Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study
Abstract
:1. Introduction
2. Methods
2.1. Ethical Approval
2.2. Measures
2.2.1. Loneliness: Pre-COVID-19 and during COVID-19 Pandemic
2.2.2. Social Isolation: Pre-COVID-19 and during COVID-19 Pandemic
2.2.3. Socio-Demographic and Other Characteristics
2.2.4. Health
2.2.5. Place and Community
2.2.6. Experiences of Bereavement and/or COVID-19
2.3. Analysis
3. Results
- (1)
- Loneliness:
- (2)
- Social isolation:
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
N (%) | |
---|---|
East Asia and Pacific | 456 (2.6%) |
Europe and Central Asia | 5739 (32%) |
Latin America and the Caribbean | 1580 (9%) |
Middle East and North Africa | 207 (1%) |
North America | 7770 (44%) |
South Asia | 1861 (10.5%) |
Sub-Saharan Africa | 88 (0.50%) |
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Variable (N Completed Item) | N (%) |
---|---|
Gender (n = 18,991) Females | 14,917 (79%) |
Age (n = 17,436) | Mean = 53 (SD 17.6) |
Education (n = 18,056) Degree + | 13,504 (75%) |
Needs met by financial resources (n = 18,231) Very well Fairly well Poorly | 8046 (44%) 8456 (46%) 1729 (10%) |
Member of minority group (n = 18,353) Yes | 1977 (11%) |
Care provider (n = 19,046) Yes | 5236 (27.5%) |
Employment status (n = 18,295) Employed including work from home Self employed In education/training Unemployed Retired Other/homemaker | 7324 (40%) 1084 (6%) 1233 (7%) 1419 (8%) 6039 (33%) 1196 (6.5%) |
Self-rated physical health (n = 18,236) Excellent/Very good/good Fair/poor | 15,728 (86%) 2508 (14%) |
Self-rated mental health (n = 18,212) Excellent/Very good/good Fair/poor | 14,873 (82%) 3339 (18%) |
Quality of sleep during COVID-19 (n = 17,852) Worse than before About the same | 5905 (33%) 10,668 (60%) |
Physical activity during COVID-19 (n = 17,840) Less than before About the same | 8677 (49%) 5909 (33%) |
Smoking during COVID-19 (n = 17,852) Less than before More than before About the same | 271 (1.5%) 709 (4%) 708 (4%) |
Urban/rural (n = 18,277) City Town Rural | 9512 (52%) 5076 (28%) 3689 (20%) |
Lived in current area (n = 18,272) 1–4 years 5–9 years 10+ years | 2940 (16%) 2125 (12%) 13,207 (72%) |
Close-knit/“tight” neighbourhood (n = 15,922) Strongly disagree | 1144 (7%) |
Use of face-to-face technology pre-COVID-19 (n = 17,055) Never/Hardly ever | 9213 (54%) |
Use of face-to-face technology during COVID-19 (n = 16,973) Never/Hardly ever | 5490 (32%) |
Satisfied with face-to-face technology for communication (n = 15,016) Very dissatisfied | 1116 (7%) |
Living with others (n = 17,231) Yes | 13,374 (78%) |
Time spent alone pre COVID-19 (n = 17,134) Always and often alone Seldom and never alone | 6748 (39%) 10,386 (61%) |
