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Meehan DE, Grunseit A, Condie J, HaGani N, Merom D. Social-ecological factors influencing loneliness and social isolation in older people: a scoping review. BMC Geriatr 2023; 23:726. [PMID: 37946155 PMCID: PMC10636946 DOI: 10.1186/s12877-023-04418-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.
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Affiliation(s)
- Drew Eleanor Meehan
- School of Health Sciences, Western Sydney University, Campbelltown, Australia.
| | - Anne Grunseit
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jenna Condie
- School of Social Sciences, Western Sydney University, Paramatta, Australia
| | - Neta HaGani
- Prevention Research Collaboration, School of Public Health, University of Sydney, Camperdown, Australia
| | - Dafna Merom
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
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Hajek A, Kretzler B, Walther C, Aarabi G, Zwar L, König HH. Neighbourhood cohesion, loneliness and perceived social isolation prior and during the COVID-19 pandemic. Longitudinal evidence from the German Ageing Survey. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1411-1420. [PMID: 36914882 PMCID: PMC10010637 DOI: 10.1007/s00127-023-02447-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/27/2023] [Indexed: 03/15/2023]
Abstract
PURPOSE To investigate the longitudinal association between neighbourhood cohesion and loneliness as well as perceived social isolation prior and during the COVID-19 pandemic (stratified by sex). METHODS Longitudinal data were taken from a nationally representative sample (German Ageing Survey) of inhabitants aged 40 years and over in Germany prior (wave 6: year 2017) and during the COVID-19 pandemic (wave 8: November 2020 until February 2021; n = 6688 observations, mean age was 67.4 years). The De Jong Gierveld tool was used to measure loneliness and the Bude and Lantermann tool was used to measure perceived social isolation. Neighbourhood cohesion was assessed based on different items. RESULTS FE regressions showed that decreases in closeness of contact with neighbours were associated with increases in loneliness and perceived social isolation levels among men, but not women. In contrast, decreases in different indicators of involvement in neighbourhood activities were associated with increases in loneliness and perceived social isolation levels among women, but not men. CONCLUSION Changes in neighbourhood factors are differently associated with loneliness and perceived social isolation among middle-aged and older women and men. Gender-specific efforts to avoid loneliness and social isolation are, therefore, needed.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
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Mao S, Lou VWQ, Lu N. Perceptions of neighborhood environment and loneliness among older Chinese adults: the mediator role of cognitive and structural social capital. Aging Ment Health 2023; 27:595-603. [PMID: 35302917 DOI: 10.1080/13607863.2022.2053500] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to examine the mediating role of social capital in the association between perceived physical neighborhood environment and loneliness among older adults in urban China. METHOD Data were derived from face-to-face interviews with people (n = 472) aged 60 or older in urban communities of Shanghai, China, in 2020. Loneliness was measured by the 6-item De Jong Gierveld Scale. A multiple mediator model was adopted to examine the research hypotheses. RESULTS Cognitive social capital played a full mediation role in the association between perceived community health care (β = -.061, p < .05), safety (β = -.168, p < .001), recreational services (β = -.058, p < .05), and loneliness. Structural social capital was associated with loneliness (β = -.102, p < .05), whereas its mediator effect was not significant. Perceived transportation convenience had neither a direct nor an indirect effect on loneliness among older adults. CONCLUSION Findings indicate that older adults' perceptions of healthcare services, safety, and recreational resources could help alleviate their loneliness via fostering cognitive social capital. Interventions improving older adults' perceptions of community health care, safety, and recreation, and their social capital level could help reduce the prevalence of loneliness.
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Affiliation(s)
- Shan Mao
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
| | - Vivian W Q Lou
- Department of Social Work & Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong SAR
| | - Nan Lu
- Department of Social Work and Social Policy, School of Sociology and Population Studies, Renmin University of China, Beijing, China
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Luhmann M, Buecker S, Rüsberg M. Loneliness across time and space. NATURE REVIEWS PSYCHOLOGY 2023; 2:9-23. [PMID: 36406179 PMCID: PMC9640887 DOI: 10.1038/s44159-022-00124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
People feel lonely when their social needs are not met by the quantity and quality of their social relationships. Most research has focused on individual-level predictors of loneliness. However, macro-level factors related to historical time and geographic space might influence loneliness through their effects on individual-level predictors. In this Review, we summarize empirical findings on differences in the prevalence of loneliness across historical time and geographical space and discuss four groups of macro-level factors that might account for these differences: values and norms, family and social lives, technology and digitalization, and living conditions and availability of individual resources. Regarding historical time, media reports convey that loneliness is on the rise, but the empirical evidence is mixed, at least before the COVID-19 pandemic. Regarding geographical space, national differences in loneliness are linked to differences in cultural values (such as individualism) but might also be due to differences in the sociodemographic composition of the population. Research on within-country differences in loneliness is scarce but suggests an influence of neighbourhood characteristics. We conclude that a more nuanced understanding of the effects of macro-level factors on loneliness is necessary because of their relevance for public policy and propose specific directions for future research.
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Affiliation(s)
- Maike Luhmann
- grid.5570.70000 0004 0490 981XFaculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Susanne Buecker
- grid.5570.70000 0004 0490 981XFaculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Marilena Rüsberg
- grid.5570.70000 0004 0490 981XFaculty of Psychology, Ruhr University Bochum, Bochum, Germany
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Bower M, Kent J, Patulny R, Green O, McGrath L, Teesson L, Jamalishahni T, Sandison H, Rugel E. The impact of the built environment on loneliness: A systematic review and narrative synthesis. Health Place 2023; 79:102962. [PMID: 36623467 DOI: 10.1016/j.healthplace.2022.102962] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023]
Abstract
Loneliness is a pressing public health issue. Although quintessentially individual, it is shaped by wider environmental, cultural, socio-economic, and political circumstances. Using a systematic review methodology, this paper draws on interdisciplinary research to conceptualise the relationship between the built environment and loneliness. We present a narrative synthesis of 57 relevant studies to characterise the body of evidence and highlight specific built-environment elements. Our findings demonstrate the need for further conceptual and empirical explorations of the multifaceted ways in which built environments can prevent loneliness, supporting calls for investment into this public-health approach.
