Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents
OBJECTIVE: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries. DESIGN: Population-based prospective observational study. SETTING: Urban and rural communi...
Published in: | BMJ Global Health |
---|---|
Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Text |
Language: | unknown |
Published: |
Advocate Aurora Health Institutional Repository
2021
|
Subjects: | |
Online Access: | https://institutionalrepository.aah.org/pop/44 https://doi.org/10.1136/bmjgh-2020-004124 https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:33753400 |
id |
ftaurorahc:oai:institutionalrepository.aah.org:pop-1043 |
---|---|
record_format |
openpolar |
spelling |
ftaurorahc:oai:institutionalrepository.aah.org:pop-1043 2023-07-23T04:18:25+02:00 Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents Naito, Ryo Leong, Darryl P Bangdiwala, Shrikant Ishver McKee, Martin Subramanian, S V Rangarajan, Sumathy Islam, Shofiqul Avezum, Alvaro Yeates, Karen E Lear, Scott A Gupta, Rajeev Yusufali, Afzalhussein Dans, Antonio L Szuba, Andrzej Alhabib, Khalid F Kaur, Manmeet Rahman, Omar Seron, Pamela Diaz, Rafael Puoane, Thandi Liu, Weida Zhu, Yibing Sheng, Yundong Lopez-Jaramillo, Patricio Chifamba, Jephat Rosnah, Ismail Karsidag, Kubilay Kelishadi, Roya Rosengren, Annika Khatib, Rasha K R, Leela Itty Amma Azam, Syed Iqbal Teo, Koon Yusuf, Salim 2021-03-01T08:00:00Z https://institutionalrepository.aah.org/pop/44 https://doi.org/10.1136/bmjgh-2020-004124 https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:33753400 unknown Advocate Aurora Health Institutional Repository https://institutionalrepository.aah.org/pop/44 doi:10.1136/bmjgh-2020-004124 https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:33753400 Population Health and Public Health public health Advocate Aurora Research Institute text 2021 ftaurorahc https://doi.org/10.1136/bmjgh-2020-004124 2023-07-05T20:24:44Z OBJECTIVE: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries. DESIGN: Population-based prospective observational study. SETTING: Urban and rural communities in 20 high income, middle income and low income. PARTICIPANTS: 119 894 community-dwelling middle-aged adults. MAIN OUTCOME MEASURES: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases. RESULTS: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association. CONCLUSION: Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects. Text Aurora Research Institute Aurora Health Care Digital Repository BMJ Global Health 6 3 e004124 |
institution |
Open Polar |
collection |
Aurora Health Care Digital Repository |
op_collection_id |
ftaurorahc |
language |
unknown |
topic |
public health Advocate Aurora Research Institute |
spellingShingle |
public health Advocate Aurora Research Institute Naito, Ryo Leong, Darryl P Bangdiwala, Shrikant Ishver McKee, Martin Subramanian, S V Rangarajan, Sumathy Islam, Shofiqul Avezum, Alvaro Yeates, Karen E Lear, Scott A Gupta, Rajeev Yusufali, Afzalhussein Dans, Antonio L Szuba, Andrzej Alhabib, Khalid F Kaur, Manmeet Rahman, Omar Seron, Pamela Diaz, Rafael Puoane, Thandi Liu, Weida Zhu, Yibing Sheng, Yundong Lopez-Jaramillo, Patricio Chifamba, Jephat Rosnah, Ismail Karsidag, Kubilay Kelishadi, Roya Rosengren, Annika Khatib, Rasha K R, Leela Itty Amma Azam, Syed Iqbal Teo, Koon Yusuf, Salim Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
topic_facet |
public health Advocate Aurora Research Institute |
description |
OBJECTIVE: To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries. DESIGN: Population-based prospective observational study. SETTING: Urban and rural communities in 20 high income, middle income and low income. PARTICIPANTS: 119 894 community-dwelling middle-aged adults. MAIN OUTCOME MEASURES: Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases. RESULTS: Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association. CONCLUSION: Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects. |
format |
Text |
author |
Naito, Ryo Leong, Darryl P Bangdiwala, Shrikant Ishver McKee, Martin Subramanian, S V Rangarajan, Sumathy Islam, Shofiqul Avezum, Alvaro Yeates, Karen E Lear, Scott A Gupta, Rajeev Yusufali, Afzalhussein Dans, Antonio L Szuba, Andrzej Alhabib, Khalid F Kaur, Manmeet Rahman, Omar Seron, Pamela Diaz, Rafael Puoane, Thandi Liu, Weida Zhu, Yibing Sheng, Yundong Lopez-Jaramillo, Patricio Chifamba, Jephat Rosnah, Ismail Karsidag, Kubilay Kelishadi, Roya Rosengren, Annika Khatib, Rasha K R, Leela Itty Amma Azam, Syed Iqbal Teo, Koon Yusuf, Salim |
author_facet |
Naito, Ryo Leong, Darryl P Bangdiwala, Shrikant Ishver McKee, Martin Subramanian, S V Rangarajan, Sumathy Islam, Shofiqul Avezum, Alvaro Yeates, Karen E Lear, Scott A Gupta, Rajeev Yusufali, Afzalhussein Dans, Antonio L Szuba, Andrzej Alhabib, Khalid F Kaur, Manmeet Rahman, Omar Seron, Pamela Diaz, Rafael Puoane, Thandi Liu, Weida Zhu, Yibing Sheng, Yundong Lopez-Jaramillo, Patricio Chifamba, Jephat Rosnah, Ismail Karsidag, Kubilay Kelishadi, Roya Rosengren, Annika Khatib, Rasha K R, Leela Itty Amma Azam, Syed Iqbal Teo, Koon Yusuf, Salim |
author_sort |
Naito, Ryo |
title |
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
title_short |
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
title_full |
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
title_fullStr |
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
title_full_unstemmed |
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
title_sort |
impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents |
publisher |
Advocate Aurora Health Institutional Repository |
publishDate |
2021 |
url |
https://institutionalrepository.aah.org/pop/44 https://doi.org/10.1136/bmjgh-2020-004124 https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:33753400 |
genre |
Aurora Research Institute |
genre_facet |
Aurora Research Institute |
op_source |
Population Health and Public Health |
op_relation |
https://institutionalrepository.aah.org/pop/44 doi:10.1136/bmjgh-2020-004124 https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:33753400 |
op_doi |
https://doi.org/10.1136/bmjgh-2020-004124 |
container_title |
BMJ Global Health |
container_volume |
6 |
container_issue |
3 |
container_start_page |
e004124 |
_version_ |
1772180753032937472 |