Showing papers by "Linda J. Waite published in 2009"

Social Disconnectedness, Perceived Isolation, and Health among Older Adults

Abstract: 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.

Marital Biography and Health at Mid-Life

Abstract: This article develops a series of hypotheses about the long-term effects of one's history of marriage, divorce, and widowhood on health, and it tests those hypotheses using data from the Health and Retirement Study. We examine four dimensions of health at mid-life: chronic conditions, mobility limitations, self-rated health, and depressive symptoms. We find that the experience of marital disruption damages health, with the effects still evident years later; among the currently married, those who have ever been divorced show worse health on all dimensions. Both the divorced and widowed who do not remarry show worse health than the currently married on all dimensions. Dimensions of health that seem to develop slowly, such as chronic conditions and mobility limitations, show strong effects of past marital disruption, whereas others, such as depressive symptoms, seem more sensitive to current marital status. Those who spent more years divorced or widowed show more chronic conditions and mobility limitations.

Measuring Social Isolation Among Older Adults Using Multiple Indicators From the NSHAP Study

Abstract: Previous research has identified social isolation as a risk factor for physical and mental health problems (e.g., Berkman, 1995; Cacioppo & Hawkley, 2003; Cacioppo, Hughes, Waite, Hawkley, & Thisted, 2006; House, 2001). Socially disconnected and lonely individuals tend to suffer higher rates of morbidity and mortality (Taylor, Repetti, & Seeman, 1997; Thoits, 1995) as well as infection (Cohen, Doyle, Skoner, Rabin, & Gwaltney, 1997; Pressman et al., 2005), depression (Heikkinen & Kauppinen, 2004), and cognitive decline (Wilson et al., 2007). The mere presence of another individual can alleviate stress (Cohen & Williamson, 1991; Thoits), whereas feelings of loneliness may exacerbate the physiological effects of stress, resulting in elevated cortisol levels (Hawkley, Burleson, Berntson, & Cacioppo, 2003; Steptoe, Owen, Kunz-Ebrecht, & Brydon, 2004) and blood pressure (Hawkley et al). The purpose of this article is to demonstrate the development of scales capturing social disconnectedness and perceived isolation using data from the National Social Life, Health, and Aging Project (NSHAP). We use procedures of scale construction to combine multiple indicators of isolation into a scale assessing social disconnectedness and a scale capturing perceived isolation. We then examine the relationship between disconnectedness and perceived isolation and assess their distributions across age, gender, and self-rated health among older adults. Our aim is not to present these scales as definitive measures but to encourage further work toward elucidating the concept, causes, and consequences of social isolation among older adults. Social Isolation Among Older Adults The examination of social isolation among older adults is particularly important for a number of reasons. First, there is some evidence that social isolation may become more common with increasing age. Older adults tend to have smaller social networks (McPherson, Smith-Lovin, & Brashears, 2006) and are more likely to experience feelings of loneliness (Dykstra, van Tilburg, & de Jong Gierveld, 2005). This may be due, in part, to older adults’ experiences of bereavement and their greater likelihood of living alone (Kramarow, 1995; Li & Ferraro, 2005). The correspondence of these conditions has led to the assumption that diminishing social networks result in lower levels of perceived social support and increased loneliness. However, recent research suggests that changes across the life course in social connectedness and satisfaction may be heterogeneous. For example, data from NSHAP indicate that the oldest old have greater participation than the young old (Cornwell, Laumann, & Schumm, 2008), and other research suggests that loneliness may peak in middle age (Carstensen, Isaacowitz, & Charles, 1999). Accordingly, social connectedness, support, and loneliness may not be inextricably linked, especially among older adults. In the face of shrinking social networks, older adults may develop closer relationships and shift expectations so that decreasing connectedness does not necessarily result in the perception of isolation (Lang & Carstensen, 1994; Schnittker, 2007). Finally, to the extent that social isolation is associated with worse health, it may pose a particularly severe risk for older adults. Older adults are more likely to experience bereavement and develop health problems, both of which may increase their need for social support and companionship. As a result, social isolation may be particularly deleterious for older adults. Indeed, research indicates that older adults who experience one or another aspect of isolation have been found to be at greater risk for all-cause mortality, increased morbidity, depression, and cognitive decline (Brummett et al., 2001; Cacioppo & Hawkley, 2003; House, Landis, & Umberson, 1988; Sherbourne, Meredith, Rogers, & Ware, 1992; Tomaka, Thompson, & Palacios, 2006). Measuring Social Isolation The variety of indicators of isolation and loneliness used across research in different disciplines is both a blessing and a curse. This work has captured an enormous number of facets of individuals’ everyday social worlds. Indicators of isolation in previous research include living alone (Dean, Kolody, Wood, & Matt, 1992; Hughes & Gove, 1981; Waite & Hughes, 1999), being unmarried (Lillard & Waite, 1995; Ross, 1995), having a small social network (Berkman & Syme, 1979; Seeman, Berkman, Blazer, & Rowe, 1994), infrequent contact with network members (Brummett et al., 2001), a lack of social network diversity (Barefoot, Gronbaek, Jensen, Schnohr, & Prescott, 2005), a perceived lack of social support (Blazer, 1982; Krause, 1987; Lin, Ye, & Ensel, 1999; Wethington & Kessler, 1986), low participation in social activities (Benjamins, 2004; Ellison & George, 1994; Thoits & Hewitt, 2001), emotionally distant relationships (Uno, Uchino, & Smith, 2002), and feelings of loneliness or not belonging (Cacioppo et al., 2006; Hawkley et al., 2003). However, most of this work has been limited to the examination of only one or two indicators of isolation (or connectedness), or it has focused on only one conceptual area, such as support, participation, or loneliness. As a result, it is difficult to discern whether multiple features of isolation might combine to create particularly severe situations of social isolation among the oldest old. It is also unclear whether feelings of loneliness and a lack of social support do, in fact, follow the loss of social network ties or if more subjective appraisals of isolation are separate from objective features of isolation. In efforts to consolidate multiple measures of social isolation, several authors have previously identified central components of isolation. For example, van Baarsen, Snijders, Smit, and van Duijn (2001) distinguish between social loneliness, as the lack of integration and companionship, and emotional loneliness, as the lack of an attachment figure. De Jong Gierveld and Hagestad (2006) similarly contrast isolation (as the opposite of integration) with loneliness (as the opposite of embeddedness). Following these distinctions and building from the disciplinary approaches of both sociology and psychology, we suggest two distinct aspects of social isolation. Social disconnectedness can be characterized by a lack of contact with others and indicated by situational factors, such as a small social network, infrequent interaction, and a lack of participation in social activities and groups. Perceived isolation, on the other hand, can be characterized by the subjective experience of a shortfall in one’s social resources such as companionship and support. Individuals who are socially disconnected may have small social networks, interact with network members infrequently, and rarely participate in social activities. On the other hand, individuals who perceive themselves to be isolated may report feelings of loneliness and perceive a lack of social support from friends and family members. Social disconnectedness and perceived isolation are related, but we hypothesize that they are distinct. Some research indicates, for example, that feelings of loneliness are responsive to changes in network size, but other findings indicate only a modest correlation between disconnectedness and perceived isolation (Hawkley et al., 2003; Hughes, Waite, Hawkley, & Cacioppo, 2004; Schnittker, 2007). Although physical separation from others and feelings of loneliness may go hand-in-hand for some individuals, infrequent social interaction may not lead to feelings of loneliness for others. Alternatively, people who are socially active and embedded within an expansive social network may feel socially isolated if their relationships lack emotional closeness and support.

