See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/259630766

Social Isolation and Perceived Barriers to Establishing Social Networks Among

Latina Immigrants

Article  in  American Journal of Community Psychology · January 2014

DOI: 10.1007/s10464-013-9619-x · Source: PubMed

CITATIONS READS

32 1,030

4 authors:

Alejandra Hurtado-de-Mendoza Felisa Gonzales

Georgetown University George Washington University
46 PUBLICATIONS   367 CITATIONS    17 PUBLICATIONS   123 CITATIONS   

SEE PROFILE SEE PROFILE

Adriana Serrano Stacey Kaltman

Latina Research Georgetown University
15 PUBLICATIONS   90 CITATIONS    50 PUBLICATIONS   2,621 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Women's Hormonal Initiation and Persistence Study View project

Telephone Coaching Adherence Study View project

All content following this page was uploaded by Alejandra Hurtado-de-Mendoza on 03 November 2014.

The user has requested enhancement of the downloaded file.

Am J Community Psychol (2014) 53:73–82
DOI 10.1007/s10464-013-9619-x
ORIGINAL ARTICLE
Social Isolation and Perceived Barriers to Establishing Social
Networks Among Latina Immigrants
Alejandra Hurtado-de-Mendoza • Felisa A. Gonzales •
Adriana Serrano • Stacey Kaltman
Published online: 9 January 2014
 Society for Community Research and Action 2014
Abstract Research has identified numerous mechanisms
through which perceived social isolation and lack of social
support negatively impact health. Little research attention
has been dedicated to factors that influence the develop-
ment of social networks, which have the potential to
decrease perceptions of social isolation and provide social
support. There is mixed evidence concerning the avail-
ability of supportive social networks for Latinos in the US.
This study explores trauma-exposed Latina immigrants’
experiences of social isolation in the US and its perceived
causes. Twenty-eight Latina immigrant women partici-
pated in an interview about traumatic experiences. Infor-
mal help seeking and the availability of friendships in the
US were also queried. Frequent comparisons between
experiences in their home countries and in the US shaped
the emerging themes of social isolation and lack of social
support. Women reported feeling lonely, isolated, closed-
in, and less free in the US due to family separation and
various obstacles to developing and maintaining relation-
ships. Socioeconomic, environmental, and psychosocial
barriers were offered as explanations for their limited
social networks in the US. Understanding experiences of
A. Hurtado-de-Mendoza
A. Serrano
S. Kaltman
Department of Psychiatry, Georgetown University Medical
Center, Washington, DC, USA
Present Address:
A. Hurtado-de-Mendoza (&)
Department of Oncology, Georgetown University Medical
Center, 3300 Whitehaven St., NW Suite 4100, Washington,
DC 20007, USA
e-mail: ahd28@georgetown.edu
F. A. Gonzales
Department of Psychology, George Washington University,
Washington, DC, USA
social isolation as well as barriers to forging social net-
works can help inform the development of social support
interventions that can contribute to improved health among
Latinos.
Keywords Latina immigrants
Social isolation
Social
networks
Qualitative
Mental health
Trauma
Introduction
As social beings, humans are integrated into webs of
interpersonal relationships that have implications for
mental and physical health. Berkman et al. (2000) contend
that these social networks provide means of social support,
social influence, social engagement, and interpersonal
contact, all of which have been shown to impact health.
Perhaps the most studied of these social network functions
is social support. The benefit of social support for physical
and mental health is well established (e.g. Berkman et al.
2000; Cohen and Wills 1985; Kawachi and Berkman
2001). Social support does not naturally result from having
social networks, as economic strain or other factors might
limit a social network’s supportive capacity (e.g. Goodman
et al. 2010; Kawachi and Berkman 2001; Menjivar 2000;
Valle and Bensussen 1985). However, social networks
must be present for social support to be provided and
received (Cacioppo and Hawkley 2003).
Just as evidence exists for a positive impact of social
support on health, there is reason to believe that social
isolation may have a negative impact on health. Social
isolation is considered a risk factor for morbidity, mortality
(Cacioppo and Hawkley 2003), and mental disorders
(Heikkinen and Kauppinen 2004; Hiott et al. 2006). Lack
of social support and limited social networks reflect two
123
74
dimensions of social isolation: perceived isolation and
social disconnectedness, respectively (Cornwell and Waite
2009). A study of social isolation among a diverse sample
of older adults found perceived isolation and social dis-
connectedness to be negatively related to self-reported
physical health. The relationship between social discon-
nectedness and self-reported mental health, however, was
mediated by perceived isolation (Cornwell and Waite
2009). These findings highlight the detrimental impact of
perceptions of isolation on mental and physical health.
Although social support may buffer against the devel-
opment of depression and posttraumatic stress disorder
resulting from trauma exposure (Charuvastra and Cloitre
2008; Ibarra-Rovillard and Kuiper 2011), these types of
mental disorders can impair a person’s ability to forge and
cultivate supportive networks (Hirschfeld et al. 2000;
Olatunji et al. 2007). Little attention has been given to the
processes that shape and maintain the development of
social networks, especially among trauma survivors. In
their proposed conceptual model of the relationship
between social networks and health, Berkman et al. (2000)
challenge researchers to explore the impact of sociostruc-
tural conditions such as culture, socioeconomic factors,
politics, social change on the structure (e.g. size of the
networks), and characteristics (e.g. frequency of contact) of
social networks. This paper provides a qualitative analysis
of experiences of social isolation and their sociostructural
and psychosocial perceived barriers that impede the
establishment of social networks in Latina immigrants
exposed to trauma.
Latinos represent one of the fastest growing minority
group in the United States (United States Census Bureau
2011); thus, the health of this growing population is of
public health importance. Previous studies with nationally-
representative samples (Fortuna et al. 2008) and with
primary care convenience samples (Holman et al. 2000;
Kaltman et al. 2010) reveal that around 75 % of Latinos
have been exposed to trauma. Approximately a third of this
trauma-exposed population manifests depression and/or
PTSD (Eisenman et al. 2003). Latinos face numerous
barriers to accessing formal health care, including financial
limitations and difficulty navigating the health care system
(Livingston et al. 2008). Some studies suggest that, without
access to formal health care services, Latinos may rely on
informal support networks that act as a protective factor for
some mental disorders (e.g. Almeida et al. 2009; Falcon
et al. 2009; Ornelas and Perreira 2011). However, there is
limited research on the access to informal networks of
support in trauma-exposed Latinos. A few studies con-
ducted with Latinos who suffered different types of inter-
personal violence suggest that they have high levels of
123
Am J Community Psychol (2014) 53:73–82
family and social support (Fortuna et al. 2008; Sumner
et al. 2011).
Some scholars argue that familismo, a cultural value
reflecting strong family attachment, leads Latinos to rely on
support provided by informal networks of family and friends
(e.g. Alvidrez 1999; Callister et al. 2011; Ornelas et al. 2009;
