Socially isolated children may become unhealthy adults

Social isolation in childhood may be associated with an increased risk for cardiovascular disease in adulthood, according to a report in the August issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Social isolation and loneliness can affect both psychological and physical health, according to background information in the article. Adults who lack social support have been shown to be at higher risk for coronary artery disease and have a poorer prognosis once they develop the condition. In addition, evidence from an emerging field known as life-course epidemiology is beginning to suggest that early life experiences are also important in determining risk factors for disease in adulthood.

Avshalom Caspi, Ph.D., University of Wisconsin, Madison, and King's College, London, England, and colleagues studied 1,037 children from birth through age 26 years. Participants underwent follow-up assessments at ages 5, 7, 9, 11, 13, 15, 18 and 21 years, during which the individuals or their parents provided information about social factors, body mass index was calculated and intelligence was evaluated. A final physical examination and evaluation was conducted at age 26 years. At that time, those who did not have a partner or had not dated in the past year and those who said they had no one to provide emotional support were considered socially isolated adults.

Twenty-six-year-olds who were socially isolated as children were significantly more likely to be unhealthy as adults, as measured by six cardiovascular risk factors, including weight, blood pressure and HDL (good) and LDL (bad) cholesterol levels. This association remained significant even when the researchers considered established childhood risk factors for poor cardiovascular health, such as low socioeconomic status, low IQ and being overweight. Unhealthy adult behaviors, including smoking, drinking and lack of exercise, also could not explain the connection, nor could the greater exposure to stressful situations typically experienced by isolated children in adulthood.

Social isolation tended to persist throughout life, and the longer an individual was isolated the worse their adult health, the authors report. "A useful concept for understanding how repeated social isolation can lead to poor health is allostatic load, which refers to the cumulative wear and tear caused by repeated adaptations to psychosocial stressors (such as social isolation) in childhood, adolescence and adulthood," they write. "It is also possible that social isolation disrupts constructive and restorative processes that enhance physiological capacities, as suggested by evidence that lonely individuals experience disrupted sleep and engage in passive rather than active coping strategies in their everyday lives." (Arch Pediatr Adolesc Med. 2006;160:805-811. Available pre-embargo to the media at http://www.jamamedia.org.)

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Editor's Note: This study was supported by grants from the UK Medical Research Council, the National Institute of Mental Health, the William T. Grant Foundation, the National Heart Foundation of New Zealand and the Health Research Council of New Zealand. Dr. Moffitt is a Royal-Society Wolfson Research Merit Award Holder. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

For more information, contact JAMA/Archives Media Relations at 312/464-JAMA (5262) or e-mail mediarelations@jama-archives.org.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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