Family violence exposure and health outcomes among older African American women: do spirituality and social support play protective roles?

Family violence (FV), spirituality, and social support are salient psychosocial determinants of health. FV is associated with poor health among older African American women. The effect of spirituality and social support levels on the health of older African American women is unknown. To assess the role of spirituality and social support as culturally relevant determinants of health status for older African American women independent of FV levels, we used a cross-sectional observational study. Two hundred twelve African American women, aged ≥ 50, were interviewed in two urban primary care practices. The measures used were (1) Family Violence Against Older Women (FVOW) scale, (2) Physical and Mental Composite Scores of the Short-Form 8® scale, (3) Medical Outcomes of Social Support survey (MOSS), and (4) Spiritual Well-Being Scale (SWBS). Spearman correlation coefficients estimated to test associations among lifetime FV exposure, spirituality, social support, and health status outcomes and multivariate regression models were used to examine the independent effect of spirituality and social support on physical and mental health status, controlling for FV and significant demographic variables. Mean participant age was 63.9 years. Higher spirituality levels were significantly associated with better physical health status after adjusting for FV levels and demographic factors (F = 6.17, p = 0.0001). Similarly, higher levels of spirituality and social support both significantly correlated with better mental health status in the multivariate model (F = 13.45, p < 0.0001) that controlled for lifetime FV levels and demographic factors. Spirituality and social support are two potentially modifiable determinants of health for older African American women. Culturally appropriate mechanisms to enhance social support and spirituality levels need to be explored as potential inteventions to improve the health of those African American women who have been exposed to FV.