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![Page 1: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/1.jpg)
Intimacy and Social IsolationIn the
National Social Life, Health and Aging Project
(NSHAP)Linda J. Waite
July 14-15, 2008ESRC/NIA London Workshop
![Page 2: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/2.jpg)
Variety of indicators of isolation
Different types of isolation affect particular aspects of health
Possible mechanisms?
Intimacy Protects & Social Isolation Kills… but How and Why?
![Page 3: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/3.jpg)
Interview 3,005 community-residing adults ages 57-85
Population-based sample with minority over-sampling
120-minute in-home interview• Questionnaire
• Biomeasure collection
Leave-behind questionnaire
National Social Life, Health, and Aging Project
![Page 4: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/4.jpg)
Mental Health Measures
Anxiety HADS (7 items) modified to match those of the Center for
Epidemiological Studies Depression Scale
Bereavement Four items
Depression CES-D (11 items)
Happiness Single item
Loneliness Three-item scale
Self esteem Single item
Stress Four item modification of Cohen’s Perceived Stress Scale
![Page 5: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/5.jpg)
Biomeasures
Anthropometrics • Height, weight, BMI • Waist circumference
Medications • Blood pressure • Get up and go
Biological or biologically-derived indicators of disease
![Page 6: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/6.jpg)
C-reactive proteinEpstein-Barr Virus Antibody TitersHemoglobin A1c
Blood Spots
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• Living alone
• Social network size and characteristics
• Social inactivity
• Perceived lack of social support
• Emotionally distant relationships
• Loneliness
Indicators of Social Isolation
Objective Social Isolation
Subjective Social Isolation
Forms of Social Isolation
• Physical separation from others
• Perception that relationships with others are low quality, emotionally distant, or unsatisfying
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Objective Social Isolation Scale (α = .74)
Social network characteristics• Size• Range• Contact volume• Proportion of network members in the household
Social involvement• Participation in organized groups• Religious attendance• Volunteering
Number of Friends
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Subjective Social Isolation Scale (α = .71)
Emotional closeness with network members
Perceived social support• Spouse or current partner• Family members• Friends
Feelings of loneliness and not belonging• Loneliness Scale (Hughes, Waite, Hawkley, and Cacioppo 2004)
• Lack companionship• Feel left out• Feel isolated
• “I was lonely”
![Page 10: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/10.jpg)
Figure 2. Predicted Probability of Very Good or Excellent Physical Health, by Levels of Objective and Subjective Isolation
0
0.2
0.4
0.6
0.8
1
-1.5 -0.7 0.1 0.9 1.7 2.5
Social isolation (standardized)
Pred
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obab
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y of
ver
y go
odor
exc
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nt p
hysi
cal h
ealt
h
Objective isolation
Subjective isolation
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Figure 3. Predicted Probability of Very Good or Excellent Mental Health, by Levels of Objective and Subjective Isolation
0
0.2
0.4
0.6
0.8
1
-1.5 -0.7 0.1 0.9 1.7 2.5
Social isolation (standardized)
Pred
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obab
ilit
y of
ver
y go
odor
exc
elle
nt m
enta
l hea
lth
Objective isolation
Subjective isolation
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Social Isolation and Self-Rated Health
Objective and subjective isolation are distinct forms of social isolation
Both objective and subjective isolation are independently related to self-rated physical health
The effect of objective isolation on mental health may operate through the very strong link between subjective isolation and mental health
![Page 13: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/13.jpg)
How Do Intimacy & Isolation Affect Health?
Through damage done by stress
![Page 14: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/14.jpg)
Sympathetic Nervous System Activationand
Atherosclerosis and Hypertension
Stress
Increased + frequent rapid changes in blood pressure
Increase in turbulent flow + shear stress on artery walls
Endothelial injury
Atherosclerosis and narrowed vessels
Hypertension
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Regressions Predicting Systolic Blood Pressure by Gender
Male(n=1067)
Female(n=1147)
Objective isolation -0.779 1.969
Co-resident partner -1.823 -5.004**
Very Low Loneliness (omitted) - -
Low Loneliness (4-5) -2.418 -1.313
Moderate Loneliness (6) -4.377* -4.021†
High Loneliness (7-9) -2.745 -1.895
Lacks Social Support 2.437* 1.034
Obese 1.913 1.019
Exercises 1.406 -0.174
Smokes cigarettes 0.939 -1.614
Drinks heavily 5.731** 3.429
Net of: Age, education, race/ethnicity, presence of spouse/partner, antihypertensive drugs, depression, anxiety, stress, and sleep quality.
