Social Relationships and Mortality Risk: A Meta-analytic Review
TL;DR: In a meta-analysis, Julianne Holt-Lunstad and colleagues find that individuals' social relationships have as much influence on mortality risk as other well-established risk factors for mortality, such as smoking.
Abstract: Background
The quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.
Objectives
This meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.
Data Extraction
Data were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.
Results
Across 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).
Conclusions
The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.
Please see later in the article for the Editors' Summary
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TL;DR: Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
Abstract: Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
3,157 citations
Cites background or result from "Social Relationships and Mortality ..."
...…from this meta-analysis are consistent with prior evidence that has demonstrated higher survival rates for those who are more socially connected (Holt-Lunstad et al., 2010) and extend those findings by focusing specifically on measurement approaches that assess the relative absence of social…...
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...Overall, the findings from this meta-analysis are consistent with prior evidence that has demonstrated higher survival rates for those who are more socially connected (Holt-Lunstad et al., 2010) and extend those findings by focusing specifically on measurement approaches that assess the relative absence of social connections....
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...…lower than those reported previously for measures of social networks (OR = 1.45, 95% CI [1.32, 1.59]) and social integration (OR = 1.52, 95% CI [1.36, 1.69]) and were much lower than complex measures of social integration (OR = 1.91, 95% CI [1.63, 2.23]; see Table 4 of Holt-Lunstad et al., 2010)....
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...Being socially connected is not only influential for psychological and emotional well-being but it also has a significant and positive influence on physical well-being (Uchino, 2006) and overall longevity (Holt-Lunstad et al., 2010; House, Landis, & Umberson, 1988; Shor, Roelfs, & Yogev, 2013)....
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...…that heightened risk for mortality from a lack of social relationships is greater than that from obesity (Flegal, Kit, Orpana, & Graubard, 2013; Holt-Lunstad et al., 2010), with the risk from social isolation and loneliness (controlling for multiple other factors) being equivalent to the risk…...
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TL;DR: This work focuses on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies and considers research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction.
Abstract: Urbanization, resource exploitation, and lifestyle changes have diminished possibilities for human contact with nature in many societies. Concern about the loss has helped motivate research on the health benefits of contact with nature. Reviewing that research here, we focus on nature as represented by aspects of the physical environment relevant to planning, design, and policy measures that serve broad segments of urbanized societies. We discuss difficulties in defining “nature” and reasons for the current expansion of the research field, and we assess available reviews. We then consider research on pathways between nature and health involving air quality, physical activity, social cohesion, and stress reduction. Finally, we discuss methodological issues and priorities for future research. The extant research does describe an array of benefits of contact with nature, and evidence regarding some benefits is strong; however, some findings indicate caution is needed in applying beliefs about those benefits,...
2,046 citations
Cites background from "Social Relationships and Mortality ..."
...Much as for physical activity, abundant research has documented positive associations between social relationships and health and well-being (57, 97)....
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University of California, Santa Barbara1, University of Texas at Austin2, Dresden University of Technology3, University of Wrocław4, University of Tartu5, Gulu University6, Middle East University7, Stockholm University8, University of the Punjab9, University of Nigeria, Nsukka10, Istanbul University11, Franklin & Marshall College12, Norwegian University of Science and Technology13, University of Algiers14, Australian National University15, Russian Academy of Sciences16, Russian State University for the Humanities17, İzmir University of Economics18, University of Social Sciences and Humanities19, Université catholique de Louvain20, Ankara University21, Pontifical Catholic University of Peru22, Cumhuriyet University23, University of the Republic24, ISCTE – University Institute of Lisbon25, The Chinese University of Hong Kong26, National Autonomous University of Mexico27, University of Pécs28, University of Constantine the Philosopher29, University of Maribor30, University of Zagreb31, University of Malaya32, Central University of Finance and Economics33, University of Crete34, University of Primorska35, Institute of Molecular and Cell Biology36, University of Amsterdam37, Catholic University of the Sacred Heart38, VU University Amsterdam39, University of Granada40, University of Delhi41, University of Havana42, Pontifical Catholic University of Rio de Janeiro43, University of Vienna44, Universiti Utara Malaysia45, Vilnius University46, University of British Columbia47, University of Sussex48, Romanian Academy49, Comenius University in Bratislava50, Slovak Academy of Sciences51, University of Monterrey52, SAS Institute53, DHA Suffa University54, Pontifical Catholic University of Chile55, South-West University "Neofit Rilski"56, University of São Paulo57, Kyung Hee University58, University of Ljubljana59
TL;DR: This work combines this large cross-cultural sample with agent-based models to compare eight hypothesized models of human mating markets and finds that this cross-culturally universal pattern of mate choice is most consistent with a Euclidean model of mate preference integration.
