The impact of loneliness and social isolation on health state utility values: a systematic literature review

Majmudar, Ishani; Mihalopoulos, Cathrine; Brijnath, Bianca; Lim, Michelle H.; Hall, Natasha; Engel, Lidia

doi:10.1007/s11136-021-03063-1

Cited by 18 publications

(6 citation statements)

References 64 publications

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“…Social isolation is a growing public health issue associated with poor physical as well as mental health outcomes including increased morbidity and mortality and reduced quality of life [69][70][71][72]. Social isolation can be defined as an objective lack of social interactions while the related concept of perceived social isolation (e.g., loneliness and perceived social support) is characterized by a subjectively perceived lack of social interactions [70,73].…”

Section: Social Isolation and Discrimination In Humans Social Isolati...mentioning

confidence: 99%

The effects of social isolation stress and discrimination on mental health

et al. 2022

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Social isolation and discrimination are growing public health concerns associated with poor physical and mental health. They are risk factors for increased morbidity and mortality and reduced quality of life. Despite their detrimental effects on health, there is a lack of knowledge regarding translation across the domains of experimental research, clinical studies, and real-life applications. Here, we review and synthesize evidence from basic research in animals and humans to clinical translation and interventions. Animal models indicate that social separation stress, particularly in early life, activates the hypothalamic-pituitary-adrenal axis and interacts with monoaminergic, glutamatergic, and GABAergic neurotransmitter systems, inducing long-lasting reductions in serotonin turnover and alterations in dopamine receptor sensitivity. These findings are of particular importance for human social isolation stress, as effects of social isolation stress on the same neurotransmitter systems have been implicated in addictive, psychotic, and affective disorders. Children may be particularly vulnerable due to lasting effects of social isolation and discrimination stress on the developing brain. The effects of social isolation and loneliness are pronounced in the context of social exclusion due to discrimination and racism, during widespread infectious disease related containment strategies such as quarantine, and in older persons due to sociodemographic changes. This highlights the importance of new strategies for social inclusion and outreach, including gender, culture, and socially sensitive telemedicine and digital interventions for mental health care.

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Section: Social Isolation and Discrimination In Humans Social Isolati...mentioning

confidence: 99%

The effects of social isolation stress and discrimination on mental health

et al. 2022

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“…While not very important in explaining variations in EQ-VAS, the two dimensions were the most important for well-being; close to 40% of the explained variation in global life satisfaction. Given the increasing empirical evidence on the crucial role of social relationships in health and well-being [ 16 , 48 ], our results would come as no surprise.…”

Section: Discussionmentioning

confidence: 77%

Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions

Chen

Olsen

2022

Qual Life Res

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Objectives The EQ-5D is the most widely applied preference-based health-related quality of life measure. However, concerns have been raised that the existing dimensional structure lacks sufficient components of mental and social aspects of health. This study empirically explored the performance of a coherent set of four psycho-social bolt-ons: Vitality; Sleep; Personal relationships; and Social isolation. Methods Cross-sectional surveys were conducted with online panel members from five countries (Australia, Canada, Norway, UK, US) (total N = 4786). Four bolt-ons were described using terms aligned with EQ nomenclature. Latent structures among all nine dimensions are studied using an exploratory factor analysis (EFA). The Shorrocks-Shapely decomposition analyses are conducted to illustrate the relative importance of the nine dimensions in explaining two outcome measures for health (EQ-VAS, satisfaction with health) and two for subjective well-being (the hedonic approach of global life satisfaction and an eudemonic item on meaningfulness). Sub-group analyses are performed on older adults (65 +) and socially disadvantaged groups. Results Strength of correlations among four bolt-ons ranges from 0.34 to 0.49. As for their correlations with the EQ-5D dimensions, they are generally much less correlated with four physical health dimensions than with mental health dimensions (ranged from 0.21 to 0.50). The EFA identifies two latent factors. When explaining health, Vitality is the most important. When explaining subjective well-being, Social isolation is second most important, after Anxiety/depression. Conclusion We provide evidence that further complementing the current EQ-5D-5L health state classification system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap.

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“…Future studies should include both loneliness and social isolation to further understand this combined effect. Given the lack of consistency in how loneliness and social isolation are de ned and measured across studies, there is a need for standardized tools to measure these constructs separately [50].…”

Section: [Insert Table 4] Discussionmentioning

confidence: 99%

Health service use associated with loneliness and social isolation among older adults in Australia

Majmudar

Mihalopoulos

Abimanyi-Ochom

et al. 2023

Preprint

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Background Loneliness and social isolation among older adults are associated with a significant health burden. However, less is known about the impact of loneliness and social isolation on health service use (HSU). The aim of this study is to examine whether loneliness and social isolation are associated with increased HSU among older adults in Australia. Methods Data were derived from three waves (2009, 2013, and 2017) of the nationally representative longitudinal Household Income and Labour Dynamics of Australia (HILDA) survey from individuals aged 65 years and older. Outcomes included health professional visits and hospital admissions in the past year. Generalized estimating equations were used to investigate longitudinal associations between the experience of loneliness and/or social isolation with HSU. Results Compared to older adults who neither experienced loneliness nor social isolation, loneliness was significantly associated with more General Practitioner (GP) visits (incident rate ratio [IRR] = 1.13, 95%-CI [1.05, 1.23] and more hospital admissions (IRR = 1.29, 95%-CI [1.11,1.50)). Social isolation was associated with more GP visits (IRR = 1.14, 95%-CI [1.05,1.29]). Experiencing both loneliness and social isolation was associated with more GP visits (IRR = 1.44, 95%-CI [1.04–1.97]) and more hospitalisations (IRR = 1.75, 95%-CI [1.2, 2.56]). Conclusions Loneliness and social isolation among older adults were significantly associated with increased health service use, including more visits to GPs and higher hospital admission rates. The findings highlight the need to address these factors for improved health outcomes and potential reduction in healthcare costs.

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The impact of loneliness and social isolation on health state utility values: a systematic literature review

Cited by 18 publications

References 64 publications

The effects of social isolation stress and discrimination on mental health

The effects of social isolation stress and discrimination on mental health

Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions

Health service use associated with loneliness and social isolation among older adults in Australia

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