Social relationships have a complex nature shaped mainly by two dimensions: structure and function. Previous research raised the importance of considering both features simultaneously given that they may operate differently. However, research on social relationships and mortality mainly refers to European and U.S. populations. This study examines structural and functional features of social relationships to understand social isolation among adults aged 50 and older in Mexico. In addition, we analyze that association with mortality, using panel data from a 12-year follow-up from the Mexican Health and Aging Study (2003–2015). Results reveal that structural and functional features of social relationships are intertwined, and social isolation was shaped by two aspects that we label lack of socialization and being alone and feeling lonely. After controlling for a series of sociodemographic and health variables, Cox proportional hazard regression models indicate that both aspects significantly increase mortality among older adults in Mexico.
Aguilar-NavarroS. G.Fuentes-CantúA.Ávila-FunesJ. A.García-MayoE. J. (2007). Validez y confiabilidad del cuestionario del ENASEM para la depresión en adultos mayores. Salud Publica de Mexico, 49(4), 256–262. http://doi.org/10.1590/s0036-36342007000400005
2.
AntmanF. M. (2010). Adult child migration and the health of elderly parents left behind in Mexico. American Economic Review, 100(2), 205–208. http://doi.org/10.1257/aer.100.2.205
3.
ArizaM.de OliveiraO. (2004). Universo familiar y procesos demográficos. In ArizaM.de OliveiraO. (Eds.), Imágenes de la familia en el cambio de siglo (pp. 9–45). UNAM.
4.
ArriagadaI. (2009). La diversidad y desigualdad de las familias latinoamericanas. Revista Latinoamericana de Estudios de Familia, 1, 9–21.
BerkmanL. F.GlassT.BrissetteI.SeemanT. E. (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51(6), 843–857. http://doi.org/10.1016/s0277-9536(00)00065-4
7.
BerkmanL. F.SymeS. L. (1979). Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda county residents. American Journal of Epidemiology, 109(2), 186–204. http://doi.org/10.1093/oxfordjournals.aje.a112674
CacioppoJ. T.CacioppoS. (2014). Social relationships and health: The toxic effects of perceived social isolation. Social and Personality Psychology Compass, 8(2), 58–72. https://doi.org/10.1111/spc3.12087
10.
CacioppoS.GrippoA. J.LondonS.GoossensL.CacioppoJ. T. (2015). Loneliness: clinical import and interventions. Perspect Psychol Sci, 10(2), 238–249. https://doi.org/10.1177/1745691615570616
11.
CattellV (2001). Poor people, poor places, and poor health: the mediating role of social networks and social capital. Social Science & Medicine, 52(10), 1501–1516. http://doi.org/10.1016/s0277-9536(00)00259-8
12.
CohenS.GottliebB. H.UnderwoodL. G. (2000). Social relationships and health. In CohenS.UnderwoodL.GottliebB. (Eds.), Measuring and intervening in social support (pp. 3–26). Oxford University Press. http://doi.org/10.1093/med:psych/9780195126709.003.0001
CornwellE. Y.WaiteL. J. (2009). Measuring social isolation among older adults using multiple indicators from the NSHAP study. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 64(Suppl 1), i38–46. http://doi.org/10.1093/geronb/gbp037
15.
de BritoT. R. P.NunesD. P.CoronaL. P.da Silva AlexandreT.de Oliveira DuarteY. A. (2017). Low supply of social support as risk factor for mortality in the older adults. Archives of Gerontology and Geriatrics, 73, 77–81. http://doi.org/10.1016/j.archger.2017.07.016
16.
EllwardtL.Van TilburgT.AartsenM.WittekR.SteverinkN. (2015). Personal networks and mortality risk in older adults: A twenty-year longitudinal study. Plos One, 10(3, e0116731). https://doi.org/10.1371/journal.pone.0116731
17.
FokkemaT.De Jong GierveldJ.DykstraP. A. (2012). Cross-national differences in older adult loneliness. The Journal of Psychology, 146(1-2), 201–228. https://doi.org/10.1080/00223980.2011.631612
18.