Importance of religion (n = 14,050) Not important at all Very important | 4756 (34%) 4049 (29%) |
Someone close died at this time (n = 18,122) Yes | 3274 (18%) |
Me or someone close diagnosed with COVID-19 (n = 18,120) | 3359 (18.5%) |
Me or Someone close Hospitalised with COVID-19 (n = 18,097) Me/ someone close | 1562 (9%) |
Outcomes | N (%) |
UCLA pre-COVID pandemic (n = 16,452) None/low (0–4) Moderate (5–6) Severe (7+) | 13,204 (80%) 2314 (14%) 934 (6%) |
UCLA during COVID pandemic (n = 16,343) None/low (0–4) Moderate (5–6) Severe (7+) | 9277 (57%) 3659 (22%) 3407 (21%) |
Lubben pre-COVID pandemic (n = 15,408) Isolated (<12) Not isolated | 3188 (21%) 12,220 (79%) |
Lubben change during COVID pandemic (n = 15,322) Large increase in isolation (score < −2) Small or no increase in isolation | 1989 (13%) 13,333 (87%) |
Base: None/Low Loneliness (UCLA = 0–4) | Moderate Loneliness (UCLA = 5–6) | Severe Loneliness (UCLA 7+) |
---|---|---|
RRR 95% CI | RRR 95% CI * Significance | |
18–34 (ref) 35–44 45–54 55–69 70 and over | 1.00 1.02 (0.78–1.32) 0.80 (0.62–1.03) 0.72 (0.57–0.91) ** 0.58 (0.42–0.78) *** | 1.00 1.07 (0.72–1.59) 0.63 (0.42–0.94) * 0.66 (0.46–0.95) * 0.48 (0.30–0.77) ** |
Female | 1.81 (0.99–1.40) | 1.10 (0.84–1.43) |
Education (ref: Degree or higher) Secondary/diploma To elementary | 1.00 1.02 (0.87–1.19) 1.21 (0.66–2.24) | 1.00 1.20 (0.96–1.51) 0.54 (0.19–1.51) |
Finances meet needs: (ref: very well) Fairly well Poorly | 1.00 1.30 (1.12–1.50) *** 1.55 (1.22–1.97) *** | 1.00 1.57 (1.23–2.00) *** 3.31 (2.40–4.58) *** |
Member of minority | 1.06 (0.85–1.30) | 0.87 (0.62–1.21) |
Employment status (ref: employed including work from home) Self employed In education/training Unemployed/not working Retired Other/homemaker | 1.00 0.86 (0.65–1.18) 1.30 (0.97–1.74) 1.08 (0.84–1.40) 0.96 (0.77–1.18) 1.08 (0.83–1.42) | 1.00 0.93 (0.57–1.50) 1.73 (1.14–2.63) * 1.24 (0.86–1.81) 1.21 (0.86–1.70) 1.68 (1.16–2.44) ** |
Self-rated mental health Fair/poor | 2.61 (2.23–3.07) *** | 5.27 (4.19–6.63) *** |
Self-rated physical health Fair/poor | 1.49 (1.24–1.79) *** | 1.32 (1.02–1.71) * |
Sleep during COVID-19 (ref: about the same) Better than before Worse than before | 1.00 1.32 (1.02–1.72) * 1.35 (1.17–1.56) *** | 1.00 1.50 (1.00–2.25) 1.08 (0.86–1.35) |
Physical activity COVID-19 (ref: about the same) Less than before More than before | 1.00 1.17 (1.00–1.36) 1.09 (0.89–1.34) | 1.00 0.96 (0.76–1.22) 0.99 (0.72–1.37) |
Alcohol consumption during COVID-19 (ref: about the same) Less than before More than before Do not partake | 1.00 0.84 (0.67–1.07) 0.99 (0.81–1.22) 1.03 (0.87–1.21) | 1.00 0.94 (0.66–1.35) 0.99 (0.71–1.38) 1.27 (0.99–1.64) |
Urban (ref: city) Town Rural | 1.00 0.99 (0.85–1.17) 1.13 (0.95–1.35) | 1.00 1.14 (0.89–1.44) 1.10 (0.83–1.44) |