Parra-Cardona et al. 2006). However, other studies suggest
that Latinos may feel socially isolated and perceive a lack of
social support in the US (Barrio et al. 2008; Bathum and
Baumann 2007; Callister et al. 2011; Ornelas et al. 2009;
Sussner et al. 2008) as they frequently leave important rela-
tionships in their home countries and often face unmet
expectations of support from family and friends upon arrival
in the US (Valle and Bensussen 1985; Menjivar 2000; Viruell-
Fuentes and Schulz 2009). These contradictory findings may
be explained by the different availability and supportive
capacity of social networks across generations and subpopu-
lations with different migration and settlement patterns (e.g.
Menjivar 1997; Viruell-Fuentes and Schulz 2009).
Most studies of social networks and social support
among Latinos have been conducted with Mexican,
Cuban, or Puerto Rican populations (e.g. Almeida et al.
2009; Falcon et al. 2009; Ribas and Lam 2010; Ornelas
et al. 2009; Rivera 2007), leaving other nationalities, such
as immigrants from Central and South America, under-
represented. Given the high prevalence of trauma in this
population (Fortuna et al. 2008; Holman et al. 2000), it is
paramount to explore perceptions of social isolation as
well as barriers that prevent the establishment of poten-
tially supportive social ties. Such efforts can contribute to
the development of social support interventions that
minimize the detrimental health impact of social isolation
and capitalize on the benefits of social networks on
health.
Many studies of social networks rely on the adminis-
tration of quantitative surveys that ask participants to list
persons in their network and answer subsequent questions
about the characteristics of those relationships (e.g. Ribas
and Lam 2010). Similarly, most social support studies use
quantitative surveys to query for perceived availability of
different types of social support (e.g. Mulvaney-Day et al.
2007; Ribas and Lam 2010; Ornelas and Perreira 2011;
Rivera 2007; Vega et al. 1991). Although important, these
surveys do not capture the experience of social isolation or
the barriers individuals face in developing supportive
social networks. This paper aims to expand the research on
the relationship between social networks and health by
qualitatively exploring experiences of, and explanations
for, social isolation in an understudied population: Latina
immigrants from Central America, South America, and
Mexico who were exposed to trauma.
Am J Community Psychol (2014) 53:73–82
Methods
Participants
Data for the current study were collected as part of a larger
study that aimed to understand Latina immigrants’ trauma
experiences and its impact in physical and mental health
(see Kaltman et al. 2011). Flyers were used to recruit
18–70-year old women from Mexico, Central or South
America, who were seeking health or social services from
clinics serving low-income and uninsured populations in
the Washington DC metropolitan area. Between January
and June, 2009, 28 women provided consent to be inter-
viewed about their life history and traumatic experiences.
Procedures
Two bilingual, bicultural Latina research assistants with post-
graduate training in psychology conducted face-to-face
interviews with the participants in Spanish in the place of
recruitment or a nearby public library. Participants were
asked to share their experiences with trauma and stress in
their home countries, during immigration, and in the US.
Additionally, participants who reported traumatic experiences
were asked whether they had received help from people in
their community and whether these experiences had caused
problems with family members and friends. In the first
interviews conducted, when asked about the impact of trauma
on their relationships with others, a number of women noted
that they had few friends in the US. Consequently, the
research team added one question to find out whether women
had friends in the US and two follow-up questions that
queried for reasons for not having friends and difficulties
making friends in the US.
Additionally, women completed demographic questions
and other measures to assess trauma exposure, depression, and
PTSD in an interview format to account for low literacy.
Exposure to traumatic events was measured with the Stressful
Life Events Screening Questionnaire (SLESQ) (Corcoran
et al. 2000), which consists of 13 questions that capture
exposure to different types of traumatic events (yes vs. no).
This measure has proven to have good test–retest reliability.
The 17-item PTSD Checklist (PCL, Weathers et al. 1993) was
used to evaluate on a 5-point scale how much participants
were bothered by various PTSD symptoms in the last month.
This measure has shown high internal consistency. To assess
depression we used the PHQ-9 (Kroenke et al. 2001) where
respondents rate on a 4-point scale how often they have been
bothered by nine depression-related symptoms over the past
2 weeks. This brief assessment has shown adequate reliability.
Interviews ranged from 1 to 2.5 h and were audio
recorded and transcribed in Spanish. Participants received a
$30 gift card for participating. Research procedures were
75
approved by Georgetown University’s Institutional Review
Board.
Qualitative Data Analysis
Qualitative methods guided the analysis of women’s
experience of social isolation. The qualitative analysis of
the data proceeded in two stages. First, the research team
reviewed two interviews together to develop a preliminary
codebook with predetermined and emergent codes for
analysis and their definitions (e.g. types of trauma, types of
stress, social support) (Creswell 2009). Categories were
iteratively refined throughout the subsequent coding pro-
cess. Two team members independently coded each of the
remaining 26 interviews. Using the Consensual Qualitative
Research framework (Hill et al. 2005), the two team
members met after having coded each interview to com-
pare codes and achieve consensus in areas of disagree-
ment. An auditor reviewed the team coding and the final
coding was entered into a qualitative software analysis
(NVIVO) (see Kaltman et al. 2011).
Lack of social support emerged as an important code, as
several women noted being isolated and lacking support
from any source. While this first stage was useful to
identify important topics from the women’s narratives,
context was missing when re-reading the excerpts coded as
lack of social support. Therefore, the first author thor-
oughly reviewed the 28 interviews to gain a deeper
understanding of the experiences of social isolation and the
reasons for the challenges in establishing relationships in
the US. An initial line-by-line coding of two interviews
was conducted. The goal of this technique, often used in
early stages of coding, is to assign codes to almost every
line of the interview to start generating a list of emerging
codes that capture participant’s own words and expres-
sions. Using the method of constant comparison, these
codes were refined while coding the remaining interviews.
Focused coding helped to select those codes that better
captured women’s experiences. Writing memos about the
codes and research team discussions allowed for elevation
of some codes into the higher-order category of ‘‘social
isolation’’ and further exploration of the category’s prop-
erties and nuances (Charmaz 2006). Quotes representing
the themes noted in the Results section below were selected
by the team, translated into English and back-translated
into Spanish. Some quotes were shortened using an ellipse
(…) to indicate excluded text.
Results
On average, participants were 43 years old (SD = 11.72)
and had lived in the US for 11.39 years (SD = 7.10). The
123
76 Am J Community Psychol (2014) 53:73–82

