness will go away”. Such types of intervention make sense for those who lack social networks. However, most older migrants are well-embedded socially (Fokkema & Das, 2023; Steinbach, 2018), confirming that loneliness and being alone are different concepts (de Jong-Gierveld & van Tilburg, 2016). As outlined above, there are multiple factors at the individual, meso, and macro level that can shape older migrants' loneliness. These require different approaches such as managing expectations of social relationships, enhancing the quality of existing relationships, providing practical support, increasing neighbourhood trust, facilitating access to community resources, and combating ethnic discrimination.

Third, high-quality research on the effectiveness of loneliness interventions specifically targeted at older migrants is lacking. The aforementioned studies on interventions primarily aimed at creating social meeting places are qualitative in nature. These studies imply the effectiveness of the intervention indirectly by outlining its multifaceted functions (e.g., opportunity for get-togethers with same-age co-ethnic peers outside the family, providing a familiar space, creating a sense of belonging, finding distraction). In rare cases, participants or implementers reported that the intervention reduced or prevented loneliness, but these findings should be interpreted with caution. Positive evaluations may be influenced by factors such as social desirability bias and the desire to please the researchers. It is therefore crucial to quantitatively examine the effectiveness of loneliness interventions, preferably using a randomised controlled trial (RCT) design (Schoenmakers et al., 2024). I do acknowledge that this is not easy to implement due to significant financial, practical, and ethical challenges.

Fourth, there is a need for more research on how to break the silence on loneliness. There is still a taboo surrounding loneliness, and it is likely to be even more pronounced among older migrants. In collectivistic cultures, discussing personal and sensitive topics is generally considered less appropriate (Heu et al., 2019), and much emphasis is placed on maintaining strong family ties – especially between parents and children – and group harmony (Pan et al., 2023; van Staden & Coetzee, 2010). Feelings of shame and fear of losing face are also characteristic of collectivistic cultures. Only when older migrants openly share their feelings are family, community members, and professionals able to recognise the signs of loneliness and provide meaningful support. Breaking the silence on loneliness is not only the responsibility of the individual but also of the social environment. For instance, children can promote open communication, while the community can create spaces where older migrants feel comfortable and valued. Additionally, both children and the community can play a role in lowering the threshold for seeking support from welfare organisations and overcoming barriers to participating in loneliness interventions. However, it is unknown to what extent children and the community are aware of the supportive role they can play and what factors may deter them from doing so.

In conclusion, clearly much research still needs to be done on loneliness among older migrants and how to effectively address it. This is not only academically stimulating but also highly relevant towards fostering a more inclusive society where older migrants have the opportunity to enjoy a good quality of life.

The opinions expressed in this Commentary are those of the author and do not necessarily reflect the views of the Editors, Editorial Board, International Organization for Migration nor John Wiley & Sons.