Qual Life Res (2016) 25:1725–1733
DOI 10.1007/s11136-015-1200-7
The association between social network factors and mental health
at different life stages
Andrew Levula1 • Andrew Wilson2 • Michael Harré1
Accepted: 27 November 2015 / Published online: 15 December 2015
Ó Springer International Publishing Switzerland 2015
Abstract
Objectives Psychosocial factors are important determi-
nants of an individual’s health. This study examines the
association between health scores and social network fac-
tors on mental health across different life stages.
Methods Data were drawn from the Household Income
and Labour Dynamics in Australia survey for adolescents
(n = 1739), adults (n = 10,309) and seniors (n = 2287).
Hierarchical regression modelling was applied to examine
effects within and across age groups. All the variables were
derived from the self-completion questionnaire.
Results The social network factors were statistically sig-
nificant predictors of mental health outcomes for all three life
stages. For adolescents, the three social network factors were
statistically significant with social isolation having the lar-
gest impact (b = -.284, p \ .001), followed by social
connection (b = .084, p \ .001) and social trust having a
similar effect (b = .073, p \ .001). For adults social isola-
tion had the highest impact (b = -.203, p \ .001), followed
by social connection (b = .110, p \ .001) and social trust
(b = .087, p \ .001).The results for seniors were social
isolation (b = -.188, p \ .001), social connection
(b = .147, p \ .001) and social trust (b = .032, p \ .05).
Conclusions After adding the social network factors, the
models improved significantly with social isolation playing
the most significant role across all life stages, whereas the
& Andrew Levula
andrew.levula@sydney.edu.au
1 removed from or lose members of their social networks
Centre for Complex Systems Research, Faculty of
Engineering and IT, The University of Sydney, Sydney,
NSW 2006, Australia.
2
Menzies Centre for Policy, School of Public Health, The
University of Sydney, Sydney, NSW 2006, Australia
other social network factors played a differentiated role
depending upon the life stage. These findings have prac-
tical implications in the design of mental health interven-
tions across different life stages.
Keywords Mental health  Social network  Social
isolation  Emotional status  Life stages
Introduction
There is longstanding interest in the way social networks
influence psychosocial and behavioural determinants of
health [1–3]. In his classical study, Durkeim [4] postulated
that there was a collapse in family, community and work
ties for migrants who had relocated to industrial areas. This
relocation had a detrimental influence on the workers’
psychological well-being, and this disruption to social ties
was thought to produce losses in social resources. The
result showed that individuals with greater social connec-
tions to those in their social environment have better health
outcomes than socially isolated individuals.
In a different study, House et al. [5] found that socially
isolated individuals are less healthy both psychologically
and physically and are more likely to have shorter life spans
than those with more social connections. They also estab-
lished that unmarried and more isolated people manifested
higher rates of chronic illnesses as well as tuberculosis,
accidents, psychiatric disorders and schizophrenia. More-
over, socially isolated individuals or those who have been
might also be at risk for illness due to the loss of social
contacts used to regulate their biological rhythms [6–9].
Recent studies show that social networks are an important
source of social support which positively influences mental
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1726
and physical health by modifying emotional and behavioural
attitudes [10, 11]. Interventions designed to alter the social
environment and the individual’s transactions with others
have proven to be successful in facilitating psychological
factors, assisting in recovery from traumatic experiences and
in extending the lifespan of patients with serious chronic
disease and mental illness [2, 12–14].
These previous studies did not address the issue of the
individual’s stage of life. Recently, Umberson et al. [15]
developed a conceptual model using a life course per-
spective for understanding the associations between social
ties and health behaviour. They suggested that former
studies on social relations were highly compartmentalised
in terms of which social tie, which health behaviour, and
which stage of life is to be considered in any given study.
This work highlighted the need to study social network
properties across different stages of life and not just in
isolation of one another (e.g. only adolescents or only
adulthood). This is crucial as new health policy interven-
tions that disregard the different roles played by social
networks during different life stages may benefit some
while undermining the health of others. For this reason it is
important to recognise the significant role played by an
individual’s social network as it unfolds throughout life.
