Social integration and mortality in Australia

Objective: To investigate the relationship between social integration and mortality at the aggregate level of analysis. Method: The data were compiled from several Australian Bureau of Statistics documents. The unit of analysis was State (Territory)-year. The multivariate regression analysis included data from all States and the Australian Capital Territory for 1990-96. Five indicators of social integration percentage of people living alone; divorce rate; unemployment rate; proportion of people who are discouraged job seekers; and unionisation rate - were used as predictors of nine measures of mortality. Results: Higher levels of social integration, as measured by all indicators except unionisation, were associated with lower mortality rates. In the case of unionisation, higher levels were associated with increased mortality rates. Conclusion: Studies concerning the relationship between social integration and health should investigate the 'type' and 'level' of social integration that is conducive to better health. Implications: To help reduce disparities in health and mortality across communities, public health researchers and policy makers need to closely monitor geographic and temporal trends in social integration measures. Social policies that emphasise investment in social integration or social capital through job creation and training, provision of gainful employment and social services for discouraged and marginalised workers, improved work conditions and social support may lower mortality directly or through their beneficial effects on health-promoting behaviours such as reduced levels of smoking, drinking and physical inactivity.