The Role of Social Isolation and Loneliness on Physical and Mental Health Among Black Older Adults

Background and Purpose: Social isolation and loneliness are known to be detrimental to physical and mental health among older adults; however, little is known about the influence of social isolation and loneliness on physical and mental health in older racial and ethnic minority populations, and specifically among older Black Americans. Additionally, many studies do not examine the influence of social isolation and loneliness on physical and mental health together in the same study. The purpose of this study, therefore, was to determine if social isolation and loneliness negatively influence physical and mental health among older Black Americans. This study is responsive to the “Eradication of Social Isolation” Grand Challenge of Social Work.

Methods: Data comes from the 2014 wave of the Health and Retirement Study (HRS). The HRS is a longitudinal nationally representative survey of adults age 50 and over living in the United States of America. Social isolation was operationalized using a 7-item social network index which includes less than monthly contact from adult children, family members, and friends, living alone, being unmarried, no participation in social groups or activities, and no participation in religious services. Loneliness was operationalized using the Hughes 3-item loneliness scale which assess how often you feel you lack companionship, how often you feel left out, and how often you feel isolated from others. Physical and mental health variables included number of chronic physical health conditions (count), dichotomized self-rated health (excellent, very good, good vs. fair, poor), number of depressive symptoms (count), and lifetime history of having any psychiatric disorder (yes vs. no). Poisson and logistic regression models were conducted given the health outcomes were count and dichotomous variables. Sociodemographic covariates were gender, age, years of education, total household income, and employment status. To address missing data, data were multiply imputed using the chained equations method.

Results: In the poisson and logistic regression models, loneliness was associated with all physical and mental health outcomes while also controlling for social isolation and all other sociodemographic covariates. Social isolation, however, was not associated with any physical or mental health outcome while controlling for loneliness and the sociodemographic covariates. Furthermore, social isolation was not associated with any health outcome even when not including loneliness in the regression models.

Conclusions and Implications: The results indicate loneliness has a strong association with physical and mental health among Black older adults; in comparison, social isolation did not have any effect on health regardless of loneliness. This is an important finding given the few studies which have examined social isolation and loneliness among Black older adults. Future studies should examine the associations between social isolation, loneliness, and health longitudinally given the potential for reciprocal relationships (i.e., worse health leading to greater social isolation and loneliness). The results of this study can be used to inform clinical and community interventions to decrease social isolation and loneliness among Black older adults. Social workers who work with older Black clients should routinely assess their clients’ loneliness given its strong association with health and well-being.