There has been growing public interests on addressing
mental illness across different life stages [16–19]. Prince
et al. [20] highlighted the need to recognise the interde-
pendencies between mental health and other health con-
ditions. Moreover, because these dependencies are
dynamic, they postulated that ‘‘there can be no health
without mental health’’ [20]. For example, Wong et al. [21]
used the Chinese version of the General Health Survey
(SF-36) to assess the long-term quality of life of 31 trau-
matic acute subdural haematoma patients. However, for
Caucasian partners of aneurysmal subarachnoid haemor-
rhage patients, the deterioration had a large impact on their
mental health. This was most likely a result of the
increased emotional distress.
To date very little research has considered how social
network properties such as social isolation, social connection
and social trust are associated with health outcomes across
the different life stages. The goal of this study then is to
examine how health scores and social network factors are
associated with mental health outcomes at different stages of
life and if there exists a gender gap across these life stages.
Data and methods
HILDA data
Data for this study were from wave 11 of the Household,
Income and Labour Dynamics in Australia (HILDA)
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Qual Life Res (2016) 25:1725–1733
Survey. This survey commenced in 2001 and is funded by
the Commonwealth Government through the Department
of Family and Community Services [22]. Data are collected
annually and in each wave participants complete four
separate survey questionnaires. One of these is the self-
completion questionnaire (SCQ) in which participants
report on their health-related quality of life outcomes and
provide their psychosocial information. The participant’s
ages ranged from 15 to 75 years and older. We categorise
those 15–21 years of age as adolescents, 22–64 years of
age as adults and 65 years of age and older as seniors. For
this study, the health scores, mental health and social net-
work factors were taken from the SCQ.
Health scores
The health measures were taken from the General Health
Survey (SF-36), a widely used health-related quality of life
screening instrument which has been translated into dif-
ferent languages across different countries [23]. The SF-36
has been thoroughly tested for its internal consistency and
reliability and has demonstrated both good reliability and
construct validity [23–25]. The health scores include
physical functioning (PF), general health (GH) and emo-
tional status (ES). In this study, the health scores were
treated as continuous variables ranging from 0 to 100,
where higher scores indicate better outcomes.
Social networks
We extracted three social network measures from the SCQ:
(1) social isolation, (2) social connection and (3) social
trust. Social isolation is the disengagement from social ties,
institutional connections or community participation [26].
Social connection is the opposite of social isolation and is
considered to be an important source of social support that
improves an individual’s health and well-being, for
example, mental health [7, 27]. Social trust is the self-
assurance in the honesty, integrity and reliability of others.
This is an important aspect of social relations, and it helps
facilitate the structural and functional aspects of social
networks, for example an individual with a higher degree
of social trust can exercise higher amounts of influence
[28]. These social network factors are described in detail
below.
Social isolation
The social isolation scores were adopted from five items
which are rated on a 7-point Likert scale ranging from 1
(strongly agree) to 7 (strongly disagree). The five items
were: I often need help from other people but cannot get it,
I have no one to lean on in time of trouble, I do not have
Qual Life Res (2016) 25:1725–1733
anyone that I can confide in, I often feel very lonely, and
people do not come to visit me as often as I would like.
Higher scores reflect higher social isolation. The social
isolation values loaded onto one factor with an eigenvalue
of 4.397. The Cronbach’s alpha reliability test result
(a = .800) shows good reliability [29].
Social connection
The social connection scores were extracted from four
items that are also given on a 7-point Likert scale ranging
from 1 (strongly agree) to 7 (strongly disagree). The four
items were: when something’s on my mind just talking
with the people I know can make me feel better, I enjoy
the time I spend with the people who are important to me,
when I need someone to help me out, I can usually find
someone, and, There is someone who can always cheer
me up when I am down. The four items loaded onto the
social connection construct with an eigenvalue = 1.508.
We also used the Cronbach’s alpha reliability test and
obtained a Cronbach’s alpha value (a = .779) showing
good reliability.
Social trust
For this factor, we extracted three items from the SCQ.
This was motivated by H. Berry and Rodgers [30] who
used a three-item scale to measure social trust: Most people
you meet keep their word, most people you meet make
arrangements honestly, and, generally speaking, most
people can be trusted. These items were given on a 7-point
Likert scale ranging from 1 (strongly agree) to 7 (strongly
disagree). Exploratory factor analysis showed the three
items loaded well onto the social trust construct with an
eigenvalue = 1.806. Again we used the Cronbach’s alpha
reliability test (a = .854) again showing good reliability.
