• Julianne Holt-Lunstad, Timothy B Smith, and J Bradley Layton.
• Department of Psychology, Brigham Young University, Provo, Utah, United States of America. julianne_holt-lunstad@byu.edu
• PLoS Med. 2010 Jul 27; 7 (7): e1000316.

BackgroundThe quality and quantity of individuals' social relationships has been linked not only to mental health but also to both morbidity and mortality.ObjectivesThis meta-analytic review was conducted to determine the extent to which social relationships influence risk for mortality, which aspects of social relationships are most highly predictive, and which factors may moderate the risk.Data ExtractionData were extracted on several participant characteristics, including cause of mortality, initial health status, and pre-existing health conditions, as well as on study characteristics, including length of follow-up and type of assessment of social relationships.ResultsAcross 148 studies (308,849 participants), the random effects weighted average effect size was OR = 1.50 (95% CI 1.42 to 1.59), indicating a 50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period. Significant differences were found across the type of social measurement evaluated (p<0.001); the association was strongest for complex measures of social integration (OR = 1.91; 95% CI 1.63 to 2.23) and lowest for binary indicators of residential status (living alone versus with others) (OR = 1.19; 95% CI 0.99 to 1.44).ConclusionsThe influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality. Please see later in the article for the Editors' Summary.

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