Close-knit neighbourhood (ref: 5 (Strongly agree)) 1 (Strongly disagree) 2 3 4 | 1.00 2.05 (1.52−2.75) *** 1.61 (1.26−2.07) *** 1.66 (1.31−2.10) *** 1.14 (0.88−1.48) | 1.00 1.62 (1.06−2.48) * 1.33 (0.92−1.92) 0.98 (0.69−1.41) 0.94 (0.64−1.38) |
Time in area (ref: 10 years+) 1–4 years 5–9 years | 1.00 1.29 (1.08−1.55) ** 1.11 (0.90−1.36) | 1.00 1.49 (1.15−1.93) ** 0.99 (0.71−1.39) |
Pre COVID-19 video calls (ref: often) Hardly ever/never Sometimes | 1.00 0.68 (0.54−0.85) ** 0.88 (0.70−1.09) | 1.00 1.01 (0.71−1.46) 0.78 (0.53−1.13) |
During COVID-19 video calls (ref: often) Hardly ever/never Sometimes | 1.00 1.79 (1.44−2.23) *** 1.36 (1.13−1.63) ** | 1.00 1.55 (1.11−2.16) * 1.02 (0.75−1.38) |
Satisfaction with video calls (ref: 5 (very satisfied)) 1 (very dissatisfied) 2 3 4 | 1.00 1.51 (1.13−2.01) * 1.31 1.04−1.67) * 1.16 (0.93−1.44) 1.13 (0.94−1.35) | 1.00 1.44 (0.95−2.17) 1.44 (1.01−2.06) * 1.21 (0.86−1.71) 1.05 (0.78−1.41) |
Living alone (ref: lives with others) Lives alone by choice Lives alone not by choice | 1.00 0.85 (0.71−1.02) 1.57 (1.18−2.09) ** | 1.00 0.66 (0.49−0.87) ** 2.70 (1.91−3.81) *** |
Pre-COVID-19 time alone (ref: always) Often Seldom Never | 1.00 0.88 (0.58−1.35) 0.38 (0.24−0.58) *** 0.29 (0.18−0.48) *** | 1.00 0.30 (0.19−0.45) *** 0.06 (0.04−0.10) *** 0.11 (0.06−0.19) *** |
Importance of religion (ref: 1 (not at all important)) 2 3 4 5 (very important) | 1.00 1.07 (0.86−1.32) 1.01 (0.79−1.28) 1.26 (1.03−1.54) * 1.17 (0.98−1.40) | 1.00 0.99 (0.71−1.36) 1.08 (0.76−1.53) 0.92 (0.67−1.27) 0.83 (0.63−1.11) |
Base: None/Low Loneliness (UCLA = 0–4) | Moderate Loneliness (UCLA = 5–6) | Severe Loneliness (UCLA 7+) |
---|---|---|
RRR 95% CI | RRR 95% CI * Significance | |
18−34 (ref) 35−44 45−54 55−69 70 and over | 1.00 0.84 (0.68−1.05) 0.72 (0.58−0.88) ** 0.84 (0.69−1.02) 0.81 (0.64−1.03) | 1.00 0.99 (0.77−1.28) 0.77 (0.60−0.98) * 1.01 (0.80−1.26) 0.99 (0.75−1.30) |
Female | 1.26 (1.10−1.43) ** | 1.67 (1.42−1.97) *** |
Education (ref: Degree or higher) Secondary/diploma To elementary | 1.00 1.23 (1.09−1.39) ** 1.51 (0.93−2.45) | 1.00 0.91 (0.79−1.06) 0.56 (0.29−1.09) |
Finances meet needs: (ref: very well) Fairly well Poorly | 1.00 1.31 (1.17−1.46) *** 1.16 (094−1.44) | 1.00 1.42 (1.25−1.62) *** 1.61 (1.29−2.02) *** |
Provides Care | 1.42 (1.26−1.61) *** | 1.46 (1.27−1.68) *** |
Employment status (ref: employed including work from home) Self employed In education/training Unemployed/not working Retired Other/homemaker | 1.00 0.97 (0.77−1.21) 1.17 (0.91−1.50) 1.53 (1.24−1.90) *** 1.07 (0.91−1.26) 1.04 (0.83−1.32) | 1.00 0.77 (0.58−1.02) 1.24 (0.92−1.67) 1.80 (1.42−2.28) *** 1.35 (1.12−1.63) ** 1.28 (0.99−1.64) |
Self−rated mental health (Fair/poor) | 1.93 (1.65−2.27) *** | 4.48 (3.83−5.24) *** |