Dependent variable
The dependent variable ‘‘mental health’’ was derived from
the MH 5, a subscale of the SF-36 survey. The mental
health items included: (1) Have you been a nervous person;
(2) Have you felt so down in the dumps nothing could
cheer you up; (3) Have you felt calm and peaceful; (4)
Have you felt down; and (5) Have you been a happy per-
son. These items have been previously tested for their
internal consistency and reliability and have demonstrated
good internal consistency and reliability [23, 25]. The
mental health score subscale is a continuous variable
ranging from 0 to 100, where higher mental health scores
indicate better mental health.
1727
Statistical models
We fitted a series of multiple hierarchical regression block
models using SPSS software version 20. These models
were individually applied to each of the three life stages.
We then regressed the health scores and social network
measures against mental health for each of the three life
stages: adolescents, adults and seniors. When constructing
model 1, we had initially included marital status, education
and employment status in the model. However, these did
not add any additional statistical value to our model so we
decided to exclude them. Gender was a binary variable in
which males were represented with a zero and females with
a one.
For model 1, we regress the mental health scores on
socio-demographic and health score factors: mental health
(MH), gender, gross income (GI), general health (GH),
physical functioning (PF) and emotional status (ES):
MH1 ¼ B0 þ B1  Gender þ B2  GI
ð1Þ
þ B3  GH þ B4  PF þ B5  ES þ e1 :
In model 2, we include social network measures and we
regress the mental health scores against these social net-
work factors as well as socio-demographic and health score
factors, where SI is social isolation, SC is social connec-
tion, and ST is social trust:
MH2 ¼ B0 þ B1  Gender þ B2  GI þ B3  GH þ B4  PF
þ B5  ES þ B6  SI þ B7  SC þ B8  ST þ e2 :
ð2Þ
Results
Participant characteristics
We carried out these analyses on 6760 males and 7575
females who had participated in wave 11 of the HILDA
survey. Most of the participants 7034 were married, fol-
lowed by 3310 which were single, and 2194 were in a de
facto relationship. The health scores showed that the mean
emotional status score was (M = 83.81, SD = 32.24), for
physical functioning it was (M = 83.76, SD = 23.08), and
for general health it was (M = 68.45, SD = 20.78). For the
social network factors, the mean social isolation value was
(M = 12.83, SD = 6.37), for social connection it was
(M = 22.94, SD = 4.59), and for social trust it was
(M = 14.64, SD = 3.63). For the dependent variable, the
mean mental health score was (M = 74.57, SD = 16.95).
These results are shown in Table 1.
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Table 1 Participant characteristics

Variables N% Mean (SD)

Socio-demographic
Male 6760 (47.2 %)
Female 7575 (52.8 %)
Age group
15–17 663 (4.6 %)
18–19 years 508 (3.5 %)
20–21 years 568 (4.0 %)
22–24 years 761 (5.3 %)
25–34 years 2292 (16.0 %)
35–44 years 2532 (17.7 %)
45–54 years 2568 (17.9 %)
55–64 years 2156 (15.0 %)
65–74 years 1380 (9.6 %)
75 years or over 907 (6.3 %)
Marital status Fig. 1 Age groups mapped against the mental health scores, error
Married 7034 (49.1 %) bars ±1 SE
De facto 2194 (15.3 %)
Separated but not divorced 328 (2.3 %)
younger male and female mental health scores compared
Divorced 846 (5.9 %)
with those in later life stages. Mean mental health scores
Widowed 614 (4.3 %)
show a tendency to improve from late adolescents or early
Single 3319 (23.2 %)
adulthood onwards and the large gender gap that favours
Employment status
the mental health of males that is prevalent early in life
Employee 8440 (58.9 %)
decreases but never quite disappears later in life.