most frequently represented countries of origin were El market, to sweep outside. There were stores nearby,
Salvador (32.1 %), Mexico (17.9 %), Honduras (17.9 %), and that was where we got together to talk with
and Guatemala (14.3 %). Other women were from Bolivia, everybody.
Peru, Chile, and Colombia. Nearly all (89.3 %) reported at
Another woman noted that her lack of familiarity in the US
least one form of trauma based on screening with the
kept her from going out: ‘‘I didn’t have a life. I was always
SLESQ (Corcoran et al. 2000). Approximately half of the
closed-in because I didn’t know anything.’’
women (53.6 %) met criteria for presumptive depression
The women also frequently referred to a lack of ‘‘lib-
and/or post-traumatic stress disorder.
ertad’’ (freedom). The term ‘‘libertad’’ was used to refer to
Participants described their experiences of feeling
women’s control over their time and money and how both
socially isolated and provided explanations for their limited
were spent. For example, one woman linked the meaning
social networks in the US. Their narratives triggered fre-
of freedom to the opportunity to communicate and spend
quent comparisons between their lives in the US and their
time with others, which is something that she reported
experiences in their home countries. In the following sec-
missing in the US: ‘‘That is what you miss, the freedom. In
tions, we first describe their experiences of social isolation,
the afternoons you can just go outside to talk with family
paying special attention to the words women used to
and your neighbors.’’ Some women equated freedom with
describe their feelings, and then we present participants’
the opportunity to engage in different activities with others
perceived obstacles to forging relationships in the US.
without necessarily spending money: ‘‘Back there it was
more fun because you are more free, more able to do
Experiences of Social Isolation
things. Here, just leaving your house will cost you $10.’’
They felt that their freedom was being undermined in the
Women often contrasted their lives in their countries of
US due to economic strain and the resulting lack of time to
origin, where they frequently interacted with family,
spend with family, friends or neighbors: ‘‘I like this country
friends, and neighbors, with the loneliness and lack of
but it is not the same, you are not completely free. Back
communication that characterized their lives in the US. For
there you don’t need to work that much in order to pay the
instance, when talking about relationships in her home
rent, the bills or everything you use.’’
country, a participant said: ‘‘There we had our families,
Limited relationships with family members, friends, and
friends, neighbors, we were in touch, we had parties and
neighbors contributed to feelings of social isolation. For
there was more affection’’ and later contrasted it with the
some women, experiences of isolation were tied to the
isolation she felt in the US: ‘‘You live isolated, in an
absence of family members. Many women reported miss-
apartment with a lot of people but at the same time you live
ing close family members that remained in their home
like on an island where you don’t talk to anyone… You are
country and some linked their feelings of sadness to being
always alone, friends are rare.’’
separated from their families. For several participants,
Feeling alone and isolated was a new experience for
however, having close family members in the US did not
many women. When asked about the most difficult or
readily translate into having available sources of support,
stressful situation experienced upon arrival one woman
which exacerbated perceptions of loneliness and lack of
mentioned: ‘‘getting used to the loneliness in which I came
support. For instance, a participant noted that she hardly
to live.’’ Not having a social network was perceived to
communicated with her mother or her father’s relatives that
complicate women’s efforts to improve their situation: ‘‘I
lived in the US and the subsequent lack of support: ‘‘I was
want to advance, be able to study, to work, but I don’t have
practically alone and sometimes when I needed to go to
anyone. I don’t have acquaintances, I don’t have my
work, I had no one to help me take care of my child.’’
family.’’
Several women expressed difficulty developing friend-
Several women used the words ‘‘encerrada’’ (closed-in)
ships in the US. Whereas in their home countries friends
to describe their experiences in the US. This term was used
felt as close as family members for many women, in the US
metaphorically when discussing the lack of opportunity to
friends were described as less close, less sincere, and less
spend time with others outside the home. Although women
trustworthy: ‘‘It is difficult to make friends because you
were not shut-ins, most of them described a feeling of
have to get to know someone well… A friend has to be
being closed-in here in the US. For example, one woman
there through the good and the bad… Here people greet
said, ‘‘I was closed-in like never before in my life.’’ In
you, talk briefly, and that’s all. One is always alone.’’
contrast, everyday activities in her home country were
Several participants clarified that they had acquaintances
more conducive to meeting and conversing with people:
or colleagues rather than real friends in the US: ‘‘Some
I used to live in the house where I worked [as a friendships are so close that they become like family. I
housekeeper] but we were able to go out to the haven’t found friends like the ones I had in Guatemala. I