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Regressions Predicting CRP by Gender
Male(n=689)
Female(n=726)
Objective isolation 0.034 0.153†
Co-resident partner -0.194† 0.104
Loneliness (standardized) -0.013 0.020
Lacks Social Support -0.004 -0.045
Obese 0.462** 0.622**
Exercises -0.239** -0.089
Smokes cigarettes 0.493** 0.197
Drinks heavily 0.145 -0.241
Good sleep quality -0.233* 0.002
Net of: Age, education, race/ethnicity, presence of spouse/partner,SBP, antihypertensive drugs, depression, anxiety, and stress. † significant at 10%; * significant at 5%; ** significant at 1%
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National Social Life, Health, and Aging Project
NSHAP data publicly available
NACDA at ICPSR
University of Michigan
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Extra Slides
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-2
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-1
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Objective Social Isolation (standardized)
Sub
ject
ive
Soc
ial I
sola
tion
(sta
ndar
dize
d)Figure 1. The Relationship between Objective Isolation
and Subjective Isolation
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Table 1. Ordered Logistic Regressions Predicting Self-Rated Physical Health (n = 2978)
Model 1 Model 2 Model 3 Model 4
Age (in decades) .02 .02 .04 .04
Attended college .68*** .58*** .65*** .58***
Co-morbidities -.54*** -.56*** -.55*** -.56***
Female .32*** .20* .23** .16
Lives alone .23 .17 .27* .22
Non-white -.65*** -.61*** -.61*** -.59***
Spouse/partner .56*** .48*** .45*** .40**
Objective social isolation -.45*** -.34***
Subjective social isolation -.64*** -.55***
*p < .05; **p < .01; ***p < .001 (two-tailed tests)a Higher values indicate better health.b Estimates presented are survey-adjusted and weighted for the probability of selection with post-stratification
adjustments for non-response.
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Table 2. Ordered Logistic Regressions Predicting Self-Rated Mental Health (n = 2980)
Model 1 Model 2 Model 3 Model 4
Age (in decades) -.06 -.06 -.03 -.03
Attended college .65*** .59*** .64*** .62***
Co-morbidities -.19*** -.20*** -.19*** -.20***
Female -.17* -.25** -.32*** -.34***
Lives alone -.02 -.07 .04 .03
Non-white -.41** -.38* -.35* -.34*
Spouse/partner .19 .13 -.02 -.03
Objective social isolation -.30*** -.08
Subjective social isolation -1.06*** -1.03***
* p < .05; ** p < .01; *** p < .001 (two-tailed tests)a Higher values indicate better mental health.b Estimates are survey-adjusted and weighted for probability of selection with post-stratification adjustments for non-response. Standard errors are presented in parentheses.
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Table 3. OLS Regressions Predicting Depressive Symptomsa
Model 1 Model 2 Model 3 Model 4
Age (in decades) -.20* -.21* -.29* -.29*
Attended college -1.10*** -.88** -.90*** -.85***
Co-morbidities .61*** .63*** .59*** .59***
Female .18 .42* .68** .73***
Lives alone .26 .39 -.06 -.03
Non-white .71* .63* .42 .40
Spouse/partner -.80 -.63 -.19 -.16
Objective social isolation .95*** .22
Subjective social isolation 3.34*** 3.29*** *p < .05; **p < .01; ***p < .001 (two-tailed tests)a Higher values indicate more depressive symptoms, based on the CES-D-ml.b Estimates presented are survey-adjusted and weighted for the probability of selection with post-stratification
adjustments for non-response.
![Page 23: Intimacy and Social Isolation In the National Social Life, Health and Aging Project (NSHAP) Linda J. Waite July 14-15, 2008 ESRC/NIA London Workshop.](https://reader030.fdocuments.us/reader030/viewer/2022032701/56649c9d5503460f9495bf1a/html5/thumbnails/23.jpg)
Figure 4. Predicted Depressive Symptoms, by Levels of Objective and Subjective Isolation
0
2
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8
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16
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Social isolation (standardized)
Pred
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ES-
D-m
l sco
re
Objective isolation
Subjective isolation