Employer 186 (1.3 %)
Own account worker 731 (5.1 %)
Pearson correlation for multicollinearity
Contributing family member 28 (.2 %)
Undetermined 4950 (34.5 %)
For adolescents, there were strong correlations between
Highest education level
general health (r = .520, p \ .001), emotional status
Postgraduate 662 (4.6 %) (r = .546, p \ .001) and social isolation (r = -.557,
Graduate diploma 805 (5.6 %) p \ .001) with mental health scores. There were more
Bachelors 2024 (14.1 %) moderate correlations between social trust (r = .343,
Diploma 1292 (9.0 %) p \ .001) and social connection (r = .386, p \ .001) with
Certificate 3019 (21.1 %) mental health scores and only weak correlations between
Year 12 2239 (15.6 %) physical functioning (r = .175, p \ .001) and mental
Year 11 and below 4294 (29.9 %) health scores. Similarly for adults, there were strong cor-
Health scores relations for general health (r = .512, p \ .001) and
Mental health 74.57 (16.95) emotional status (r = .569, p \ .001) with mental health
Emotional status 83.81 (32.24) scores. There were moderate correlations between social
Physical functioning 83.76 (23.08) isolation (r = -.476, p \ .001), social trust (r = .316,
General health 68.45 (20.78) p \ .001) and social connection (r = .375, p \ .001) with
Social network factors mental health scores and weak correlations between
Social isolation 12.83 (6.37) physical functioning (r = .284, p \ .001) with mental
Social connection 22.94 (4.59) health scores. The results for seniors showed strong cor-
Social trust 14.64 (3.63) relations between general health (r = .527, p \ .001) and
SD standard deviation
emotional status (r = .521, p \ .001) with mental health
outcomes. Moreover, there were moderate correlations
In Fig. 1, we show the mean mental health scores for between social isolations (r = -.411, p \ .001) and
different age groups plotted by gender. The result shows physical functioning (r = .377, p \ .001) with mental
that there exists a substantial difference between the health scores, and there were weak correlations between

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social trust (r = .196, p \ .001) and social connection
(r = .278, p \ .001) with mental health scores.
These results demonstrate there was no significant
multicollinearity amongst our predictors. This was also
confirmed by observing the variance inflation factor (VIF)
values which were well below 10 and the tolerance
statistics which were well above .2 which signifies there
were no multicollinearity issues amongst our predictors
[29].
Hierarchical regression analysis results
for adolescents
The socio-demographic and health scores (model 1)
accounts for 43 % of the variation in mental health scores.
After adding the social network factors in model 2, the
model further improved by accounting for 53 % of the
variations in mental health scores. The ANOVA results
showed that by adding the social network variables to the
model, this improved our ability to predict mental health
outcomes with F values of (F5, 1736 = 266.08, p \ .001)
and (F8, 1733 = 248.34, p \ .001) for models 1 and 2,
respectively.
For model 1, incorporating health scores shows emo-
tional status (b = .415, p \ .001) was the best predictor
followed by general health (b = .368, p \ .001), with
physical functioning (b = .050, p \ .01) and gross income
(b = .039, p \ .05) playing relatively minor roles. In
model 2, incorporating the social network factors showed
that emotional status was still the highest predictor for
mental health scores (b = .340, p \ .001), but now social
isolation was the second most influential factor (b =
-.284, p \ .001), then general health (b = .230, p \ .001),
social connection (b = .084, p \ .001), social trust (b =
.073, p \ .001) and gender (b = -.053, p \ .01). These
results are shown in Table 2.
Hierarchical regression analysis results for adults
The socio-demographic and health scores (model 1)
account for 42 % of the variance in mental health scores.
For model 2 with the social network factors, this further
improved the model by accounting for 50 % of the varia-
tion in mental health scores. In model 1, emotional status
was the best predictor of mental health scores (b = .433,
p \ .001). This was followed by general health (b = .349,
p \ .001) and then physical functioning (b = -.033,
p \ .001). In model 1, gender and gross income also had
statistically significant results with (b = -.031, p \ .001)
for gender and (b = .023, p \ .01) for gross income.
For model 2, emotional status was the highest predictor
for mental health scores (b = .369, p \ .001) followed by
general health (b = .261, p \ .001). For adults, social
1729
isolation (b = -.203, p \ .001) had less of an effect than
for adolescents. Social connection had a (b = .110,
p \ .001), social trust had a (b = .087, p \ .001), gender
(b = -.066, p \ .001) and then physical functioning
(b = -.026, p \ .001) (see Table 2).
