Dataset Information

Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health?

ABSTRACT: Loneliness is a growing public health issue. It is more common in disadvantaged groups and has been associated with a range of poor health outcomes. Loneliness may also form an independent pathway between socio-economic disadvantage and poor health. Therefore, the aim of this study was to explore the contribution of loneliness to socio-economic health inequalities. These contributions were studied in a Dutch national sample (n = 445,748 adults (≥19 y.o.)) in Poisson and logistic regression models, controlling for age, gender, marital status, migration background, BMI, alcohol consumption, smoking, and physical activity. Loneliness explained 21% of socioeconomic health inequalities between the lowest and highest socio-economic groups in self-reported chronic disease prevalence, 27% in poorer self-rated health, and 51% in psychological distress. Subgroup analyses revealed that for young adults, loneliness had a larger contribution to socioeconomic gaps in self-rated health (37%) than in 80+-year-olds (16%). Our findings suggest that loneliness may be a social determinant of health, contributing to the socioeconomic health gap independently of well-documented factors such as lifestyles and demographics, in particular for young adults. Public health policies targeting socioeconomic health inequalities could benefit from integrating loneliness into their policies, especially for young adults.

SUBMITTER: Meisters R

PROVIDER: S-EPMC8508269 | biostudies-literature | 2021 Sep

REPOSITORIES: biostudies-literature

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Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health?

Meisters Rachelle R Putrik Polina P Westra Daan D Bosma Hans H Ruwaard Dirk D Jansen Maria M

International journal of environmental research and public health 20210928 19

Loneliness is a growing public health issue. It is more common in disadvantaged groups and has been associated with a range of poor health outcomes. Loneliness may also form an independent pathway between socio-economic disadvantage and poor health. Therefore, the aim of this study was to explore the contribution of loneliness to socio-economic health inequalities. These contributions were studied in a Dutch national sample (<i>n</i> = 445,748 adults (≥19 y.o.)) in Poisson and logistic regressio ...[more]

PMID: 34639477

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Project description:BackgroundLower socioeconomic status is associated with poorer wellbeing among children. Identifying how children participate in after-school activities and how after-school activities are associated with wellbeing may inform interventions to improve wellbeing among children from low socioeconomic backgrounds. This study explored whether children's after-school activities varied by socioeconomic status and examined the associations between after-school activities and wellbeing in low socioeconomic status children.MethodsThis study analysed cross-sectional data from 61,759 school students in years 4 to 9 who completed the 2018 South Australian Wellbeing and Engagement Collection. Students reported the number of days per week they participated in 12 activities (after-school care, homework, music lessons or practice, youth organisations, sports, television, videogames, social media, reading, chores, arts and crafts, and socialising with friends) during the after-school period (3-6 pm) and their wellbeing (happiness, sadness, worry, engagement, perseverance, optimism, emotion regulation, and life satisfaction). Socioeconomic status was measured by parents' highest education level obtained from school enrolment data. Linear multilevel models were used to examine whether frequency of after-school activities varied by socioeconomic status. Multilevel ordered logit models were used to analyse the association between after-school activities and wellbeing amongst participants in the low socioeconomic status category.ResultsAfter-school activities differed according to socioeconomic status; high socioeconomic status children did more frequent sport, homework, and reading and low socioeconomic status children did more frequent screen-based activities (TV, videogames and social media). Among children from low socioeconomic status backgrounds, higher wellbeing was associated most consistently with more frequent sports participation, homework, reading and spending time with friends and less frequent videogames, social media and after-school care.ConclusionsChildren's wellbeing is positively associated with socioeconomic status. Amongst children from disadvantaged backgrounds, participating in sport, spending time with friends and getting less screen time may be protective for wellbeing. The results suggest that programming targeted at increasing sports participation and reducing screen time amongst children from low socioeconomic status backgrounds may support their wellbeing.

Project description:BackgroundSocio-economic disadvantage at both individual and neighbourhood levels has been found to be associated with single lifestyle risk factors. However, it is unknown to what extent their combined effects contribute to a broad lifestyle profile. We aimed to (i) investigate the associations of individual socio-economic disadvantage (ISED) and neighbourhood socio-economic disadvantage (NSED) in relation to an extended score of health-related lifestyle risk factors (lifestyle risk index); and to (ii) investigate whether NSED modified the association between ISED and the lifestyle risk index.MethodsOf 77 244 participants [median age (IQR): 46 (40-53) years] from the Lifelines cohort study in the northern Netherlands, we calculated a lifestyle risk index by scoring the lifestyle risk factors including smoking status, alcohol consumption, diet quality, physical activity, TV-watching time and sleep time. A higher lifestyle risk index was indicative of an unhealthier lifestyle. Composite scores of ISED and NSED based on a variety of socio-economic indicators were calculated separately. Linear mixed-effect models were used to examine the association of ISED and NSED with the lifestyle risk index and to investigate whether NSED modified the association between ISED and the lifestyle risk index by including an interaction term between ISED and NSED.ResultsBoth ISED and NSED were associated with an unhealthier lifestyle, because ISED and NSED were both positively associated with the lifestyle risk index {highest quartile [Q4] ISED beta-coefficient [95% confidence interval (CI)]: 0.64 [0.62-0.66], P < 0.001; highest quintile [Q5] NSED beta-coefficient [95% CI]: 0.17 [0.14-0.21], P < 0.001} after adjustment for age, sex and body mass index. In addition, a positive interaction was found between NSED and ISED on the lifestyle risk index (beta-coefficient 0.016, 95% CI: 0.011-0.021, Pinteraction < 0.001), which indicated that NSED modified the association between ISED and the lifestyle risk index; i.e. the gradient of the associations across all ISED quartiles (Q4 vs Q1) was steeper among participants residing in the most disadvantaged neighbourhoods compared with those who resided in the less disadvantaged neighbourhoods.ConclusionsOur findings suggest that public health initiatives addressing lifestyle-related socio-economic health differences should not only target individuals, but also consider neighbourhood factors.

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Dataset Information

Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health?

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Is Loneliness an Undervalued Pathway between Socio-Economic Disadvantage and Health?

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