123
Am J Community Psychol (2014) 53:73–82
have lived here for 8 years and I don’t have many close
friends.’’
In their countries of origin, neighbors were often con-
sidered close persons who could provide companionship
and resources. Several women reported missing the
everyday casual interaction with their neighbors as well as
the habit of visiting neighbors. Contrarily, in the US many
felt that not knowing their neighbors contributed to their
feelings of loneliness and isolation, as one woman noted:
‘‘Sometimes you live together and you don’t even know
your neighbors, so it is better to be reserved.’’
Barriers to Establishing Social Networks in the US
Women mentioned several obstacles and challenges they
encountered when attempting to meet new people or to
develop closer relationships with the people they did meet.
Participants’ perceived obstacles were classified into three
types: socioeconomic, environmental, and psychosocial.
Socioeconomic Barriers
Most participants reported feeling enormous pressure to
cover their expenses in the US and to send money to their
relatives in their home countries. For some, paying rent
was a new and stressful experience as they were not
accustomed to paying for housing in their country of origin.
One woman stated that in her home country she could rely
on neighbors in times of need, whereas she felt that this
was not an option in the US:
If I hadn’t paid the water bill, they wouldn’t come to
cut the service or at least I would have gone to the
neighbor, ‘would you share some water with me?’
Here, if you don’t pay for everything, they take it
away from you and you live stressed.
With the pressure to cover expenses, several women
described how they got absorbed into demanding job
schedules that left little time for socializing and spending
time with others: ‘‘In my country I had a lot of friends.
They used to tell me their problems and we joked together.
Here I go from home to work and from work back home,
and on my day off I sleep.’’ In addition to their own tight
schedules, some women mentioned how difficult it was to
coordinate their free time with other people’s schedules,
which often resulted in limited chances to develop closer
friendships; ‘‘There is no time to make friends (because of
differences in) work schedules. When some people work it
is your day off and vice versa.’’
In this context of constant stress and lack of leisure time,
the habit of visiting neighbors that was common in many
women’s home countries became hard to sustain in the US:
‘‘People here are too busy, there is no time for you to visit
77
your neighbor or for your neighbor to visit you.’’ One
woman further explained how in her country it was com-
mon to offer food when neighbors came to visit. She felt
that in the US people did not maintain that custom, pos-
sibly due to difficult economic situations that could make
people become less able or willing to give.
In a climate of scarce resources, relationships can
become burdensome and result in unmet expectations of
reciprocity. For instance, a participant explained her reti-
cence in making friends because she felt that people only
contacted her to ask for favors but never returned the help
when she was the one in need:
You cannot call them friends because when they need
something they say ‘look, I need to eat,’ and some-
times I have something like beans and eggs, so I say
‘here, let’s share’… When I’m the one who doesn’t
have money even to buy a coffee, nobody says ‘I can
give you this.’
Some women also noted how a climate of competition
fostered envy and lack of cooperation, which hindered the
chances of developing closer friendships. For instance, one
participant explained that when she was given a lot of
responsibility at a new job, she realized that her acquain-
tances got envious instead of feeling happy for her: ‘‘Here I
have seen the worst… My husband used to tell me ‘here the
people, and even you at some point, will have to step on
others to make progress.’’’ Despite similar backgrounds,
economic competition impeded the sense of community, as
another woman said: ‘‘There is a lot of hypocrisy and
ambition in people. They don’t care about others, if
someone has fallen down, another Hispanic person would
step on that person to climb higher.’’
Environmental Barriers
In addition to the socioeconomic barriers, women brought
up environmental obstacles to establishing relationships or
to spending time with others that included the structure of
their surrounding physical space, limited access to public
transportation, and weather conditions. Several women
described how the places where they lived or worked in
their home countries fostered more everyday random
encounters with neighbors, friends or family, thus
increasing the possibility of communicating and interacting
with others: ‘‘We used to go out in the street and a neighbor
was there so we could have a conversation… we would
sweep the street and the neighbor was there… But not
here.’’ As this comment suggests, the physical structure of
the houses and the design of the neighborhoods where
women lived likely made everyday activities, such as
sweeping, more conducive for in-person interactions.
123
78
One woman explained that she had never felt isolated
until she started working in a house that was very remote:
‘‘There were no buses nearby. If I didn’t have someone
picking me up, I would have to stay closed-in at home.’’
Another woman mentioned how far distances and mobility
restricted her chances of meeting and staying in touch with
people: ‘‘Here people live far away from each other.
Sometimes, the friends you make move to other places.’’
Additionally, for a few women, moving to a colder
climate limited their opportunities to go out and interact
with others. For instance, a woman noted how she missed
the fun activities she used to do back in her home country
and contrasted this with her experience in the US: ‘‘Here
the cold weather does not allow you to go out… My three
first Decembers made me cry.’’
Psychosocial Barriers
In addition to the barriers described above, women also
mentioned psychosocial obstacles that limited their
opportunities to build or maintain relationships including
difficulties building trust, their emotional state, or rela-
tionships with controlling significant others. Several par-
ticipants explained their reluctance to develop closer
relationships with others due to the lack of trust: ‘‘I don’t
have many friends… We can talk about things but later I
find out they have told others what I shared with them. It is
difficult to find sincere friends.’’
Some women reported becoming more reserved and
secluded in the US because they found it difficult to build
trust as they did not interact frequently enough to get to
