Social engagement and health outcomes among older people: introduction to a special section.

Abstract

Active social engagement has been shown to be associated with better health and health outcomes across a number of studies (Berkman and Syme 1979; House et al. 1982; Kaplan et al. 1988; Bygren et al. 1996; Glass et al. 1999; Bassuk et al. 1999; Wang et al. 2002; Mendes de Leon et al. 2003). However, the research studies over the last few decades have used different definitions and measures of social engagement, and the terminology used to define and measure social engagement has not been wholly consistent (Andersson 1998; Bennett 2002). Some studies on social engagement have considered social participation (Bygren et al. 1996; Glass et al. 1999), i.e. the involvement in actual activities which have a social element, other studies have examined social networks, i.e. the number of contacts with friends and relatives and membership of groups and organisations (Bowling and Browne 1991; Seeman et al. 1996; Unger et al. 1999), and yet others have focused on social support, i.e. the level of instrumental and emotional help available to an individual (e.g. Everard et al. 2000). Although the distinction between these different types of social engagement is apparent in the literature, there are clear overlaps between these types of social engagement across studies (e.g. Everard et al. 2000). For example, while attending church services is an activity which often has a social element, it can also stimulate contact with close friends. The overlap is also reflected in studies which have examined two or more of these types of engagement in combination—for example, Mendes de Leon et al. (2003) examined the effects of both participation in social activity and social networks on disability. In this special section on social engagement in older people, the studies focus on social participation, and in this Introduction we review research which has examined the relationship between this aspect of social engagement and health. While this review includes studies which have examined social participation and the other types of social engagement, it excludes those studies focusing only on social networks and/or social support, without reference to actual participation in social activities. The research to date has considered social engagement in relation to an increasingly varied series of health outcome measures, including mortality (Berkman and Syme 1979; House et al. 1982; Kaplan et al. 1988; Bygren et al. 1996; Glass et al. 1999), disability (Mendes de Leon et al. 2003), cognitive functioning (Aartsen et al. 2002), cognitive decline (Bassuk et al. 1999) and the risk of dementia (Fratiglioni et al. 2000; Wang et al. 2002). This special section reports new research concerning the relationship between social participation and physical health. Likewise, in this review we concentrate on research which has examined the impact of social participation on physical health outcomes.