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Affiliation(s)
- Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Jennifer Kent
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia.
| | - Roger Patulny
- Faculty of the Arts, Social Sciences, and Humanities, University of Wollongong, Australia
| | - Olivia Green
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | - Laura McGrath
- Faculty of Arts and Social Sciences, The Open University, Milton Keynes, England; UK
| | - Lily Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Australia
| | | | - Hannah Sandison
- The University of Sydney School of Architecture, Design, and Planning, The University of Sydney, Australia
| | - Emily Rugel
- Westmead Applied Research Centre, The University of Sydney, Australia
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Santos CJ, Paciência I, Ribeiro AI. Neighbourhood Socioeconomic Processes and Dynamics and Healthy Ageing: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116745. [PMID: 35682327 PMCID: PMC9180257 DOI: 10.3390/ijerph19116745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 02/05/2023]
Abstract
Elderly citizens are concentrated in urban areas and are particularly affected by the immediate residential environment. Cities are unequal and segregated places, where there is an intensification of urban change processes such as gentrification and displacement. We aimed to understand how neighbourhood socioeconomic processes and dynamics influence older people’s health. Three bibliographic databases—PubMed, Web of Science, and Scopus—were used to identify evidence of the influence of neighbourhood socioeconomic deprivation, socio-spatial segregation, urban renewal, and gentrification on healthy ageing. We followed the method of Arksey and O’Malley, Levac and colleagues, the Joanna Briggs Institute, and the PRISMA-ScR. The included studies (n = 122) were published between 2001 and 2021. Most evaluated neighbourhood deprivation (n = 114), followed by gentrification (n = 5), segregation (n = 2), and urban renewal (n = 1). Overall, older people living in deprived neighbourhoods had worse healthy ageing outcomes than their counterparts living in more advantaged neighbourhoods. Older adults pointed out more negative comments than positive ones for gentrification and urban renewal. As to segregation, the direction of the association was not entirely clear. In conclusion, the literature has not extensively analysed the effects of segregation, gentrification, and urban renewal on healthy ageing, and more quantitative and longitudinal studies should be conducted to draw better inferences.
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Affiliation(s)
- Cláudia Jardim Santos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Correspondence: ; Tel.: +351-222-061-820
| | - Inês Paciência
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, P.O. Box 5000, 90570 Oulu, Finland;
- Biocenter Oulu, University of Oulu, P.O. Box 5000, 90570 Oulu, Finland
| | - Ana Isabel Ribeiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, 4050-600 Porto, Portugal;
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), 4050-600 Porto, Portugal
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, 4200-319 Porto, Portugal
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Hsueh YC, Batchelor R, Liebmann M, Dhanani A, Vaughan L, Fett AK, Mann F, Pitman A. A Systematic Review of Studies Describing the Effectiveness, Acceptability, and Potential Harms of Place-Based Interventions to Address Loneliness and Mental Health Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4766. [PMID: 35457637 PMCID: PMC9029472 DOI: 10.3390/ijerph19084766] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/05/2022] [Accepted: 04/12/2022] [Indexed: 12/02/2022]
Abstract
Given the links between the built environment and loneliness, there is interest in using place-based approaches (addressing built environment characteristics and related socio-spatial factors) in local communities to tackle loneliness and mental health problems. However, few studies have described the effectiveness, acceptability, or potential harms of such interventions. This review aimed to synthesize the literature describing local community-based interventions that target place-based factors to address loneliness and mental health problems, informing the development of future public health approaches. We searched PsycINFO, Medline, and Embase using a structured search strategy to identify English-language studies evaluating the effectiveness, acceptability, and potential harms of place-based community interventions in addressing loneliness and mental health problems, both in general and clinical populations. Seven studies met the inclusion criteria, classified as evaluating provision of community facilities (such as clubhouses), active engagement in local green spaces, and housing regeneration. None were randomised trials. Quantitative and qualitative findings suggested promising effects and/or acceptability of six interventions, with minimal potential harms. There is a clear need for randomised trials or quasi-experimental studies of place-based interventions to describe their effectiveness in addressing loneliness and mental health problems, as well as complementary qualitative work investigating acceptability. This will inform future policy development.
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Affiliation(s)
- Yung-Chia Hsueh
- Division of Psychiatry, University College London (UCL), London W1T 7NF, UK; (Y.-C.H.); (M.L.); (F.M.)
| | | | - Margaux Liebmann
- Division of Psychiatry, University College London (UCL), London W1T 7NF, UK; (Y.-C.H.); (M.L.); (F.M.)
| | - Ashley Dhanani
- Bartlett School of Architecture, University College London (UCL), London WC1H 0AY, UK; (A.D.); (L.V.)
| | - Laura Vaughan
- Bartlett School of Architecture, University College London (UCL), London WC1H 0AY, UK; (A.D.); (L.V.)
| | - Anne-Kathrin Fett
- Department of Psychology, City, University of London, London EC1V 0HB, UK;
| | - Farhana Mann
- Division of Psychiatry, University College London (UCL), London W1T 7NF, UK; (Y.-C.H.); (M.L.); (F.M.)
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London (UCL), London W1T 7NF, UK; (Y.-C.H.); (M.L.); (F.M.)
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK
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