Differences in Loneliness Across the Rural‐Urban Continuum Among Adults Living in Washington State

Abstract

Purpose Rural residents may be at higher risk for loneliness than urban residents due to factors such as social isolation, poorer health, and socioeconomic disadvantage. To date, there have been few studies examining rural‐urban differences in loneliness among adults in the United States. We examined differences in loneliness across the rural‐urban continuum among adult residents living in Washington State. Methods Stratified random sampling was used to select 2,575 adults from small rural, large rural, suburban, and urban areas who were invited to complete a survey on factors affecting health. Data were obtained from 616 adults (278 from small rural, 100 from large rural, 98 from suburban, and 140 from urban areas) from June 2018 through October 2019. Loneliness was measured using the UCLA Loneliness Scale (3rd version). Multivariable linear and logistic regressions were used to examine geographic differences in loneliness (measured continuously and dichotomously). Findings Mean unadjusted loneliness scores were lower in suburban compared to urban areas (35.06 vs 38.57, P = .03). The prevalence of loneliness was 50.7%, 59.0%, 40.8%, and 54.3% in small rural, large rural, suburban, and urban areas, respectively. Suburban living was associated with lower odds for being lonely compared to urban living (unadjusted OR = 0.58; 95% CI = 0.34‐0.98), but this association was not statistically significant in the adjusted model (OR = 0.63; 95% CI = 0.33‐1.19). Conclusion Loneliness is a prevalent health issue across the rural‐urban continuum among Washington State adults.

Examining Rural and Racial Disparities in the Relationship Between Loneliness and Social Technology Use Among Older Adults

“…Further analyses examining potential racial and rural differences in loneliness, social contact, social negativity, and social support were also performed. Rural individuals had fewer social contacts than urban individuals and experienced greater loneliness, which varies from prior studies that did not observe differences in rurality on loneliness ( 59 – 62 ). Differences in design methodology and sample demographics, including age and country of residence, may potentially contribute to these differences.…”

“…Similar to the relationship between race/ethnicity and loneliness findings, research that has sought to characterize rural-urban differences in loneliness also portrays complex, inconsistent results. On the one hand, several large-scale epidemiological studies in the United States (U.S.) and Canada have observed no association between rural-urban residence and loneliness ( 59 – 62 ). In contrast, other longitudinal research with U.S. populations shows that rural older adults report being able to rely on friends and family more than urban older adults ( 63 ).…”

Loneliness in young people: a multilevel exploration of social ecological influences and geographic variation

“…27 Responses to the three items were summed, creating a variable ranging from 0 to 6. In line with previous use of this scale, [28][29][30] we considered loneliness as a continuous outcome.…”

Rural depopulation and the rural‐urban gap in cognitive functioning among older adults

“…Other studies have also shown differences among rural regions and suggested that morbidities cluster in the most geographically isolated areas of the United States. Most have focused on differences in rural regions’ size and adjacency to urban areas 29–32 . Population decline has received far less attention, and yet it varies across the rural United States.…”

“…Most have focused on differences in rural regions' size and adjacency to urban areas. [29][30][31][32] Population decline has received far less attention, and yet it varies across the rural United States. About 24% of rural counties have experienced chronic population losses, 33 yet, we know very little about its link to cognitive functioning and cognitive decline.…”