know people or they did not have a shared past to rely on.
As one woman noted: ‘‘Here I have become quiet and
isolated. Not there. There I had friends who I trusted
because we had known each other from school, so we care
about each other.’’ Additionally, some women expressed
difficulty developing deeper relationships because of war-
iness to become involved in the problems of others as well
as the perception that everyone was focused on their own
struggles, as one woman said: ‘‘A lot of times people are
living their own lives, focused on their own business and
problems. It is difficult [to make friends]’’.
Other women explained how their emotional state
impacted their ability or willingness to establish mean-
ingful relationships; feeling depressed or stressed pre-
vented them from taking advantage of opportunities to
engage in activities with others. For instance, one woman
noted how her depression had reduced her motivation to
stay in touch with her friends, ‘‘I am a very sociable person.
I have a lot of friends here, but I am not in touch with them
anymore. I don’t even feel like talking to them by the
phone. I’m not feeling well.’’ Additionally, some women
reported having controlling partners or relatives who
123
Am J Community Psychol (2014) 53:73–82
limited their chances of meeting new people or their ability
to preserve friendships: ‘‘I used to have more friends but
my ex-husband prohibited me from seeing or talking to
them. I ended up not having any friends.’’ One woman,
who was engaged, mentioned that when she arrived in the
US, her father did not let her go out with friends because he
thought it was inappropriate to go out without her fiancé
(who was still en route to the US). Psychosocial obstacles
such as these hindered the development of social networks
in the US and impacted the relationships that were more
likely to emerge.
Discussion
This study sought to analyze experiences of social isolation
among Latina immigrants exposed to trauma as well as
their perceived barriers for developing relationships in the
US. Contrary to the research that highlights Latino immi-
grants’ reliance on networks of family and friends (e.g.
Parra-Cardona et al. 2006; Vega et al. 1991), our research
supports the findings of studies which have documented
Latinos’ perceived social isolation and difficulties building
social networks (e.g. Callister et al. 2011; Ornelas et al.
2009; Parrado et al. 2005). Compared to their experiences
in their home countries, Latinas reported feeling socially
isolated as they faced important lifestyle changes that were
not always conducive to forging meaningful relationships.
Women described socioeconomic, environmental, and
psychosocial barriers to establishing social networks in the
US.
Participants expressed missing family members that
stayed in their home countries and described difficulties
with unsupportive family members in the US. Developing
close friendships or interacting with neighbors was also
deemed to be harder in the US, which added to their
feelings of isolation. Our findings regarding feelings of
loneliness due to family separation (e.g. Callister et al.
2011; Negi 2013; Ornelas et al. 2009) and unmet expec-
tations of support from family members in the US (Men-
jivar 2000; Viruell-Fuentes and Schulz 2009) have been
observed in other samples, as have the use of the phrases
such as being ‘‘closed-in’’ and ‘‘lacking freedom’’ (e.g.
Ornelas et al. 2009; Viruell-Fuentes and Schulz 2009). This
study thus corroborates previous research on perceptions of
isolation and lack of social support in a trauma-exposed
Latina sample from diverse nationalities, including an
understudied population of immigrants from Central and
South America, and explored further the meanings of these
words.
In our study, socioeconomic barriers such as the pres-
sure to work and the subsequent lack of time for socializing
impacted the structure of the network by limiting the
Am J Community Psychol (2014) 53:73–82
number of people women interact with as well as the
characteristics of the social networks (e.g. reducing the
frequency of contact with others). Our findings regarding
lack of time due to work schedules and competing priori-
ties as explanations for limited networks are in alignment
with prior studies with Latino samples (e.g. Bathum and
Baumann 2007; Sussner et al. 2008). As others have also
found (Bathum and Baumann 2007; Menjivar 2000; Vir-
uell-Fuentes and Schulz 2009), the climate of economic
scarcity also influenced the valence of the relationships
sometimes fostering competitive versus cooperative rela-
tionships or envy versus sympathy. It was not surprising
that socioeconomic barriers were very salient, as partici-
pants were low-income and the data was collected during
the peak of the US economic crisis in 2009.
With regard to environmental barriers, physical isolation
accompanied by limited transportation access, the design of
physical spaces, and weather conditions were brought up
by women to explain the reduced likelihood of interacting
with neighbors, friends or family. This finding contributes
to the recognized impact of environmental factors in social
relationships and health. For instance, Brown et al. (2009)
found that some architectural features that are conducive to
face-to-face interactions (e.g. outside porches) were asso-
ciated with more perceived social support and reduced
psychological distress in a sample of Hispanic elders.
Another recent study (Roy et al. 2013) found that neigh-
borhood characteristics (high ethnic density accompanied
by low socioeconomic status) were related to poor self-
reported health among Island-born Puerto Ricans, sug-
gesting that scarcity may impair the supportive capacity of
members of one’s ethnic group. Limited access to trans-
portation (Viruell-Fuentes and Schulz 2009), working in
remote areas (Hagan 1998), and a physical environment not
being conducive to meet neighbors (Brown et al. 2009;
Ornelas et al. 2009) have been previously reported as
obstacles to forging social relationships and increased
feelings of isolation.
Finally, difficulty building trust to develop closer rela-
tionships, the impact of emotional states in reducing the
motivation to stay in touch with others, and having con-
trolling family members were psychosocial barriers
described by study participants that hindered their chances
of developing and nurturing social relationships. Similar
challenges building trusting relationships among the Latino
community were described in Menjivar’s (2000) study with
Salvadoran immigrants. Concerning the impact of con-
trolling family members, Parrado et al. (2005) noted that
social isolation made Mexican immigrant women more
dependent on their partners. If socially isolated women
