Is resistance to help the same thing as disengagement?
The research corpus does not contain evidence to support the claim that lonely or socially disconnected people disengage from care. Instead, the evidence shows two simultaneous behaviors. Socially disconnected people show a lower uptake of preventive services, which is the most consistent engagement finding in the corpus. At the same time, these individuals show a higher volume of care contact, including more physician visits, more frequent use of urgent care, and higher telemedicine use. The accurate framing is high demand meeting unmet need. Resistance describes the terms on which help is accepted, rather than absence from the system. Current evidence does not support the view that disconnected people are simply absent. A systematic review of older adults' social relationships and health care utilization, which is the primary source for this topic in the corpus, concludes that evidence does not support the view that patients with lower social support place greater demands on ambulatory care once health status is accounted for (Valtorta, 2018). The corpus does not contain a study directly comparing the constructs of resistance and disengagement.