Social isolation, health dynamics, and mortality: Evidence across 21 Europe countries

We provide a comprehensive picture of the health effects of social isolation using longitudinal data over 21 European countries (SHARE) and seven waves (14 years) : first by looking at how social isolation at baseline impacts mortality at follow-up using Cox duration models, then looking at the dynamics of the health effects of social isolation, i.e. how social isolation at baseline affects functional, physical, mental and cognitive health at each future wave, when controlling for all these facets of health at baseline along with an extensive set of other covariates, in a standard linear regression framework. Our results suggest social isolation leads to worse health along all the dimensions we observe, and this effect is persistent. Being socially isolated at baseline is associated with a 20 to 30% increase in the mortality hazard, in line with other studies. Allowing for heterogeneity across countries, we find a remarkably strong association (up to a 45% increase) in Eastern countries. This association is not just picking up a correlation of social isolation with concurrent loneliness, health behaviors or health care utilization.