depend on controlling partners who limit their interactions
with others, as some of our participants stated, the cycle of
isolation is reinforced and exacerbated.
79
Our results suggest that Latina immigrants may not only
face barriers to accessing formal health services described
in the literature (e.g. Livingston et al. 2008) but they may
also face important barriers to establishing supportive
social networks. Therefore, it is important to understand
more fully the impact of each type of barrier and also their
possible interrelations. For instance, socioeconomic and
environmental barriers can limit face-to-face interactions,
promoting brief infrequent encounters with others, which
leaves little room to build trust (psychosocial barriers). The
stress and depression that partly results from this situation
can further reinforce this cycle of isolation. Thus, an
adaptation of Berkman et al.’s model (2000) that incor-
porates psychosocial factors as well as the dynamic inter-
relationships between the factors may be useful to account
for the complexity of women’s perceived experiences of
social isolation and its causes.
Understanding barriers to developing social networks is
crucial to inform interventions to help individuals learn
how to capitalize on the benefits of social networks and
social support. Practitioners sometimes hold stereotypic
perceptions of Latino clients and can disregard the pos-
sibility that they might be socially isolated (e.g. Barrio
et al. 2008; Phillips and Crist 2008). In this respect it
would be helpful to assess Latino’s social support net-
works and incorporate a social support component in
mental health interventions (e.g. Barrio et al. 2008;
Callister et al. 2011; Hiott et al. 2006; Ornelas et al.
2009). However, in doing this work it is important to keep
in mind that social networks are not always supportive, as
relationships with others can be conflict-laden or bur-
densome, especially for low-income populations for
whom networks can become draining in a context of
scarce resources and for women in particular as they tend
to feel an obligation to provide support to others (e.g.
Falcon et al. 2009; Goodman et al. 2010; Kao 2004;
Kawachi and Berkman 2001; Menjivar 2000; Parrado
et al. 2005; Viruell-Fuentes and Schulz 2009). Addition-
ally, having experienced trauma as well as symptoms of
depression and PTSD can further limit the person’s ability
to nurture supportive relationships.
National surveys indicate that three-quarters of Latina
women have experienced some form of trauma (Fortuna
et al. 2008). In our sample, nearly all women were exposed
to multiple traumas and about half of the sample met
suspected criteria for depression and/or PTSD. Research
has shown social support to be associated with lower risk
as well as decreased severity of PTSD among individuals
who have experienced trauma (Charuvastra and Cloitre
2008; Schumm et al. 2006). As Latinos tend to rely more
on informal resources after traumatic experiences (Almeida
et al. 2009; Falcon et al. 2009; Ornelas and Perreira 2011;
Sabina et al. 2012), social support may be an important tool
123
80
for reducing the impacts of trauma on mental health in this
population.
Trauma-exposed women may benefit from social sup-
port to a greater extent than trauma-exposed men. One
study of victims of violent crime found both the positive
impact of satisfaction with social support as well as the
detrimental impact of negative social support on mental
health symptoms to be greater among women as compared
to men (Andrews et al. 2003). Thus, while the development
of supportive social networks may be an important means
of reducing the mental health impacts of trauma among
women (Schumm et al. 2006), it is important that those
networks provide positive support rather than negative
responses (Andrews et al. 2003). Furthermore, for indi-
viduals suffering from mental health disorders such as
depression, social support must be perceived as meeting
one’s needs to be effective (Ibarra-Rovillard and Kuiper
2011). Despite the potential beneficial impact of social
support on mental health of trauma-exposed women, our
study suggests that Latina women face tremendous chal-
lenges to forging social networks capable of providing
positive social support.
Future studies should analyze what types of social net-
works are more or less conducive to fostering positive
social support and what types of social support interven-
tions are more effective for trauma-exposed Latinas, as
little is known about which interventions may work better
for different populations and different types of problems
(Cacioppo and Hawkley 2003; Hogan et al. 2002). Com-
munity-based participatory research incorporates commu-
nity members well acquainted with community struggles
into the delineation of the research problems, design, and
delivery of the interventions. As such, this type of research
may yield particularly effective community-based inter-
ventions that target social isolation and mental health (e.g.
Kieffer et al. 2013; Hernandez and Organista 2013) while
addressing poverty and accounting for the impact of scar-
city in social support and mental health (e.g. Goodman
et al. 2010).
Several study limitations are worth mentioning. The
main goal of the study was to explore Latina women
experiences of trauma and its impact on physical and
mental health (Kaltman et al. 2011). Instances of social
isolation and challenges in developing social networks
were frequently voiced within these narratives, but the
study was not explicitly designed to analyze social isola-
tion. This might explain why we did not find additional
barriers to forging relationships that have been identified in
other studies such as migration status (e.g. Menjivar 1997;
Viruell-Fuentes and Schulz 2009), discrimination experi-
ences (Negi 2013), or racism and classism among Latinos
(e.g. Bathum and Baumann 2007; Menjivar 2000). The
sample was a convenience sample of Latina women, most
123
Am J Community Psychol (2014) 53:73–82
of which reported having experienced trauma and currently
feeling some symptoms of depression or anxiety, so the
results might not generalize to Latino men or Latinas who
were not seeking primary care or social services or who did
not experience traumatic events. The small sample size
additionally limits generalizability of the results.
The study contributes knowledge of an understudied
research area within an underrepresented population. Social
isolation and lack of social support have primarily been
studied quantitatively as predictors that influence health
outcomes while little is known about factors that influence
the development of social networks that have the potential to
provide social support. This study aimed to fill a gap in the
