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      Associations of loneliness and social isolation with physical and mental health among adolescents and young adults

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          Abstract

          Aims:

          The present study investigates whether loneliness and social isolation are associated with poor physical and mental health among adolescents and young adults, and whether age and gender play a role in the associations of loneliness and social isolation with mental and physical health.

          Methods:

          This study used cross-sectional self-report data from the 2017 Danish Health and Morbidity Surveys titled ‘How are you?’ ( N = 19,890, M = 22.6 years).

          Results:

          Logistic regression analyses showed that loneliness and social isolation were independently associated with poor physical and mental health. Loneliness was associated with increased odds of asthma, migraine, osteoarthritis, rheumatoid arthritis, hypertension, slipped disc/back pain, tinnitus, long-term mental illness, depressive symptomatology, anxiety symptomatology and alcohol problems. Social isolation was associated with decreased odds of having migraine, osteoarthritis and alcohol problems, and an increased risk of long-term mental illness and depressive symptomatology. Small age and gender differences were detected.

          Conclusions:

          In adolescents and young adults, loneliness and social isolation were associated with poor mental health and loneliness with poor physical health. These findings highlight the need for targeted prevention and intervention initiatives to alleviate loneliness and social isolation.

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          Most cited references44

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          Loneliness and social isolation as risk factors for mortality: a meta-analytic review.

          Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.
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            A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies.

            Most studies of social relationships in later life focus on the amount of social contact, not on individuals' perceptions of social isolation. However, loneliness is likely to be an important aspect of aging. A major limiting factor in studying loneliness has been the lack of a measure suitable for large-scale social surveys. This article describes a short loneliness scale developed specifically for use on a telephone survey. The scale has three items and a simplified set of response categories but appears to measure overall loneliness quite well. The authors also document the relationship between loneliness and several commonly used measures of objective social isolation. As expected, they find that objective and subjective isolation are related. However, the relationship is relatively modest, indicating that the quantitative and qualitative aspects of social relationships are distinct. This result suggests the importance of studying both dimensions of social relationships in the aging process.
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              Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies

              Background The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. Objective We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke. Methods Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models. Results Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender. Conclusions Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries. Study registration number CRD42014010225.
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                Author and article information

                Contributors
                Journal
                Perspectives in Public Health
                Perspect Public Health
                SAGE Publications
                1757-9139
                1757-9147
                July 2021
                June 19 2021
                July 2021
                : 141
                : 4
                : 226-236
                Affiliations
                [1 ]Public Health & Health Services Research, DEFACTUM, Central Denmark Region, Olof Palmes Allé 15, DK-8200 Aarhus N, Denmark
                [2 ]Department of Psychology, University of Southern Denmark, Odense, Denmark
                [3 ]Manchester Institute of Education, The University of Manchester, Manchester, UK
                [4 ]Public Health & Health Services Research, DEFACTUM, Central Denmark Region, Aarhus N, Denmark
                [5 ]Department of Cardiology, Odense University Hospital, Odense, Denmark
                [6 ]Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
                [7 ]Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
                [8 ]Center for Clinical Research and Prevention, The Capital Region of Denmark, Copenhagen, Denmark
                Article
                10.1177/17579139211016077
                34148462
                12feccf3-2053-43a9-81bf-e8b4532f46df
                © 2021

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