Social Network Types and Self-Rated Health Among Diverse Older Adults: Stability, Transitions, and Implications for Health Equity.

Abstract

Background and objectives: This study explores how social networks among older adults evolve over time and their impact on self-rated health (SRH), emphasizing differences across ethnoracial and linguistic groups. Though the link between social networks and well-being is well-known, how these networks change and affect health remains less understood.

Research design and methods: The study examined changes in social network types across 3 rounds of the National Social Life, Health, and Aging Project. The initial sample included 3 005 individuals, which decreased to 1 592 by the final follow-up. We analyzed data from participants in every round, totaling 6 858 observations, using Random-Intercept Latent Transition Analysis. Multinomial logistic regressions were conducted to predict network membership and transitions and to assess correlations with SRH.

Results: We identified 3 distinct social network types: "Enriched," "Focused," and "Restricted." "Enriched" networks feature broad connections, high marriage rates, active engagement, and low loneliness. "Focused" networks involve small, close-knit groups with frequent interactions, moderate marriage rates, and low loneliness. "Restricted" networks are family-oriented, with low marriage rates and the highest loneliness levels. Over time, "Restricted" networks became more prevalent, whereas "Focus" networks showed the most mobility. Network type membership varied significantly by ethnoracial identity and gender, with Black, Hispanic, and female respondents less likely to belong to "Enriched" networks. Membership in "Enriched" networks was linked to better SRH scores.

Discussion and implications: The growth of "Restricted" networks over time raises concerns about older adults becoming confined to limited social environments. However, there is a silver lining: within the "Focused" group, more individuals transition to "Enriched" networks than to "Restricted" ones, indicating that older adults can expand their social connections as they age. Understanding the factors driving this shift can guide interventions to promote network expansion for vulnerable groups, enhancing social well-being, and mitigating the risks associated with restricted networks.