Isolation, Health Effects

Isolation and Mortality

The notion that social isolation has powerful effects on well-being and mortality was proposed in social theory over a century ago. In his sociological study of social regulation in the late 1800s, Émile Durkheim concluded that low levels of social attachment led to a higher likelihood of suicide, highlighting the pivotal role of social bonding in individual and societal survival. More than a half-century later, epidemiological studies began to confirm the impact of social isolation on mortality. Common among these and more current studies has been the extensive measurement of family ties, friendships, marital status, and group memberships in order to characterize individuals' social integration. Provocative evidence [Page 933]has accumulated that having fewer social ties is as good a predictor of earlier death as are substantial biomedical risks like cigarette smoking and sedentary lifestyle. In their seminal study of almost 7,000 residents of Alameda County, California, Lisa Berkman and S. Leonard Syme found that individuals who reported the fewest social ties were significantly more likely to die over a 9-year period compared with those having the highest levels of social connections, even after controlling for well-established biomedical risk factors. A later reanalysis of the Alameda County study data by Teresa Seeman and her colleagues suggested that the importance of various social ties changes for survival as people age. Although being unmarried related more strongly to earlier death than ties with family and friends for residents below age 60, among those older than 60, having fewer than five contacts per month with close friends and/or family was a better predictor of mortality than marital status. Notably, social isolation among those older than 60 related to a 17 percent higher risk of death, compared with older adults with 5 or more family or friend contacts per month.

Since the 1970s, associations between isolation and mortality have been widely replicated with residents from Tecumseh, Michigan; Durham County, North Carolina; Evans County, Georgia; Sweden; and Finland, among various samples. In some studies, the effects of isolation on survival have been stronger for men than women, and racial differences have also been found, but more research is needed to determine the nuances of the isolation and health link. In all, supported by strong evidence from these large-scale, general population-based studies, the association between isolation and mortality has gained a foothold in the biomedical and behavioral science literatures, substantiating long-held beliefs about the role of social relationships to human survival.

...