RURAL-URBAN DIFFERENCES IN SOCIAL ISOLATION AND ITS RELATIONSHIP TO HEALTH

Research on geographic differences in social isolation and its relationship with health is limited. Using data from Wave 2 of the National Social Life, Health, and Aging Project (n=3,377, mean age=72.4), we compared differences by rurality (urban vs. rural) in measures of reported social support, social relationships, and loneliness. We also conducted stratified ordered logistic regression models to assess how the association between isolation and self-rated health (1=poor; 5=excellent) differs by rurality. Overall, rural older adults were more likely than urban older adults to say that they could rely on family and friends, and rural residents reported larger numbers of close friends and relatives. There were no differences by rurality in loneliness, with all respondents scoring an average of 3 out of 9 on the loneliness scale. In stratified models, scoring higher on the loneliness scale was associated with poorer health for both urban and rural older adults (adjusted odds ratio [AOR]: 0.88, p<0.001 and 0.92, p<0.05, respectively). In contrast, being able to rely on family members was associated with better health (AOR: 1.46, p<0.05) for urban older adults, whereas having more friends was associated with better health for rural older adults (AOR: 1.19, p<0.05). As social isolation and loneliness continue to gain recognition as urgent population health issues, there is a critical need for targeted information on the prevalence and risk factors for social isolation and associated poorer health by geography in order to design targeted, effective interventions; this study adds useful information with which to do so.