Self−rated physical health (Fair/poor) | 1.05 (0.89−1.25) | 1.24 (1.04−1.48) * |
Sleep during COVID-19 (ref: about the same) Better than before Worse than before | 1.00 0.95 (0.77−1.17) 1.85 (1.65−2.08) ** | 1.00 0.94 (0.72−1.22) 2.47 (2.17−2.81) *** |
Physical activity during COVID-19 (ref: about the same) Less than before More than before | 1.00 1.39 (1.23−1.56) *** 1.02 (0.88−1.19) | 1.00 2.01 (1.75−2.32) *** 1.16 (0.96−1.40) |
Smoking during COVID-19 (ref: about the same) Less than before More than before Do not partake | 1.00 0.68 (0.40−1.17) 0.98 (0.65−1.47) 0.98 (0.74−1.30) | 1.00 0.91 (0.51−1.64) 1.56 (1.00−2.43) 1.08 (0.76−1.51) |
Alcohol consumption during COVID-19 (ref: about the same) Less than before More than before Do not partake | 1.00 1.14 (0.95−1.37) 1.34 (1.14−1.58) *** 1.07 (0.94−1.22) | 1.00 1.36 (1.07−1.66) ** 1.85 (1.55−2.20) *** 1.15 (0.99−1.33) |
Close−knit neighbourhood (ref: 5 (Strongly agree)) 1 (Strongly disagree) 2 3 4 | 1.00 1.62 (1.28−2.05) *** 1.31 (1.09−1.58) ** 1.38 (1.16−1.64) *** 1.06 (0.88−1.27) | 1.00 1.55 (1.19−2.00) ** 1.18 (0.96−1.44) 1.05 (0.87−1.28) 0.91 (0.74−1.11) |
Time in area (ref: 10 years+) 1−4 years 5−9 years | 1.00 1.17 (1.01−1.36) * 1.07 (0.91−1.26) | 1.00 1.55 (1.32−1.82) *** 1.07 (0.88−1.28) |
Pre COVID-19 video calls (ref: often) Hardly ever/never Sometimes | 1.00 0.89 (0.77−1.03) 1.02 (0.88−1.19) | 1.00 1.03 (0.87−1.23) 1.02 (0.85−1.23) |
Satisfaction with video calls (ref: 5 (very satisfied)) 1 (very dissatisfied) 2 3 4 | 1.00 1.57 (1.23−1.99) *** 1.99 (1.65−2.40) *** 1.56 (1.32−1.84) *** 1.44 (1.26−1.65) *** | 1.00 2.31 (1.80−2.96) *** 2.54 (2.07−3.11) *** 1.63 (1.35−1.97) *** 1.30 (1.11−1.52) ** |
Living alone and choice (ref: lives with others) Lives alone by choice Lives alone not by choice | 1.00 1.31 (1.12−1.52) ** 2.36 (1.75−3.18) *** | 1.00 1.61 (1.37−1.90) *** 6.82 (5.19−8.95) *** |
Pre COVID-19 time alone (ref: always) Often Seldom Never | 1.00 1.51 (1.01−2.26) * 1.25 (0.83−1.87) 1.19 (0.77−1.83) | 1.00 1.13 (0.77−1.67) 0.97 (0.66−1.44) 0.68 (0.44−1.07) |
Importance of religion (ref: 1 (not at all important)) 2 3 4 5 (very important) | 1.00 1.28 (1.08−1.52) ** 1.37 (1.13−1.66) ** 1.27 (1.07−1.49) * 1.45 (1.26−1.68) *** | 1.00 1.55 (1.28−1.86) *** 1.37 (1.10−1.70) * 1.39 (1.15−1.67) ** 1.53 (1.30−1.80) *** |
Hospitalised with COVID-19 (ref: neither) Respondent or someone close to respondent | 1.00 1.21 (0.97−1.52) | 1.00 0.99 (0.76−1.28) |
Diagnosed with COVID-19 (ref: neither) Respondent Someone close to respondent Both | 1.00 0.67 (0.41−1.08) 0.90 (0.76−1.06) 1.31 (0.82−2.10) | 1.00 0.63 (0.37−1.08) 1.00 (0.83−1.20) 1.18 (0.67−2.07) |
Someone close to respondent died at this time due to any cause | 1.02 (0.88−1.17) | 1.11 (0.95−1.30) |