literature by qualitatively exploring the barriers to estab-
lishing social relationships, a prerequisite to obtain social
support and its possible health benefits, in a particularly
vulnerable population of trauma-exposed Latina women.
This qualitative analysis expands and complements previous
quantitative research by offering in depth insights into par-
ticipants’ experiences of social isolation that can help
develop social support interventions that take into account
women’s identified barriers to forging meaningful relation-
ships. While barriers to accessing formal services have been
extensively studied (e.g. Scheppers et al. 2006), it has not
been the case for informal social networks. Importantly,
little research has focused on the availability of supportive
social networks among trauma-exposed Latina immigrants.
By including Latina immigrants from diverse nationalities,
this study expanded a field that has tended to focus on
Latinos from Mexico, Puerto Rico or the Caribbean.
Although the size of the sample prevents us from discussing
differences among nationalities, future research should
continue exploring how differences in nationality as well as
generations or immigration and settlement patterns (Menji-
var 1997; Viruell-Fuentes and Schulz 2009) influence the
development of social networks that can potentially become
supportive and ultimately benefit health outcomes. Simi-
larly, future research is needed to explore similarities and
differences in the challenges to the establishment of infor-
mal social networks among trauma-exposed and non-trauma
exposed Latina immigrants in the US.
Acknowledgments This research was supported by a grant from the
National Institute of Mental Health (K23MH077071) to Dr. Kaltman.
The authors would like to acknowledge the assistance of Marta Ge-
novez who transcribed the interviews and Dr. Casaus and Dr. Ribes
who provided feedback on an earlier version of the manuscript.
References
Almeida, J., Molnar, B. E., Kawachi, I., & Subramanian, S. V. (2009).
Ethnicity and nativity status as determinants of perceived social
support: Testing the concept of familism. Social Science and
Medicine, 68, 1852–1858.
Am J Community Psychol (2014) 53:73–82
Alvidrez, J. (1999). Ethnic variations in mental health attitudes and
service use among low-income African American, Latina, and
European American young women. Community Mental Health
Journal, 35, 515–530.
Andrews, B., Brewin, C. R., & Rose, S. (2003). Gender, social
support, and PTSD in victims of violent crime. Journal of
Traumatic Stress, 16, 421–427.
Barrio, C., Palinkas, L. A., Yamada, A., Fuentes, D., Criado, V.,
Garcia, P., et al. (2008). Unmet needs for mental health services
for Latino older adults: Perspectives from consumers, family
members, advocates, and service providers. Community Mental
Health Journal, 44, 57–74.
Bathum, M. E., & Baumann, L. C. (2007). A sense of community
among immigrant Latinas. Family & Community Health: The
Journal of Health Promotion & Maintenance, 30, 167–177.
Berkman, L. F., Glass, T., Brissette, I., & Seeman, T. E. (2000). From
social integration to health: Durkheim in the new millennium.
Social Science and Medicine, 51, 843–857.
Brown, S. C., Mason, C. A., Lombard, J. L., Martinez, F., Plater-
Zyberk, E., Spokane, A. R., et al. (2009). The relationship of
built environment to perceived social support and psychological
distress in Hispanic elders: The role of ‘‘eyes on the street’’. The
Journals of Gerontology: Series B: Psychological Sciences and
Social Sciences, 64B, 234–246.
Cacioppo, J. T., & Hawkley, L. C. (2003). Social isolation and health,
with an emphasis on underlying mechanisms. Perspectives in
Biology and Medicine, 46, 39–52.
Callister, L. C., Beckstrand, R. L., & Corbett, C. (2011). Postpartum
depression and help-seeking behaviors in immigrant Hispanic
women. Journal of Obstetric, Gynecologic, & Neonatal Nursing:
Clinical Scholarship for the Care of Women, Childbearing
Families, & Newborns, 40, 440–449.
Charmaz, K. (2006). Constructing grounded theory: A practical guide
through qualitative analysis. LA: Sage.
Charuvastra, A., & Cloitre, M. (2008). Social bonds and posttrau-
matic stress disorder. Annual Review of Psychology, 59,
301–328.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the
buffering hypothesis. Psychological Bulletin, 98, 310–357.
Corcoran, C. B., Green, B. L., Goodman, L. A., & Krinsley, K. E.
(2000). Conceptual and methodological issues in trauma history
assessment. In A. Shalev, R. Yehuda, & A. C. McFarlane (Eds.),
International handbook of human response to trauma. New
York: Kluwer/Plenum.
Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness,
perceived isolation, and health among older adults. Journal of
Health and Social Behavior, 50, 31–48.
Creswell, J. W. (2009). Research design: Qualitative, quantitative,
and mixed methods approaches (3rd ed.). Los Angeles: Sage.
Eisenman, D. P., Gelberg, L., Liu, H., & Shapiro, M. F. (2003).
Mental health and health-related quality of life among adult
Latino primary care patients living in the United States with
previous exposure to political violence. JAMA: The Journal of
the American Medical Association, 290(5), 627–634.
Falcon, L. M., Todorova, I., & Tucker, K. (2009). Social support, life
events, and psychological distress among the Puerto Rican
population in the Boston area of the United States. Aging and
Mental Health, 13, 863–873.
Fortuna, L., Porche, M., & Alegria, M. (2008). Political violence,
psychosocial trauma, and the context of mental health services
among immigrant Latinos in the United States. Ethnicity &
Health, 13, 435–463.
Goodman, L. A., Smyth, K. F., & Banyard, V. (2010). Beyond the
50-minute hour: Increasing control, choice, and connections in
the lives of low-income women. American Journal of Ortho-
psychiatry, 80(1), 3–11.
81
Hagan, J. M. (1998). Social networks, gender, and immigrant
incorporation: Resources and constraints. American Sociological
Review, 63, 55–67.
Heikkinen, R. R. L., & Kauppinen, M. (2004). Depressive symptoms
in late life: A 10-year follow-up. Archives of Gerontology and
Geriatrics, 38, 239–250.
Hernandez, M. Y., & Organista, K. C. (2013). Entertainment–
education? A fotonovela? A new strategy to improve depression
literacy and help-seeking behaviors in at-risk immigrant Latinas.
American Journal of Community Psychology, 52, 224–235.
Hill, C. E., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A., &
Ladany, N. (2005). Consensual qualitative research: An update.
Journal of Counseling Psychology, 52, 196–205.
Hiott, A., Grzywacz, J. G., Arcury, T. A., & Quandt, S. A. (2006).
Gender differences in anxiety and depression among immigrant
Latinos. Families, Systems, & Health, 24, 137–146.
Hirschfeld, R. M. A., Montgomery, S. A., Keller, M. B., Kasper, S.,