Fuller-IglesiasHRAntonucciTC (2016). Familism, social network characteristics, and well-being among older adults in Mexico. Journal of Cross Cultural Gerontology, 31(1), 1–17. http://doi.org/10.1007/s10823-015-9278-5
19.
GaoQPrinaA. M.PrinceM.AcostaD.Luisa SosaA.GuerraM.HuangY. Y.Jimenez-VelazquezI. ZLlibre RodriguezJ. J.SalasA. A.WilliamsJ. D.LiuZ. Z.Acosta CastilloI. I.MaystonR. (2021). Loneliness among older adults in Latin America, China, and India: Prevalence, correlates and association with mortality. International Journal of Public Health, 66(14), 604449. https://www.ssph-journal.org/articles/10.3389/ijph.2021.604449
20.
Garza-SánchezR. I.González-TovarJ.Rubio-RubioL.Dumitrache-DumitracheC. G. (2020). Soledad en personas mayores de España y México: un análisis comparativo. Acta Colombiana de Psicología, 23(1), 106–116. https://doi.org/10.14718/acp.2020.23.1.6
21.
GuzmánJ. M.HuenchuanS.Montes de OcaV. (2003). Redes de apoyo social a las personas mayores: marco teórico conceptual. Notas de Población, 77, 35–70.
22.
HernandezL.BlazerD. (Eds.). (2006). The impact of social and cultural environment on health. In Genes, behavior, and the social environment: Moving beyond the nature/nurture debate (pp. 25–43). The National Academy Press.
Holt-LunstadJ.SmithT. B.BakerM.HarrisT.StephensonD. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. http://doi.org/10.1177/1745691614568352
25.
JylhäM.JokelaJ. (1990). Individual experiences as cultural – a cross-cultural study on loneliness among the elderly. Ageing and Society, 10(3), 295–315. http://doi.org/10.1017/S0144686X00008308
26.
KaiserH. F. (1991). Coefficient alpha for a principal component and the Kaiser-Guttman Rule. Psychological Reports, 68(3, Pt 1), 855–858. https://doi.org/10.2466/PR0.68.3.855-858
27.
KaplanG. A.SalonenJ. T.CohenR. D.BrandR. J.SymeS. L.PuskaP.Puska, P. (1988). Social connections and mortality from all causes and from cardiovascular disease: Prospective evidence from Eastern Finland. American Journal of Epidemiology, 128(2), 370–380. http://doi.org/10.1093/oxfordjournals.aje.a114977
28.
KatzS.BranchL. G.BransonM. H.PapsideroJ. A.BeckJ. C.GreerD. S. (1983). Active life expectancy. New England Journal of Medicine, 309(20), 1218–1224. http://doi.org/10.1056/NEJM198311173092005
29.
KnaulF. M.González-PierE.Gómez-DantésO.García-JuncoD.Arreola-OrnelasH.Barraza-LlorénsM.SandovalR.CaballeroF.Hernández-ÁvilaM.JuanM.KershenobichD.NigendaG.RuelasE.SepúlvedaJ.TapiaR.SoberónG.ChertorivskiS.FrenkJ. (2013). Hacia la cobertura universal en salud: Protección social para todos en México. Salud Publica de Mexico, 55(2), 207–235. http://doi.org/10.1590/s0036-36342013000200013
30.
LandisJ. RKochG. G (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 1, 159–174. https://doi.org/10.2307/2529310
31.
LuoYHawkleyL. CWaiteL. JCacioppoJ. T (2012). Loneliness, health, and mortality in old age: A national longitudinal study. Social Science & Medicine, 74(6), 907–914. https://doi.org/10.1016/j.socscimed.2011.11.028
32.
Michaels-ObregonA.Mejía ArangoS.WongR. (2014). The Mexican Health and Aging Study: Cognitive Functioning Measures Version 3.
33.
Montes de OcaV.GarayS.RicoB.GarcíaS. J. (2014). Living arrangements and aging in Mexico: changes in households, Poverty and regions, 1992-2009. International Journal of Social Science Studies, 2(4), 61–74. https://doi.org/10.11114/ijsss.v2i4.453
34.