OR 95% CI * Significance | |
---|---|
18–34 35−44 45−54 55−69 70 and over | 1.00 1.06 (0.84−1.34) 1.04 (0.83−1.30) 1.20 (0.98−1.47) 0.97 (0.75−1.25) |
Female | 0.72 (0.63−0.82) *** |
Education (ref: Degree or higher) Secondary/diploma To elementary | 1.00 1.17 (1.03−1.33) * 2.99 (1.85−4.82) *** |
Finances meet needs (ref: very well) Fairly well Poorly | 1.00 1.28 (1.13−1.44) *** 1.42 (1.15−1.74) ** |
Member of minority | 1.12 (0.94−1.34) |
Employment status (ref: employed including work from home) Self employed In education/training Unemployed/not working Retired Other/homemaker | 1.00 0.89 (0.69−1.15) 1.29 (0.99−1.67) 1.10 (0.88−1.37) 0.95 (0.79−1.13) 1.01 (0.80−1.27) |
Self−rated mental health (Fair/poor) | 2.06 (1.78−2.37) *** |
Self−rated physical health (Fair/poor) | 1.28 (1.09−1.50) ** |
Physical activity during COVID-19 (ref: about the same) Less than before More than before | 1.00 1.20 (1.06−1.36) * 1.03 (0.87−1.23) |
Alcohol consumption during COVID-19 (ref: about the same) Less than before More than before Do not partake | 1.00 0.77 (0.62−.95) * 0.99 (0.82−1.18) 1.43 (1.24−1.63) *** |
Urban/rural (ref: city) Town Rural | 1.00 1.27 (1.11−1.45) *** 1.28 (1.11−1.49) ** |
Close−knit neighbourhood (ref: 5 (Strongly agree)) 1 (Strongly disagree) 2 3 4 | 1.00 3.01 (2.37−3.81) *** 1.82 (1.49−2.23) *** 1.47 (1.21−1.79) *** 0.99 (0.80−1.22) |
During COVID video calls (ref: often) Hardly ever/never Sometimes | 1.00 2.49 (2.12−2.91) *** 1.26 (1.09−1.47) ** |
Satisfaction with video calls (ref: 5 (very satisfied)) 1 (very dissatisfied) 2 3 4 | 1.00 1.49 (1.19−1.88) ** 1.24 (1.01−1.51) * 1.12 (0.94−1.35) 1.06 (0.91−1.23) |
Living alone and choice (ref: lives with others) Lives alone by choice Lives alone not by choice | 1.00 1.01 (0.87−1.18) 1.15 (0.90−1.48) |
Pre−COVID time alone (ref: always) Often Seldom Never | 1.00 0.45 (0.33−0.62) *** 0.26 (0.19−0.36) *** 0.61 (0.43−0.88) * |
Importance of religion (ref: 1 (not at all important)) 2 3 4 5 (very important) | 1.00 0.78 (0.65−0.94) * 0.76 (0.62−0.94) * 0.74 (0.92−0.88) ** 0.76 (0.65−0.88) *** |
Hospitalised with COVID-19 (ref: neither) Respondent or someone close to respondent | 1.00 1.21 (0.94−1.55) |
Diagnosed with COVID-19 (ref: neither) Respondent Someone close to respondent Both | 1.00 0.70 (0.42−1.18) 0.76 (0.63−0.91) ** 1.67 (1.06−2.62) * |
Someone close to respondent died at this time due to any cause | 0.92 (0.79−1.08) |
OR 95% CI * Significance | |
---|---|
18–34 35−44 45−54 55−69 70 and over | 1.00 1.06 (0.84−1.32) 0.96 (0.78−1.20) 0.79 (0.64−0.97) 0.59 (0.45−0.79) *** |
Female | 1.10 (0.94−1.29) |
Finances meet needs (ref: Very well) Fairly well Poorly | 1.00 1.25 (1.10−1.43) ** 1.57 (1.27−1.93) *** |
