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Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing

Smith, SG; Jackson, SE; Kobayashi, LC; Steptoe, A; (2018) Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing. Health Psychology , 37 (2) pp. 160-169. 10.1037/hea0000541. Green open access

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Abstract

OBJECTIVE: To investigate the relationships between social isolation, health literacy, and all-cause mortality, and the modifying effect of social isolation on the latter relationship. METHODS: Data were from 7731 adults aged ≥50 years participating in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing. Social isolation was defined according to marital/cohabiting status and contact with children, relatives, and friends, and participation in social organizations. Scores were split at the median to indicate social isolation (yes vs. no). Health literacy was assessed as comprehension of a medicine label and classified as "high" (≥75% correct) or "low" (<75% correct). The outcome was all-cause mortality up to February 2013. Cox proportional hazards models were adjusted for sociodemographic factors, health status, health behaviors, and cognitive function. RESULTS: Mortality rates were 30.3% versus 14.3% in the low versus high health literacy groups, and 23.5% versus 13.7% in the socially isolated versus nonisolated groups. Low health literacy (adj. HR = 1.22, 95% CI 1.02-1.45 vs. high) and social isolation (adj. HR = 1.28, 95% CI 1.10-1.50) were independently associated with increased mortality risk. The multiplicative interaction term for health literacy and social isolation was not statistically significant (p = .81). CONCLUSIONS: Low health literacy and high social isolation are risk factors for mortality. Social isolation does not modify the relationship between health literacy and mortality. Clinicians should be aware of the health risks faced by socially isolated adults and those with low health literacy. (PsycINFO Database Record

Type: Article
Title: Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1037/hea0000541
Publisher version: http://dx.doi.org/10.1037/hea0000541
Language: English
Additional information: © 2018 American Psychological Association. This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10042810
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