The influence of low social support and living alone on premature mortality among aging Canadians

Objectives Among older Canadians, we examined the influence of low social support, a weak sense of belonging, and living alone to understand their role on mortality risk in Canada. Methods We conducted a retrospective cohort study of older Canadians surveyed in 2001 from the Canadian Community Health Survey and followed up with death events through December 31, 2011 from the Canadian Vital Statistics Database. Analyses were stratified by age: 55-64 and 65 and older. Social support was assessed using measures developed for the Medical Outcomes Study. A sense of belonging, a binary measure, measured community integration. Living alone was a binary measure. Survival analysis was applied using a Cox proportional hazards model, adjusted for age, sex, income, smoking, and frailty. Results Among respondents 55-64 (n = 6822), low affection (HR = 1.37; 95% CI 1.07, 1.75), low emotional/informational support (HR = 1.36; 95% CI 1.06, 1.74), and low positive social interactions (HR = 1.36; 95% CI 1.06, 1.75) were associated with mortality risk. Among respondents 65 and older (n = 8966), low affection (HR = 1.17; 95% CI 1.04, 1.31), low positive social interactions (HR = 1.20; 95% CI 1.07, 1.34), low emotional/informational support (HR = 1.19; 95% CI 1.06, 1.33), and a weak sense of belonging (HR = 1.13; 95% CI 1.05, 1.22) were associated with mortality risk. Conclusion Low social support and a weak sense of belonging are important risk factors among older Canadians and should be part of the dialogue in Canada about their roles in healthy aging.