Hierarchical regression analysis results for seniors
The socio-demographic and health scores (model 1)
account for 39 % of the variation in mental health scores,
significantly less than that of both adolescents and adults.
In model 2, adding the social network measures further
improved the model accounting for 45 % of the variation
and a result comparable to model 1 for adolescents and
adults. In model 1, general health is the highest predictor
(b = .389, p \ .001), followed by emotional status (b =
.362, p \ .001) and then gender (b = -.053, p \ .01) and
gross income (b = .008, p \ .001).
In model 2, in descending order of importance, the sig-
nificant predictors were general health (b = .349, p \ .001),
emotional status (b = .300, p \ .001), social isolations
(b = -.188, p \ .001), social connection (b = .147, p \
.001, gender (b = -.076, p \ .001), physical functioning
(b = -.042, p \ .05) and social trust (b = -.032, p \ .05).
In model 2, the social connection for seniors was a more
important factor than for adolescents and adults, while social
trust values were less important (see Table 2).
These results confirm the significance of social network
measures for predicting mental health outcomes. It sup-
ports our hypothesis in that social networks do add statis-
tically significant explanatory power to mental health
outcomes across the three life stages.
Discussion
The aim of this study was to examine the association
between health scores and social network measures and
mental health outcomes across the different stages of life.
In this study, males have higher overall mental health
scores than females. An important finding from our study is
that the gender gap between male and female mental health
scores decreases across the different life stages, particularly
in transitioning from adolescence to adulthood.
Health scores and mental health
For adolescents and adults, emotional status was the most
significant predictor of mental health outcomes. From the
health factors, physical functioning had the least effect on
mental health outcomes when compared with emotional
status and general health factors. These results suggests the
need for targeted interventions such as school-based
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Table 2 Multiple hierarchical regression estimates for the prediction of variance in mental health scores by health scores and social network
measures for the different life stages
Predictors Adolescents Adults
2
Bi SE b R F Sig. Bi SE b R2 F Sig.
Bi Bi

Model 1: Socio-demographic .434*** 266.08 .000 .422*** 1502.86 .000

and health scores
Gendera -4.88 .628 -.014 -1.055 .257 -.031***
Gross income .219 .103 .039* .142 .048 .023**
General health .325 .017 .368*** .292 .008 .349***
Emotional status .252 .012 .415*** .236 .005 .433***
Physical functioning .044 .016 .050** -.028 .007 -.033***
Model 2: Social networks .534*** 248.34 .000 .503*** 1304.80 .000
Gendera -1.82 .578 -.053** -2.252 .242 -.066***
Gross income .059 .094 .011 -.059 .045 -.010
General health .204 .017 .230*** .218 .007 .261***
Emotional status .207 .011 .340*** .201 .004 .369***
Physical functioning .024 .015 .028 -.022 .007 -.026***
Social isolation -4.05 .294 -.284*** -2.725 .114 -.203***
Social trust 1.030 .254 .073*** 1.256 .110 .087***
Social connection .318 .074 .084*** .421 .032 .110***
Predictors Seniors
Bi SE Bi b R2 F Sig.

Model 1: Socio-demographic and health scores .387*** 286.35 .000

Gendera -1.726 .553 -.053***
Gross income .053 .114 .008***
General health .290 .016 .389***
Emotional status .155 .008 .362***
Physical functioning -.016 .013 -.027
Model 2: Social networks .452*** 233.82 .000
Gendera -2.467 .525 -.076***
Gross income -.027 .108 -.004
General health .260 .016 .349***
Emotional status .128 .008 .300***
Physical functioning -.025 .013 -.042*
Social isolation -2.274 .207 -.188***
Social trust .432 .217 .032*
Social connection .467 .520 .147***

SE standard error
*** p \ .001; ** p \ .01; * p \ .05
a
Gender = female versus male

interventions and community-based programs because of
the concerns that if the mental health issues are not
addressed in the earlier life stages, the affected individuals
could retain the associated health risks into the later life
stages [20]. The National Mental Health Commission [31]
reported issues associated with stigmatisation effects that
people with mental health problems face, this makes it
difficult for them to engage and interact with those in their
schools, work places and communities thus increasing the
chances of further isolation.
