We need a public health approach to loneliness

O’Sullivan, Roger; Leavey, Gerard; Lawlor, Brian A.

doi:10.1136/bmj.o280

Cited by 16 publications

(15 citation statements)

References 7 publications

(6 reference statements)

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“…Our findings that people with disability have increased risk of loneliness reinforce those from previous reports [17,[19][20][21][22][23] and adds to the existing evidence by demonstrating that inequalities in loneliness have persisted for decades without improvement. Loneliness is known to be associated with poorer physical and mental health outcomes [7][8][9][10] and is considered to be a public health concern in the general population [4,5,8,9,11,12]; given this, the consistently higher levels of loneliness observed for people with disability may contribute to the considerable health inequalities experienced by this population [13,15,16]. In contrast, for people without disability loneliness prevalence decreased over the 18 years, mostly occurring between 2003 and 2009; yet there was no downward trend for people with disability over the same period.…”

Section: Discussionmentioning

confidence: 99%

“…Experiencing loneliness can be distressing and cause considerable suffering [6], however increasing evidence indicates that being lonely is also associated with poor health outcomes including increased mortality, increased risk of cardiovascular disease and metabolic syndrome, and poorer mental and emotional health [7][8][9][10]. The significant health issues associated with loneliness, together with the social factors that underpin it, mean that addressing loneliness requires a public health approach to understand the distribution of loneliness in the population and its impact on population health [4,5,8,9,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020

Bishop,

Llewellyn,

Kavanagh

et al. 2024

BMC Public Health

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Background Experiencing loneliness can be distressing and increasing evidence indicates that being lonely is associated with poor physical and mental health outcomes. Cross-sectional studies have demonstrated that people with disability have increased risk of experiencing loneliness compared to people without disability. However, we do not know if these inequalities have changed over time. This study investigated the prevalence of loneliness for people with disability in Australia annually from 2003 to 2020 to examine whether disability-related inequalities in loneliness have changed over time, and disaggregated results for subgroups of people with disability by age group, sex, and disability group. Methods We used annual data (2003–2020) from the Household, Income and Labour Dynamics in Australia Survey. Loneliness was measured by a single question assessing the subjective experience of loneliness. For each wave, we calculated population-weighted age-standardised estimates of the proportion of people experiencing loneliness for people with and without disability. We then calculated the absolute and relative inequalities in loneliness between people with and without disability for each wave. Analyses were stratified by 10-year age groups, sex, and disability group (sensory or speech, physical, intellectual or learning, psychological, brain injury or stroke, other). Results From 2003 to 2020, the prevalence of loneliness was greater for people with disability, such that people with disability were 1.5 to 1.9 times more likely to experience loneliness than people without disability. While the prevalence of loneliness decreased for people without disability between 2003 and 2020, the prevalence of loneliness did not decrease for people with disability during this period. Inequalities in loneliness were more substantial for people with intellectual or learning disabilities, psychological disability, and brain injury or stroke. Conclusion This study confirms that people with disability have increased risk of loneliness compared to people without disability. We add to the existing evidence by demonstrating that disability-related inequalities in loneliness have persisted for two decades in Australia without improvement. Our findings indicate that addressing inequalities in loneliness for people with disability is a critical public health concern given that loneliness is associated with a wide range of poor health outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020

Bishop,

Llewellyn,

Kavanagh

et al. 2024

BMC Public Health

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“…Given its robust links with declining health, many, including the U.S. Surgeon General and the National Academies of Sciences, consider loneliness a public health epidemic especially in older adulthood (National Academies Press, 2020; O’Sullivan et al, 2022; U.S. Department of Health & Human Services, 2023).…”

Section: Public Health Relevance Of Loneliness and Potential Mechanismsmentioning

confidence: 99%

Loneliness, epigenetic age acceleration, and chronic health conditions.

