The Second Fifty Years Promoting Health and Preventing Disability (1992) / Chapter Skim
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Social Isolation Among Older Individuals: The Relationship to Mortality and Morbidity
Social Isolation Among Older Individuals: The Relationship to Mortality and Morbidity
Pages 243-262
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From page 243... ...
A consideration of social isolation almost always occurs in the context of social support, and the two in most cases are used interchangeably. Both concepts have been defined inexactly over the past few deca(les, and this lack of a standard definition has become more apparent with the increase in the body of work analyzing social isolation as a risk factor for the general well-being of the older population.
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From page 244... ...
This definition is thus a qualitative one denoting the absence of meaningful relationships. Social support has been used as and continues to be an indicator of the degree of social isolation, and it can serve as the major independent variable in studies of the effect of social isolation as a risk factor of disease or dysfunction.
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From page 245... ...
levels of risk factors, onset of clinical disease, gap between onset and diagnosis and treatment, case fatality)
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From page 246... ...
.~7 \ Costs The very early, almost primitive level of definition, measurement, and hence attribution of specific risk to this factor in disease and its outcome is undoubtedly the basis for the lack of estimates of the cost of social isolation, although related areas have been studied. There have been rough estimates made of the cost to families and other care givers for specific diseases, notably Alzheimer's disease in addition, there have been efforts made to analyze the cost-effectiveness of prevention programs for older individuals.
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From page 247... ...
. One seminal theory, linking social isolation and resultant stress to weakened host resistance, suggests a nonspecific effect.
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From page 248... ...
2. How are existing biological risk factors and the structure of social supports representing psychological risk factors related in the overall disease etiology?
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From page 249... ...
The role in health of such phenomena as social support and social isolation has its roots in early consideration and theoretical formulation of the mind/body controversy. Despite the hazy and at times unscientific approaches to this area of human functioning, the role of psychosocial concepts in disease and health demands attention.
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From page 250... ...
This association occurred only for the older age group (aged 65 and older) , suggesting that risk factors may change at different ages.27 Reed and colleagues36 reported that prevalence rates for myocardial infarction, angina, and all coronary heart disease were associated with a lack of social network Ithe study controlled for 12 other
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From page 251... ...
WalIston and colleagues maintain that these studies fail to distinguish between psychosocial assets as a buffer against the negative health effects of stressful situations and social support as a buffer against illness occurrence. There have been attempts to identify a relationship between social network characteristics and patterns of utilization of health care, but these authors feel the findings from this research are equivocal.
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From page 252... ...
2. Consistency: There is a similarity in the direction and magnitude of effect across all major study designs and across a wide variety of age, sex, race, ethnic, and health status groups.
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From page 253... ...
Langlie3i suggests the effect derives from preventive health practices or the buffer or indirect effect. People with strong social networks will be encouraged and actively assisted in following better health practices, thereby achieving better health and increased longevity.
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From page 254... ...
Rook39 delineates three levels at which intervention against social isolation may occur: to prevent loneliness, to help the already lonely person establish satisfying interpersonal ties, and to prevent loneliness from evolving into or contributing to more serious problems. Interventions can seek to restructure existing opportunities for social contact or create new opportunities for social contact through network building, thereby bolstering an individual's ability to cope with social Toss.
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From page 255... ...
Effectiveness of Each Intervention Blooms summarized the literature on recent prevention programs in a monograph for the National Institute of Mental Health that was written for the purpose of disseminating and exchanging information on prevention activities. He notes the difficulty of evaluating such programs, especially primary prevention in mental morbidity, and underscores the nonspecific nature of the causal link between concepts of social isolation and social support and disease.
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From page 256... ...
From this combination of "conventional wisdom" and certain established facts, tentative recommendations can be made regarding the role of services in approaches to social isolation.
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From page 257... ...
Research The knowledge base for social isolation as a risk factor for disease, for functional incapacity in general, and for disability and handicap as a result of that incapacity is in an early, even primitive stage when compared with knowledge regarding the risk of smoking, the importance of dietary control, and other more directly observable and more thoroughly researched areas. However, the work to date provides sufficient evidence of the serious consideration commanded by social isolation as a risk factor.
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From page 258... ...
. This research should be integrated into experimental, targeted intervention studies for reducing the risk factor of social isolation and for examining the effects of doing so.
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From page 259... ...
L Stressful Life Event Theory and Research: Implications for Primary Prevention.
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From page 260... ...
Social isolation. In: The Encyclopedia of Aging.
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From page 261... ...
Reed, D., McGee, D., Yano, K., et al. Social networks and coronary heart disease among Japanese men in Hawaii.
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From page 262... ...
H Stressful Life Events, Social Support Networks and Gerontological Health.
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