MultonK. D.ColemanJ. S. M. (2012). Coefficient alpha. In SalkindN. J. (Ed.), Encyclopedia of research design (pp. 160–163). SAGE Publications, Inc. https://doi.org/10.4135/9781412961288
35.
OliveiraO.GarcíaB. (2017). Aproximaciones sociodemográficas al estudio de los hogares y familias en México. In GarcíaB.PachecoE.NájeraJ. (Eds.), Hogares y trabajadores en México en el siglo XXI. El Colegio de Mexico.
36.
Orth-GomérK.JohnsonJ. V. (1987). Social network interaction and mortality. A six year follow-up study of a random sample of the Swedish population. Journal of Chronic Diseases, 40(10), 949–957. https://doi.org/10.1016/0021-9681(87)90145-7
37.
PantellM.RehkopfD.JutteD.SymeS. L.BalmesJ.AdlerN. (2013). Social isolation: A predictor of mortality comparable to traditional clinical risk factors. American Journal of Public Health, 103(11), 2056–2062. http://doi.org/10.2105/AJPH.2013.301261
38.
ParkerS. W.SaenzJ.WongR. (2018). Health insurance and the aging: Evidence from the Seguro popular program in Mexico. Demography, 55(1), 361–386. http://doi.org/10.1007/s13524-017-0645-4
39.
PerissinottoC. M.Stijacic CenzerI.CovinskyK. E. (2012). Loneliness in older persons: a predictor of functional decline and death. Archives of Internal Medicine, 172(14), 1078–1083. http://doi.org/10.1001/archinternmed.2012.1993
40.
Reyes UribeA. C. (2015). Perceptions of successful aging among Mexican older adults. Journal of Behavior, Health & Social Issues, 7(2), 9–17. https://doi.org/10.5460/jbhsi.v7.2.52888
SantiniZ. I.KoyanagiA.TyrovolasS.HaroJ. M.FioriK. L.UwakwaR.ThiyagarajanJ. A. J.WebberM. M.PrinceM. M.PrinaA. M. (2015). Social network typologies and mortality risk among older people in China, India, and Latin America: A 10/66 Dementia research group population-based cohort study. Social Science & Medicine, 147, 134–143. http://doi.org/10.1016/j.socscimed.2015.10.061
43.
ShawJ. G.FaridM.Noel-MillerC.JosephN.HouserA.AschS. M.BhattacharyaJ. J.FlowersL. (2017). Social isolation and medicare spending: among older adults, objective isolation increases expenditures while loneliness does not. Journal of Aging and Health, 29(7), 1119–1143. http://doi.org/10.1177/0898264317703559
44.
SoaresM. U.FacchiniL. A.NedelF. B.WachsL. S.KesslerM.ThuméE. (2021). Social relationships and survival in the older adult cohort. Revista Latino-Americana de Enfermagem, 29, e3395. https://doi.org/10.1590/1518-8345.3844.3395
45.
SteptoeA.ShankarA.DemakakosP.WardleJ. (2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797–5801. http://doi.org/10.1073/pnas.1219686110
46.
TanskanenJ.AnttilaT. (2016). A prospective study of social isolation, loneliness, and mortality in Finland. American Journal of Public Health, 106(11), 2042–2048. http://doi.org/10.2105/AJPH.2016.303431
ValtortaN. K.KanaanM.GilbodySHanrattyB (2016). Loneliness, social isolation and social relationships: what are we measuring? A novel framework for classifying and comparing tools. BMJ Open, 6, 4, e010799. https://doi.org/10.1136/bmjopen-2015- 010799
49.
WeissR. S. (1973). Loneliness: The experience of emotional and social isolation. The MIT Press.
50.
WelinL.TibblinG.SvärdsuddK.TibblinB.Ander-PecivaS.LarssonB.WilhelmsenL. (1985). Prospective study of social influences on mortality. The study of men born in 1913 and 1923. Lancet, 1(8434), 915–918. http://doi.org/10.1016/s0140-6736(85)91684-8
51.
WongR.Michaels-ObregonA.PalloniA. (2017). Cohort profile: The Mexican health and aging study (MHAS). International Journal of Epidemiology, 46(2), e2. https://doi.org/10.1093/ije/dyu263
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