Family Connection in Adolescence and Social Connection in Adulthood

Importance: Loneliness and perceived social isolation, with their negative health impacts, are increasing. It is not known whether adolescents with greater levels of family connection experience greater social connection as adults. Objective: To determine the association between adolescents' sense of connection with their families and their overall social connection in adulthood. Design, Setting, and Participants: This cohort study of a nationally representative US sample used data from 5 survey waves of The National Longitudinal Study of Adolescent to Adult Health: I (1994-1995), II (1996), III (2001-2002), IV (2008-2009), and V (2016-2018). Wave I involved 20 745 adolescents (grades 7-12), and 7293 participated in all 4 subsequent waves. Data were analyzed from April through November 2025. Exposure: Quartiles of adolescent family connection were created using responses to 5 items asked in wave II, and covariates, including indicators of socioeconomic status, were assessed at wave I. Main Outcomes and Measures: Adult social connection was assessed at waves IV and V with a score (0-6) created by summing 6 binary measures (no = 0, yes = 1) across 3 dimensions of social connection: structure ([1] participated in weekly activities with relatives/friends or neighbors, [2] had >2 close friends), function ([3] high perceived social support, [4] never felt isolated), and quality ([5] very close with either parent figure, [6] high relationship satisfaction with partner). Results: The analytic sample contained 7018 of the 7293 respondents to all 5 waves. The mean (SD) ages at waves II, IV, and V were 16.3 (1.8), 28.2 (1.8), and 37.3 (1.9) years, respectively, and 4097 respondents (49.7%) were female. The covariate-adjusted prevalence of high social connection in adulthood (score ≥4) increased across increasing quartiles of family connection in adolescence: 16.1% (95% CI, 13.4%-18.9%) for low, 22.0% (95% CI, 18.9%-25.1%) for medium-low, 28.6% (95% CI, 25.1%-32.1%) for medium-high, and 39.5% (95% CI, 36.2%-42.8%) for high family connection. The prevalence of high social connection in adulthood was 23.4 (95% CI, 19.2-27.6) percentage points greater in those in the highest quartile of adolescent family connection than those in the lowest quartile. Conclusions and Relevance: In this cohort study, among US adolescents, those reporting higher family connection had higher levels of social connection as adults up to 2 decades later. These findings suggest that increasing family connection during adolescence may help reduce the burden of adult social disconnection.