title: A Prospective Study of Social Isolation, Loneliness, and Mortality in Finland.
abstract: To estimate the simultaneous effects of social isolation and loneliness on mortality.
  
  
  
  We analyzed a representative Finnish sample (n = 8650) from the cross-sectional Living Conditions Survey of 1994, with a 17-year follow-up period (1995-2011), by using Cox regression models adjusted for several possible confounding variables. We examined the possible nonlinear threshold effect of social isolation on mortality.
  
  
  
  The analyses revealed that social isolation predicted mortality even after we controlled for loneliness and control variables. The connection between social isolation and mortality was linear in nature and there was no synergistic effect between social isolation and loneliness. The effect of loneliness became nonsignificant when studied simultaneously with social isolation.
  
  
  
  This study reveals strong evidence for an adverse effect of social isolation on mortality. Social isolation and loneliness seem to have distinct pathways to mortality and health. The results imply that the risk of mortality exists along a continuum, affecting not only those who experience extreme social isolation, but also those who suffer from mild to progressively increasing intensity of isolation.
authors.affiliation: Jussi Tanskanen and Timo Anttila are with the Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Tanskanen
authors.affiliation: Jussi Tanskanen and Timo Anttila are with the Department of Social Sciences and Philosophy, University of Jyväskylä, Jyväskylä, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Anttila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D005387:Finland / Q000453:epidemiology; D006304:Health Status; D006801:Humans; D008132:Loneliness; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011446:Prospective Studies; D012307:Risk Factors; D012934:Social Isolation; D012944:Social Support; D012959:Socioeconomic Factors; D055815:Young Adult