For seniors, general health was the most significant
predictor, followed by emotional status and then physical
functioning. From the three life stages, only adults physical
functioning had statistically significant influence on their

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mental health score. It is evident through this study that the
different life stages are distinctly influenced by the health
scores which affects their mental health outcomes. This
needs to be explored further. This study is also confirma-
tory analysis in that mental health score increases with age
and that seniors are likely to have higher mental health
outcomes than adolescents and adults [32–35].
Social networks and mental health
The principal finding from this study is that the social
network predictors all had statistically significant associa-
tions with mental health scores across the three life stages.
In particular social isolation was the second highest pre-
dictor for adolescent’s mental health scores. This result is
surprising because of the potential flow-on effect into later
life stages. Social isolation is often associated with other
psychological risk factors such as depressive symptoms,
suicide attempts and low self-esteem [7, 36, 37]. Given the
statistically significant effects of social isolation on ado-
lescent’s mental health outcome, it is important that pro-
tective factors or mechanisms are put in place that would
prevent these negative effects from influencing later life
stages.
Social isolation was also an important factor for adults
and seniors. As previously mentioned, seniors tend to have
smaller social networks because their friends are most
likely to fall away over time and their children tend to
become more independent and for various reasons move to
other locations (e.g. for education, work and to live with
their partners) and some contacts may have died [38, 39].
Thus seniors are caught in a dilemma in that they invest in
smaller social networks, but these networks are likely to
diminish drastically which negatively influence their
mental health outcomes.
For this study, social trust had the largest influence on
adult’s mental health scores, followed by adolescents and
then seniors. For social connection, seniors had the highest
values and adults had the second highest values followed
by adolescents. These findings suggests the need for tar-
geted interventions that would facilitate social engagement
because it is important that we have adequate friendship
and family support for developing confidence and good
self-esteem when going through life [40].
Given these considerations there is need to further study
the associations between social isolation and mental health
outcomes on adolescents and the policy and intervention
strategies required to reduce the flow-on effects into later
life stages. Furthermore, for seniors they need to be sup-
ported to develop and build strong social networks of
discretionary relationships to ensure that they have
1731
adequate levels of social, emotional and health support that
would facilitate a better quality of life.
Limitations of this study
There are several limitations for this study: (1) the analysis
is of cross-sectional data so we are unable to show any
causation from our data, (2) this study is based on self-
reported data which cannot be validated against objective
measures, (3) we only report on two socio-demographic
predictors excluding age. In further analysis (not shown),
we added marital status, employment status and education.
However, this did not add any additional statistical value to
our models; hence, they were not included in this study.
Overall, our findings are highly consistent with the litera-
ture and objective measures [2, 10, 15]. There is still a need
for more detailed studies using multilevel analysis to
describe the relationships amongst different constructs and
their measures [19, 27, 41]. Furthermore, Umberson et al.
[15] suggests that future studies should assess how social
networks and health behaviours change across life stages.
Within these limitations, we believe that our findings have
practical implications for the design and planning of health
policy and intervention plans.
Conclusions
To date there has been a lack of research into the relation-
ship between social network and mental health outcomes
across different stages of life. We learn how to build and
develop these social networks at a very early stage in our
lives and the degree to which each individual is successful in
acquiring these skills has a profound influence on the life-
time health outcomes of the individual. From this point of
view, we argue that social networks play an important role
in predicting mental health outcomes across all ages and our
findings show that an individual’s social network plays an
important role in influencing their mental health outcomes.
The results show that the gender gap between male and
female mental health outcomes does not quite disappear in
later life stages. Furthermore, social isolation has an
important impact on adolescent’s mental health outcomes
and this merits further analysis as it could lead to other
detrimental health outcomes in later stages of life.
Acknowledgments This paper uses unit record data from the
Household, Income and Labour Dynamics in Australia (HILDA)
Survey. The HILDA Project was initiated and is funded by the
Australian Government Department of Social Services (DSS) and is
managed by the Melbourne Institute of Applied Economic and Social
Research (Melbourne Institute). The findings and views reported in
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this paper, however, are those of the author and should not be
attributed to either DSS or the Melbourne Institute.
Compliance with ethical standards
Conflicts of interest The authors declare that there is no conflict of
interest.
Human and animal rights This article does not contain any studies
with human participants or animals performed by any of the authors.
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