Study finds race, gender differences in fear of death among elderly

Tuesday, June 14, 2016 - 10:05am

A recent University of Michigan study shows that racial and gender differences can affect one’s death anxiety — or fear of death — and subsequently affect the best ways to reduce these feelings.

Death anxiety, an issue particularly prevalent in elderly people, reduces one’s well-being and will to live, according to the research. This negatively affects elderly patients and could potentially be a barrier to patient-caretaker communication.

According to the Geriatric Mental Health Foundation, depression affects about 15 percent of adults over the age of 65 in the United States. This often results from one’s loss of senses or mobility, retirement or the death of a loved one. When untreated, depression — one of many mental health illnesses that can affect the elderly — can worsen other medical issues or lead to premature death due to a prolonged inability to physically or mentally function normally.

The University study was conducted by Shervin Assari, the lead author and a psychiatric research investigator, who used data from a religion, aging and health survey from 2004. The survey represents a nationally representative assessment of 1,074 white and Black people over the age of 65 who either identify as Christian or never associated with a religion or faith.

Previous studies have shown that people's attitude toward death is influenced by their cultures and religions, usually tied to race and gender. Assari sought to further explore the differences in death anxiety between Blacks and whites caused by race, gender and culture. 

“We are not interested in how culture shapes our feelings or our behaviors, but we are looking at how culture changes the effects of our psychosocial factors, behaviors and feelings on our health outcomes,” Assari said. “We don’t necessarily believe that culture directly shapes our behaviors, feeling and health. We believe that culture changes the complex associations that shape health in humans.”

The researchers measured death anxiety using participants' responses to four statements: "I find it hard to face up to the fact that I will die," "Thinking about death makes me feel uneasy," "I do not feel prepared to face my own death" and "I am disturbed by the shortness of life." Participants responded to these statements using a scale from four (strongly agree) to one (strongly disagree).

The researchers also took into account the participants' perceived control over life, demographics, socio-economics, number of physical health conditions, self-rated health and financial difficulty.

Ultimately, the study found that, while race and gender did not have a significant effect on death anxiety, they influenced factors associated with death anxiety, such as a number of physical health conditions and financial difficulty. While the results do not explain exactly why there are discrepancies in death anxiety among different people, it is significant to show these discrepancies exist for different races and genders. 

The study revealed that race and gender were different moderating factors linked to death anxiety, something Assari said he believes resulted from the historical adversity Blacks have faced, leading to greater resilience. 

“People say when people get sick they start getting scared or feel the fear of death, and then losing control over life makes you scared of death again, but I am showing that it is only an association among whites and it is missing among Blacks,” Assari said. “Leading a socially adverse life would come with a gift of resilience."

The study raises the question as to exactly how people’s cultural backgrounds or races could be so influential in their mental processes and physiological responses.

Shinobu Kitayama, University professor of social and cultural psychology and director of the Culture and Cognition Program — a program that focuses on the intersection between socio-cultural and psychological processes — focuses his research on how the role of culture cognition and emotion. Kitayama said Assari’s findings support his research because they place an emphasis on one’s cultural background, a significant factor in one’s overall social perception.

“His work is the first to show that physical health or some self-perception of health might be related to death anxiety differently depending on ethnic or racial group,” Kitayama said.

According to Kitayama, larger factors, such as history, evolution and ecology, influence of one’s culture. Kitayama believes ecological factors — such as crop availability and rainfall — constrict which types of societies can and cannot arise. These societies, in turn, create socioeconomic structures, which later influence things like religion. Kitayama said religion ultimately has a lot of potential in affecting fear of death. 

“Once religions are held in place, that really provides a moral matrix by which people’s behaviors are regulated,” Kitayama said.

It could be argued that those who care for the elderly could adapt them to different cultures in which death anxiety is less harmful. However, Kitayama believes that, while this is possible, there is a point at which it could become difficult. Instead, caretakers might benefit more from learning how to care for each culture individually based on their individual beliefs, rather than changing them.

“People can be flexible, and people can behave differently depending on social expectations and normative expectations depending on some cues available to the extent they can understand what those cues might mean,” Kitayama said. “This said, however, I also believe that there may be some critical period in which you absorb your cultural expectations very deeply, before puberty or around puberty. Once you acquire your, say, primary cultural characteristics, it might be a little bit more challenging to change your second nature just because you moved to a second culture.”