Sexuality: Measures of Partnerships, Practices, Attitudes, and Problems in the National Social Life, Health, and Aging Study

Abstract: Objectives. The National Social Life, Health, and Aging Project (NSHAP) was designed to examine the relationship between sexual behavior, sexual problems, and health among older women and men. We describe measures of sexual partnerships, sexual practices, sexual problems, attitudes toward sex, and nonsexual intimacy in the fi rst wave of NSHAP. Methods. We compare measures of sexuality for those 57 ‐ 85 years old, by age, separately for men and women. We construct scales of sexual mores, sexual interest, and relationship satisfaction and discuss properties of each scale. Results. Sexuality among older adults tends to vary with age and gender. At all ages in this study, men are more likely than women to have a partner, more likely to be sexually active with that partner, and tend to have more positive and permissive attitudes toward sex. The proportions in a sexual partnership, behavior, problems, and attitudes all differ substantially by age. And these age patterns often differ for men and women. Discussion. Data obtained in the NSHAP can be used to construct key measures of sexuality among older adults; to examine sexuality itself; and to explore the link between sexuality, health, well-being, and other dimensions of the lives of older adults.

The Changing Family and Aging Populations

Abstract: This is an expanded version of comments on the future of the demography of aging at an invited session of the 2008 annual meeting of the Population Association of America. In an introduction, John Haaga offers reasons for a revival of interest in population aging, including greater realization of plasticity in aging trajectories at both individual and societal levels. Linda Martin proposes that population scientists working in aging emulate those studying fertility and family planning in previous decades, learning from interventions (in this case, aimed at increasing retirement savings and reducing disability at older ages). Changes in family structure will increasingly affect new cohorts of the elderly, and Linda Waite speculates on the ways in which changes in the economy, medicine, and the legal environment could affect the social context for aging. Research on mortality at older ages is “alive and well” asserts James Vaupel, who sets out six large questions on mortality trends and differentials over time and across species. Lastly, Wolfgang Lutz expands the scope of projections, showing the considerable uncertainty about the timing and pace of population aging in the developing world and the effects on future elderly of the increases in educational attainment in much of the world during the second half of the twentieth century.