Objective: to examine if a low level of social engagement is a precursor for mortality.
Methods: a case-control design, controlling for physical health, age and sex examining social engagement and morale. We took measures on 3 occasions, 4 years apart.
Results: a low level of social engagement was an important precursor of 8-year mortality. There were intermediate significant differences for social engagement, physical health and morale.
Conclusions: levels of social engagement either have a direct effect on mortality, or represent hidden health problems, acting as a marker for later ill health. Social engagement may also have a role in intermediate declines in physical health and morale.