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Previous research has identified a wide range of indicators of social isolation that pose health risks, including living alone, having a small social network, infrequent participation in social activities, and feelings of loneliness. However, multiple forms of isolation are rarely studied together, making it difficult to determine which aspects of isolation are most deleterious for health. Using population-based data from the National Social Life, Health, and Aging Project, we combine multiple indicators of social isolation into scales assessing social disconnectedness (e.g., small social network, infrequent participation in social activities) and perceived isolation (e.g., loneliness, perceived lack of social support). We examine the extent to which social disconnectedness and perceived isolation have distinct associations with physical and mental health among older adults. Results indicate that social disconnectedness and perceived isolation are independently associated with lower levels of self-rated physical health. However, the association between disconnectedness and mental health may operate through the strong relationship between perceived isolation and mental health. We conclude that health researchers need to consider social disconnectedness and perceived isolation simultaneously.
Health risks associated with social isolation have been compared in magnitude to the well- known dangers of smoking cigarettes and obe- sity (House 2001). Individuals who lack social connections or report frequent feelings of lone- liness tend to suffer higher rates of morbidity and mortality (Brummett et al. 2001; Seeman 2000; Uchino, Cacioppo, and Kiecolt-Glaser 1996), as well as infection (Cohen et al. 1997; Pressman et al. 2005), depression (Heikkinen and Kauppinen 2004), and cognitive decline (Barnes et al. 2004; Wilson et al. 2007). Yet, compared to health behaviors such as smoking and obesity, much less is known about how and why social isolation affects health (Cacioppo and Hawkley 2003; House, Landis, and Umberson 1988).
One problem is that most research on social connectedness and health focuses on only one or two measures of social isolation, often due to data limitations (House 2001). Across a of studies, a number of indicators of isolatlon have been associated with worse health, such as living alone, having a small social network, low participation in social activities, a perceived lack of social support, and feelings of loneliness (Berkman and Syme 1979; Dean et al. 1992; Hawkley et al. 2006; Krause 1987; Thoits and Hewitt...