Kinlessness, sole family survivorship, and the mental and physical health of U.S. older adults

Limited family ties are increasingly common among U.S. older adults. Kinless individuals lack a family of procreation, namely a spouse/partner and children. Sole family survivorship refers to lacking family of origin kin, including parents and siblings. Familial ties are linked to health across the life course and, in line with socioemotional selectivity theory, play an increasingly salient role with age. Consequently, older adults who are kinless or sole family survivors may face worse health outcomes than their counterparts with kin. However, substitution of friends or relatives nearby may mitigate some of the health burden of limited family ties. Drawing on 191,146 person-waves of data from the 1998–2018 Health and Retirement Study, we assessed how these two forms of limited family ties were associated with chronic conditions, (instrumental) activities of daily living (ADL/IADL) limitations, self-rated poor health, and depressive symptoms. Among women, kinlessness was largely unrelated to women's health, only being associated with an increased rate of ADL/IADL difficulties. In contrast, sole family survivorship was positively associated with women's ADL/IADL difficulties, self-rated poor health, and depressive symptoms. Among men, kinlessness was not associated with worse health outcomes. Sole family survivorship was associated with more ADL/IADL difficulties and depressive symptoms among men. Social ties were not uniformly protective of women's and men's health, calling into question the viability of substitutes and underscoring the unique advantages of immediate family ties in later life. Our study demonstrates the utility of examining multiple forms of limited family ties which have distinct ramifications for older adult well-being.