Schatzberg, A. F., Möller, H.-J., et al. (2000). Social functioning
in depression: A review. Journal of Clinical Psychiatry, 61,
268–275.
Hogan, B. E., Linden, W., & Najarian, B. (2002). Social support
interventions: Do they work? Clinical Psychology Review, 22,
381–440.
Holman, E. A., Silver, R. C., & Waitzkin, H. (2000). Traumatic life
events in primary care patients: A study in an ethnically diverse
sample. Archives of Family Medicine, 9(9), 802.
Ibarra-Rovillard, M. S., & Kuiper, N. A. (2011). Social support and
social negativity findings in depression: Perceived responsive-
ness to basic psychological needs. Clinical Psychology Review,
31, 342–352.
Kaltman, S., Green, B. L., Mete, M., Shara, N., & Miranda, J. (2010).
Trauma, depression, and comorbid PTSD/depression in a
community sample of Latina immigrants. Psychological
Trauma: Theory, Research, Practice, and Policy, 2, 29–31.
Kaltman, S., Hurtado-de-Mendoza, A., Gonzales, F., Serrano, A., &
Guarnaccia, P. (2011). Contextualizing the trauma experiences
of women immigrants from Central America, South America,
and Mexico. Journal of Traumatic Stress, 24, 635–642.
Kao, G. (2004). Social capital and its relevance to minority and
immigrant populations. Sociology of Education, 77, 172–175.
Kawachi, I., & Berkman, L. F. (2001). Social ties and mental health.
Journal of Urban Health: Bulletin of the New York Academy of
Medicine, 78, 458–467.
Kieffer, E. C., Caldwell, C. H., Welmerink, D. B., Welch, K. B.,
Sinco, B. R., & Guzmán, J. R. (2013). Effect of the healthy
MOMs lifestyle intervention on reducing depressive symptoms
among pregnant Latinas. American Journal of Community
Psychology, 51(1–2), 76–89.
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9:
Validity of a brief depression severity measure. Journal of
General Internal Medicine, 16, 606–613.
Livingston, G., Minushkin, S., & Cohn, D. (2008). Hispanics and
health care in the United States: Access, information and
knowledge. Washington, DC: Pew Hispanic Center. Retrieved
from http://www.pewhispanic.org/files/reports/91.pdf.
Menjivar, C. (1997). Immigrant kinship networks: Vietnamese,
Salvadorans and Mexicans in comparative perspective. Journal
of Comparative Family Studies, 28, 1–24.
Menjivar, C. (2000). Fragmented ties: Salvadoran immigrant net-
works in America. Berkeley: University of California Press.
Mulvaney-Day, N. E., Alegria, M., & Sribney, W. (2007). Social
cohesion, social support, and health among Latinos in the United
States. Social Science and Medicine, 64, 477–495.
Negi, N. J. (2013). Battling discrimination and social isolation:
Psychological distress among Latino day laborers. American
Journal of Community Psychology, 51(1–2), 164–174.
123
82
Olatunji, B. O., Cisler, J. M., & Tolin, D. F. (2007). Quality of life in
the anxiety disorders: A meta-analytic review. Clinical Psychol-
ogy Review, 27, 572–581.
Ornelas, I. J., & Perreira, K. M. (2011). The role of migration in the
development of depressive symptoms among Latino immigrant
parents in the USA. Social Science and Medicine, 73,
1169–1177.
Ornelas, I. J., Perreira, K. M., Beeber, L., & Maxwell, L. (2009).
Challenges and strategies to maintaining emotional health:
Qualitative perspectives of Mexican immigrant mothers. Journal
of Family Issues, 30, 1556–1575.
Parra-Cardona, J. R., Bulock, L. A., Imig, D. R., Villarruel, F. A., &
Gold, S. J. (2006). Trabajando duro todos los dı́as: Learning
from the life experiences of Mexican-origin migrant families.
Family Relations, 55, 361–375.
Parrado, E. E. A., Flippen, C. A., & McQuiston, C. (2005). Migration
and relationship power among Mexican women. Demography,
42, 347–372.
Phillips, L. R., & Crist, J. (2008). Social relationships among family
caregivers: A cross-cultural comparison between Mexican
Americans and non-Hispanic white caregivers. Journal of
Transcultural Nursing, 19, 326–337.
Ribas, A. C., & Lam, C. S. (2010). Social support and quality of life
among Latinos with mental illness. Journal of Nervous and
Mental Disease, 198, 137–143.
Rivera, F. I. (2007). Contextualizing the experience of young Latino
adults: Acculturation, social support and depression. Journal of
Immigrant and Minority Health, 9, 237–244.
Roy, A. L., Hughes, D., & Yoshikawa, H. (2013). Intersections
between nativity, ethnic density, and neighborhood SES: Using
an ethnic enclave framework to explore variation in Puerto
Ricans’ physical health. American Journal of Community
Psychology, 51, 468–479.
Sabina, C., Cuevas, C. A., & Schally, J. L. (2012). The cultural
influences on help-seeking among a national sample of victim-
ized Latino women. American Journal of Community Psychol-
ogy, 49, 347–363.
123
View publication stats
Am J Community Psychol (2014) 53:73–82
Scheppers, E., Van Dongen, E., Dekker, J., Geertzen, J., & Dekker, J.
(2006). Potential barriers to the use of health services among
ethnic minorities: A review. Family Practice, 23, 325–348.
Schumm, J. A., Briggs-Phillips, M., & Hobfoll, S. E. (2006).
Cumulative interpersonal traumas and social support as risk
and resiliency factors in predicting PTSD and depression among
inner-city women. Journal of Traumatic Stress, 19, 825–836.
Sumner, L. A., Valentine, J., Eisenman, D., Ahmed, S., Myers, H.,
Wyatt, G., et al. (2011). The influence of prenatal trauma, stress,
social support, and years of residency in the US on postpartum
maternal health status among low-income Latinas. Maternal and
Child Health Journal, 15(7), 1046–1054.
Sussner, K. M., Lindsay, A. C., Greaney, M. L., & Peterson, K. E.
(2008). The influence of immigrant status and acculturation on
the development of overweight in Latino families: A qualitative
study. Journal of Immigrant and Minority Health, 10, 497–505.
United States Census Bureau. (2011). The Hispanic population: 2010.
Retrieved from http://www.census.gov/prod/cen2010/briefs/
c2010br-04.pdf.
Valle, R., & Bensussen, G. (1985). Hispanic social networks, social
support and mental health. In W. A. Vega & M. R. Miranda
(Eds.), Stress and Hispanic mental health: Relating research to
service delivery. MD: National Institute of Mental Health.
Vega, W. A., Kolody, B., Valle, R., & Weir, J. (1991). Social
networks, social support, and their relationship to depression
among immigrant Mexican women. Human Organization, 50,
154–162.
Viruell-Fuentes, E. A., & Schulz, A. J. (2009). Toward a dynamic
conceptualization of social ties and context: Implications for
understanding immigrant and Latino health. American Journal of
Public Health, 99, 2167–2175.
Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T.
M. (1993). The PTSD checklist: Reliability, validity, and
diagnostic utility. In Paper presented at the annual meeting of
the International Society for Traumatic Stress Studies, San
Antonio, TX.