Freilich,

Markon,

Cole

et al. 2024

Psychology and Aging

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Having associations with a range of adverse physical health outcomes including mortality, loneliness is increasingly recognized as a pressing public health concern, but the mechanisms studied to date do not yet explain all loneliness-related health risk. We sought to evaluate whether epigenetic influences on DNA methylation could help explain the relationship between loneliness and health. To do so, we first estimated associations between loneliness and epigenetic age acceleration (EAA) in a subsample of participants in the study of midlife in the United States (n = 1,310), before testing whether EAA mediated and/or moderated the association between loneliness and the onset of chronic health conditions in older adulthood (n = 445 completing longitudinal follow-ups). Greater loneliness was weakly associated with greater EAA in the Horvath, DunedinPACE, and GrimAge measures after accounting for demographic (0.08 ≤ β ≤ 0.11) and behavioral (0.06 ≤ β ≤ 0.08) covariates. Loneliness also predicted increases in chronic condition counts and these effects were more pronounced for individuals with higher DunedinPACE EAA values (interaction term β = 0.09, p = .009), suggesting possible synergistic impacts. EAA measures appear to be promising in helping to understand individual variations in the health impacts of loneliness, but the specific mechanisms involved require further research. Public Significance StatementLonely individuals face poorer health outcomes than nonlonely individuals. These data support the notion that loneliness is associated with accelerated epigenetic aging which may amplify the impact of loneliness on physical health in older adulthood.

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“…Loneliness, defined as a “ a subjective unpleasant or distressing feeling of a lack of connection to other people, along with a desire for more, or more satisfying, social relationships” [ 1 ], is closely linked to the quality of social connections as opposed to the quantity [ 2 ]. Globally, there is a growing concern about the rates and health consequences of loneliness [ 1 , 3 – 6 ], with it now considered a public health priority [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Health and wellbeing outcomes associated with loneliness for people with disability: a scoping review

Bailie,

Bishop,

Badland

et al. 2023

BMC Public Health

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BackgroundLoneliness is a significant public health concern due to its detrimental impact on health and wellbeing. Despite people with disability reporting higher levels of loneliness than the general population, there has been little research into how this is affecting their health and wellbeing. In light of this, the aim of our study was to scope both the existing evidence about the health and wellbeing outcomes associated with loneliness for people with disability, as well as the conceptual frameworks and measures utilised in this field of research.MethodsTo conduct this scoping review, we followed the methodology outlined by JBI and searched MEDLINE, Scopus, Informit, Embase, and Web of Science for peer-reviewed, English-language articles published between 1 January 2000 and 8 February 2023. Two independent reviewers completed screening, full-text review and data extraction, with consensus sought at each stage. Data were analysed using content analysis and presented both numerically and narratively.ResultsOut of the initial 1602 publications identified in the scoping review, only nine were included after duplicate removal, title and abstract screening, and full-text review. This limited number of studies, with the earliest study one published in 2015, represents a key finding. Eight of the nine studies were quantitative, and all were conducted in high income countries. Most of these studies utilised a version of the University of Los Angles Loneliness Scale to measure loneliness and addressed specific impairment groups. Notably, most of the studies identified associations between loneliness and health and wellbeing outcomes for people with disability.ConclusionsThis scoping review highlights the current scarcity of studies examining the effect that loneliness has on the health and wellbeing outcomes of people with disability. As most of the reviewed studies relied on loneliness measures designed for individuals without disability, they potentially overlook the unique life experiences of people with disability. Given that loneliness is an international public health concern, it is imperative that people with disability are not left behind or overlooked in efforts to address the impact of loneliness on health and wellbeing.

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We need a public health approach to loneliness

Abstract: Loneliness is costly to individuals and society; it should be a political priority

Cited by 16 publications

References 7 publications

Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020

Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020

Loneliness, epigenetic age acceleration, and chronic health conditions.

Health and wellbeing outcomes associated with loneliness for people with disability: a scoping review

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