Provides care | 1.29 (1.13−1.48) *** |
Employment status (ref: employed including work from home) Self employed In education/training Unemployed/not working Retired Other/homemaker | 1.00 0.91 (0.69−1.19) 1.40 (1.09−1.80) * 1.09 (0.87−1.37) 0.90 (0.74−1.10) 1.44 (1.15−1.80) ** |
Self−rated mental health (Fair/poor) | 1.25 (1.07−1.47) * |
Self−rated physical health (Fair/poor) | 1.28 (1.08−1.52) * |
Sleep during COVID-19 (ref: about the same) Better than before Worse than before | 1.00 1.08 (0.85−1.38) 1.55 (1.36−1.77) *** |
Physical activity during COVID-19 (ref: about the same) Less than before More than before | 1.00 1.38 (1.20−1.59) *** 0.95 (0.79−1.15) |
Alcohol consumption during COVID-19 (ref: about the same) Less than before More than before Do not partake | 1.00 1.45 (1.18−1.78) *** 1.37 (1.14−1.65) ** 1.23 (1.05−1.43) * |
Pre COVID-19 video calls (ref: often) Hardly ever/never Sometimes | 1.00 0.93 (0.79−1.10) 0.98 (0.82−1.17) |
Satisfaction with video calls (ref: 5 (very satisfied)) 1 (very dissatisfied) 2 3 4 | 1.00 1.76 (1.35−2.28) *** 2.07 (1.69−2.54) *** 1.40 (1.15−1.71) ** 1.54 (1.31−1.81) *** |
Living alone and choice (ref: lives with others) Lives alone by choice Lives alone not by choice | 1.00 0.90 (0.74−1.08) 1.68 (1.29−2.20) *** |
Pre−COVID time alone (ref: always) Often Seldom Never | 1.00 1.56 (0.97−2.51) 2.08 (1.29−3.36) * 1.84 (1.10−3.06) * |
Importance of religion (ref: 1 (not at all important)) 2 3 4 5 (very important) | 1.00 1.40 (1.15−1.70) ** 1.32 (1.06−1.65) * 1.37 (1.13−1.66) ** 1.62 (1.37−1.91) *** |
Hospitalised with COVID-19 (ref: neither) Respondent or someone close to respondent | 1.00 0.89 (0.72−1.11) |
Someone close to respondent died at this time due to any cause | 1.03 (0.88−1.21) |
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O’Sullivan, R.; Burns, A.; Leavey, G.; Leroi, I.; Burholt, V.; Lubben, J.; Holt-Lunstad, J.; Victor, C.; Lawlor, B.; Vilar-Compte, M.; et al. Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study. Int. J. Environ. Res. Public Health 2021, 18, 9982. https://doi.org/10.3390/ijerph18199982
O’Sullivan R, Burns A, Leavey G, Leroi I, Burholt V, Lubben J, Holt-Lunstad J, Victor C, Lawlor B, Vilar-Compte M, et al. Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study. International Journal of Environmental Research and Public Health. 2021; 18(19):9982. https://doi.org/10.3390/ijerph18199982
Chicago/Turabian StyleO’Sullivan, Roger, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, and et al. 2021. "Impact of the COVID-19 Pandemic on Loneliness and Social Isolation: A Multi-Country Study" International Journal of Environmental Research and Public Health 18, no. 19: 9982. https://doi.org/10.3390/ijerph18199982