Mental Health Risks Associated with Social Isolation in Older Immigrants: The Mediating Role of Loneliness

Background: Social isolation (an objective lack of social contacts) and loneliness (a subjective feeling of being lonely) are common indicators of social disconnectedness that pose a significant risk to mental health. Social disconnectedness is a major public health concern as one in four Americans aged 65 and older is considered socially isolated and over 40% report feelings of loneliness. Social disconnectedness and its detrimental impact on mental health are common across older populations; however, the issue is pronounced among older immigrants due to their challenges with language and culture. Focusing on older Korean Americans, the present study examined the associations among social isolation, loneliness, and mental distress. Guided by the Stress Appraisal Theory, we conceptualized social isolation as a stressor, loneliness as an appraisal, and mental distress as an outcome. We hypothesized that (1) social isolation and loneliness would have a negative effect on mental health and (2) the negative effect of social isolation on mental health would be mediated by loneliness.

Methods: Data came from the Study of Older Korean Americans (SOKA), which includes 2,150 older Korean Americans (age 60 or older) surveyed in five states (CA, NY, TX, HI, and FL). Measures for the major study variables are Lubben Social Network Scale-6 (LSNS-6), UCLA loneliness scale, and Kessler Psychological Distress Scale (K6). Using multiple linear regression and PROCESS macro analyses, the direct and mediating effects were examined.

Results: Both social isolation (B [SE] = 1.64 [ .21], p < .001) and loneliness (B [SE] = 1.20 [ .04], p < .001) had direct effects on mental distress. Older individuals who were socially isolated and who reported more frequent feelings of isolation had greater levels of mental distress. Supporting the mediation hypothesis, the indirect effect of social isolation on mental distress through loneliness was significant (bias-corrected 95% confidence interval for the indirect effect = 1.02, 1.64). The mediation model suggests that loneliness serves as an intervening step in the pathways from social isolation to mental distress.

Implications: The findings not only confirmed the mental health risks posed by social isolation and loneliness but also demonstrated the psychological mechanisms that underlie the link between social isolation and mental health. The intervening role of loneliness suggests the strategies to alleviate the negative mental health consequences of social isolation in older immigrants and promote their social engagement and mental well-being.