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Social Integration, Social Support and Mortality in the US National Health Interview Survey

Barger, Steven D. PhD

doi: 10.1097/PSY.0b013e318292ad99
Original Articles

Background Social relationship quantity and quality are associated with mortality, but it is unclear whether each relationship dimension is equally important for longevity and whether these associations are sensitive to baseline health status.

Methods This study examined the individual and joint associations of relationship quantity (measured using a social integration score) and quality (measured by perceived social support) with mortality in a representative US sample (n = 30,574). The study also evaluated whether these associations were consistent across individuals with and without diagnosed chronic illness and whether they were independent of socioeconomic status (SES; education, income, employment, and wealth). Baseline data were collected in 2001 and were linked to vital status records 5 years later (1836 deaths).

Results Both social integration and social support were individually related to mortality (hazard ratios [HRs] = 0.83 [95% confidence interval {CI} = 0.80–0.85] and HR = 0.94 [95% CI = 0.89–0.98], respectively). However, in multivariate models including demographic and SES variables, social integration (HR = 0.86, 95% CI = 0.83–0.89) but not social support (HR = 1.03, 95% CI = 0.98–1.08) was associated with mortality. The social integration association was linear and consistent across baseline health status and men and women.

Conclusions Social integration but not social support was independently associated with mortality in the US sample. This association was consistent across baseline health status and not accounted for by SES.

Supplemental digital content is available in the article.

From the Department of Psychology, Northern Arizona University, Flagstaff, Arizona.

Address correspondence and reprint requests to Steven D. Barger, PhD, Department of Psychology, Northern Arizona University, PO Box 15106, Flagstaff, AZ 86011. E-mail:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Received for publication July 26, 2012; revision received January 25, 2013.

Copyright © 2013 by American Psychosomatic Society
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