Abstract: Humans express a wide array of ideal mate preferences. Around the world, people desire romantic partners who are intelligent, healthy, kind, physically attractive, wealthy, and more. In order for these ideal preferences to guide the choice of actual romantic partners, human mating psychology must possess a means to integrate information across these many preference dimensions into summaries of the overall mate value of their potential mates. Here we explore the computational design of this mate preference integration process using a large sample of n = 14,487 people from 45 countries around the world. We combine this large cross-cultural sample with agent-based models to compare eight hypothesized models of human mating markets. Across cultures, people higher in mate value appear to experience greater power of choice on the mating market in that they set higher ideal standards, better fulfill their preferences in choice, and pair with higher mate value partners. Furthermore, we find that this cross-culturally universal pattern of mate choice is most consistent with a Euclidean model of mate preference integration.
1,827 citations
Book•
01 Jan 2010
TL;DR: The Spirit Level as discussed by the authors provides hard evidence to show how almost everything -from life expectancy to depression levels, violence to illiteracy - is affected not by how wealthy a society is, but how equal it is; that societies with a bigger gap between rich and poor are bad for everyone in them -including the well-off; and how we can find positive solutions and move towards a happier, fairer future.
Abstract: Why do we mistrust people more in the UK than in Japan? Why do Americans have higher rates of teenage pregnancy than the French? What makes the Swedish thinner than the Greeks? The answer: inequality. This groundbreaking book, based on years of research, provides hard evidence to show: how almost everything - from life expectancy to depression levels, violence to illiteracy - is affected not by how wealthy a society is, but how equal it is; that societies with a bigger gap between rich and poor are bad for everyone in them - including the well-off; and, how we can find positive solutions and move towards a happier, fairer future. Urgent, provocative and genuinely uplifting, "The Spirit Level" has been heralded as providing a new way of thinking about ourselves and our communities, and could change the way you see the world.
1,608 citations
TL;DR: It was found that mortality was higher among more socially isolated and more lonely participants, and the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation.
Abstract: Both social isolation and loneliness are associated with increased mortality, but it is uncertain whether their effects are independent or whether loneliness represents the emotional pathway through which social isolation impairs health. We therefore assessed the extent to which the association between social isolation and mortality is mediated by loneliness. We assessed social isolation in terms of contact with family and friends and participation in civic organizations in 6,500 men and women aged 52 and older who took part in the English Longitudinal Study of Ageing in 2004–2005. A standard questionnaire measure of loneliness was administered also. We monitored all-cause mortality up to March 2012 (mean follow-up 7.25 y) and analyzed results using Cox proportional hazards regression. We found that mortality was higher among more socially isolated and more lonely participants. However, after adjusting statistically for demographic factors and baseline health, social isolation remained significantly associated with mortality (hazard ratio 1.26, 95% confidence interval, 1.08–1.48 for the top quintile of isolation), but loneliness did not (hazard ratio 0.92, 95% confidence interval, 0.78–1.09). The association of social isolation with mortality was unchanged when loneliness was included in the model. Both social isolation and loneliness were associated with increased mortality. However, the effect of loneliness was not independent of demographic characteristics or health problems and did not contribute to the risk associated with social isolation. Although both isolation and loneliness impair quality of life and well-being, efforts to reduce isolation are likely to be more relevant to mortality.
1,584 citations
Cites background from "Social Relationships and Mortality ..."
...S relationships are central to human well-being and are critically involved in the maintenance of health (1, 2)....
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01 Jan 2000TL;DR: Putnam as mentioned in this paper showed that changes in work, family structure, age, suburban life, television, computers, women's roles and other factors are isolating Americans from each other in a trend whose reflection can clearly be seen in British society.
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...13) and for continuous variables (mean intraclass correlation [26] = 0....
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TL;DR: The four articles in this special section onMeta-analysis illustrate some of the complexities entailed in meta-analysis methods and contributes both to advancing this methodology and to the increasing complexities that can befuddle researchers.
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TL;DR: There is evidence consistent with both main effect and main effect models for social support, but each represents a different process through which social support may affect well-being.
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