Older adults who are socially isolated may not necessarily see doctors or visit health clinics more often than their peers who have close ties to many friends and family members, a research review suggests.
When their health takes a turn for the worse, however, older people without strong social relationships may be more likely to have long hospital stays and repeat hospitalizations, researchers report in the American Journal of Public Health.
“It is evident that strong social relationships (i.e., large social network, close interpersonal connection and adequate social support) are beneficial to health and wellbeing,” said Dr. Guohua Li, a researcher at the Columbia University Mailman School of Public Health in New York.
“It is less clear about the mechanisms through which social relationships affect health outcomes such as (medical complications) and mortality,” Li, who wasn’t involved in the study, said by email.
There are, however, many possible explanations, said Ben Lennox Kail, a sociology and gerontology researcher at Georgia State University in Atlanta who wasn’t involved in the study.
For starters, people with few close relationships with friends or relatives may be more likely to suffer from depression or other mental health issues than individuals with expansive social networks, Kail said by email.
“People who are not particularly well socially integrated may have poorer mental health or wellbeing, which may lead to poorer physical health, which may make longer hospital stays and more repeat visits more necessary,” Kail said.
“That said, if this were the primary explanation, we might expect to see more regular doctor’s visit – and we don’t,” Kail added.
Instead, it’s possible that people without friends and family to rely on might benefit more from longer hospital stays where they can get extra support from nurses, Kail said. With strong social networks, people might also have healthier habits, more reasons to leave the house and keep active, and people in their life to remind them to eat right, exercise, and take any prescribed medicine.
For the study, Nicole Valtorta of Newcastle University in the U.K. and colleagues examined data from 126 studies involving a total of more than 226,000 people in 19 countries. Most were from the U.S. and Canada.
Only one study was a controlled experiment designed to test whether social relationships directly impacted health utilization. Most of the studies examined data collected over time on outcomes like emergency room visits, doctor checkups and hospital admissions.
Valtorta declined to comment on the study, citing an ongoing strike over pensions at the university.
“The evidence is not quite there yet to indicate that increasing the quantity and/or quality of older adults’ social ties will reduce health care utilization,” said Christina Matz-Costa of the Boston College School of Social Work.
“That is not to say that individual or population-based interventions to strengthen social relationships and reduce loneliness do not represent important public health strategies,” Matz-Costa, who wasn’t involved in the study, said by email.
People experiencing health problems often seek out close friends or family for help, Matz-Costa said.
“When health issues arise, informal networks are often used to obtain advice, guidance and support around how to recognize and interpret their symptoms before seeking out formal care services, and those who lack informal social supports for vetting their health issues or complaints may be more likely to seek out formal services,” she said.