Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May;44(5):509-517.
doi: 10.1037/hea0001409.

Social asymmetry and physical health in the United States and Japan

Anthony D Ong  1 , Dakota W Cintron  1 , Tomiko Yoneda  2 , Emorie D Beck  2 , Kathryn Jackson  3 , Jing Luo  3 , Daniel K Mroczek  3 , Andrew Steptoe  4 , Eileen K Graham  3
Affiliations

Social asymmetry and physical health in the United States and Japan

Anthony D Ong et al. Health Psychol. 2025 May.

Abstract
in English, Spanish

Objective: Social relationships are increasingly recognized as crucial determinants of health, but cultural variations in the health implications of social disconnection remain understudied. This study examines how nationality, reflecting cultural differences in social norms, moderates the relationship between social asymmetry and physical health in Japanese and U.S. adults. We hypothesized that the association between greater social asymmetry and poorer health would be attenuated in Japan compared to the United States.

Method: The sample comprised adults aged 23-84 years from Japan (N = 1,027) and the United States (N = 6,650) participating in the Midlife in Japan and Midlife in the United States longitudinal studies. Social asymmetry was quantified as the residual score from regressing loneliness on social isolation, with positive residuals indicating higher loneliness than expected based on isolation levels. Physical health was a latent variable indicated by chronic conditions, symptoms, activities of daily living, and physical activity. Structural equation modeling examined the moderating effect of nationality on the social asymmetry-health link.

Results: Across both cultural contexts, greater social asymmetry (i.e., higher loneliness than predicted by isolation) was associated with worse physical health. However, as hypothesized, this relationship was significantly weaker in Japan compared to the United States, highlighting the role of cultural context in shaping the health implications of discrepant social experiences.

Conclusions: Findings contribute to understanding cultural variations in the health consequences of social disconnection and emphasize the need to consider sociocultural factors when examining social determinants of health across diverse populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objetivo:: Las relaciones sociales se reconocen cada vez más como determinantes cruciales de la salud, pero las variaciones culturales en las implicaciones de la desconexión social para la salud siguen siendo poco estudiadas. Este estudio examina si la nacionalidad modera la relación entre la asimetría social, la discrepancia entre la soledad subjetiva y el aislamiento objetivo, y la salud física en adultos japoneses y estadounidenses. Nuestra hipótesis es que la asociación entre una mayor asimetría social y una peor salud se atenuaría en Japón en comparación con los Estados Unidos.

Método:: La muestra estuvo compuesta por adultos de 23 a 84 años de Japón (N = 1,027) y Estados Unidos (N = 6,650) que participaron en los estudios longitudinales Midlife in Japan (MIDJA) y Midlife in the United States (MIDUS). La asimetría social se cuantificó como la puntuación residual de la regresión de la soledad en el aislamiento social, con residuos positivos indicando una soledad mayor de la esperada según los niveles de aislamiento. La salud física fue una variable latente indicada por condiciones crónicas, síntomas, actividades de la vida diaria y actividad física. El modelo de ecuaciones estructurales (SEM, por sus siglas en inglés) examinó el efecto moderador de la nacionalidad en el vínculo entre la asimetría social y la salud.

Resultados:: En ambos contextos culturales, una mayor asimetría social (es decir, mayor soledad que la prevista por el aislamiento) se asoció con una peor salud física. Sin embargo, como se planteó la hipótesis, esta relación fue significativamente más débil en Japón en comparación con los Estados Unidos, lo que destaca el papel del contexto cultural en la configuración de las implicaciones para la salud de las experiencias sociales discrepantes.

Conclusiones:: Los hallazgos contribuyen a comprender las variaciones culturales en las consecuencias para la salud de la desconexión social y enfatizan la necesidad de considerar factores socioculturales al examinar los determinantes sociales de la salud en poblaciones diversas.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Measurement and Structural Models Depicting Associations Between Social Asymmetry and Latent Physical Health
Note. Values are standardized path coefficients and variances. Bolded coefficients are significant at p < .05. IADL= intermediate activities of daily living; FIML = full information maximum likelihood; CFI = comparative fit index; SRMR = standardized root-mean-square residual; RMSEA = root-mean-square error of approximation.
Figure 2
Figure 2. Moderating Effect of Culture on the Relationship Between Social Asymmetry and Latent Physical Health
Note. The plot depicts the predicted values of physical health problems for the United States and Japan with 95% confidence intervals. Predicted factor scores were used for physical health problems. See the online article for the color version of this figure.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Akhter-Khan SC, Prina M, Wong GH-Y, Mayston R, & Li L (2023). Understanding and addressing older adults’ loneliness: The social relationship expectations framework. Perspectives on Psychological Science, 18(4), 762–777. 10.1177/17456916221127218 - DOI - PMC - PubMed
    1. Bamba S, & Haight WL (2007). Helping maltreated children to find their Ibasho: Japanese perspectives on supporting the well-being of children in state care. Children and Youth Services Review, 29(4), 405–427. 10.1016/j.childyouth.2006.10.001 - DOI
    1. Beller J, & Wagner A (2020). Loneliness and health: The moderating effect of cross-cultural individualism/collectivism. Journal of Aging and Health, 32(10), 1516–1527. 10.1177/0898264320943336 - DOI - PubMed
    1. Briesch AM, Cintron DW, Dineen JN, Chafouleas SM, McCoach DB, & Auerbach E (2020). Comparing stakeholders’ knowledge and beliefs about supporting students’ social, emotional, and behavioral health in schools. School Mental Health, 12(2), 222–238. 10.1007/s12310-019-09355-9 - DOI
    1. Brim OG, Ryff CD, & Kessler RC (Eds.). (2004). How healthy are we?: A national study of well-being at midlife. The University of Chicago Press.