“…Similarly, evidence for an association between level of education, geographical location (eg, rural versus urban) or material circumstances (eg, limited income) and loneliness/isolation is equivocal. 5,25,34,[38][39][40][41][42][43] Another group of risk factors relate to health, both physical (eg, poor self-assessed physical health status, chronic illness 21,25,42,44 ) and mental health (eg, reported depression, elevated mental morbidity 25 ). Although deteriorating physical health (or perceived poor health) is one of the most consistently identified factors, the direction of causation is still not well understood.…”