A multitude of emotional, physical, and behavioral facets of human interaction are included in the complex phenomena of social connection. Functioning (e.g., subjective emotions of loneliness) and structural (e.g., objective frequency of social contacts) are two categories of interrelated conceptual components that make up the social connection.
An increased risk of cardiovascular disease (CVD) and all-cause mortality is linked to deficiencies in either component. The exact mechanisms by which social connection components are linked to mortality may differ depending on the component or the metric employed, although they are generally believed to be mediated directly (e.g., increased blood pressure, worse immunological function, neurodevelopmental impairment).Â
Although social connection factors are linked to mortality, there is a dearth of research comparing the effects of these factors alone and in combination within the same dataset. The purpose of this study was to investigate the separate and combined relationships between death and the structural and functional elements of social connectedness. Â
examination of 458,146 individuals from the UK Biobank cohort whose complete data were connected to death records. Three structural component measures—frequency of visits from friends and family, weekly group activities, and living alone—and two functional component measures—frequency of being able to confide in someone close and frequently feeling lonely—were used to evaluate social connection.
Utilizing Cox proportional hazard models, the relationships with mortality from cardiovascular disease (CVD) and all causes were investigated. A total of 44,390 participants, constituting 8.8% of the sample, were excluded due to missing data. Those with missing data were more likely to be male, older, from minority ethnic backgrounds, assessed in spring or summer, from more deprived areas, current smokers, with low physical activity levels, a higher BMI, and more long-term conditions.
After excluding those without complete data, 458,146 (91.2%) UK Biobank participants were included in the main analyses. Participants had a mean age of 56.5 years (SD 8.1; range 38–73), with 54.7% women and 95.5% of white ethnicity. Generally, individuals reporting any form of reduced social connection were more likely to be from a minority ethnic background, experience higher deprivation, engage in unhealthy behaviors (smoking, high alcohol intake, low physical activity), have a higher BMI, and have more long-term conditions.
Among those reporting each measure of reduced social connection, there was variability in the percentage of females: often feeling lonely (62.9% women), not engaging in weekly group activities (55.1% women), living alone (58.5% women), never being able to confide in someone close (40.9% women), and friend and family visits less than monthly (42.0% women).Â
This research raises several potential concerns: a threshold effect for visits from friends and family; a high-risk population may be those who live alone and exhibit additional concurrent structural isolation markers; the possibility that the benefits of some forms of social connection may not be felt in the absence of other forms of social connection; and the possibility that identifying the most isolated members of society may involve taking into account both the structural and functional aspects of social connection.Â
Journal Reference Â
Hamish M. E. Foster, Social connection and mortality in UK Biobank: a prospective cohort analysis, BMC Medicine (2023). DOI: 10.1186/s12916-023-03055-7.  Â
