BACKGROUND: Social isolation (SI) has been seen as an emerging socioeconomic factor that negatively affects health. A considerable body of research has found that SI is associated with increased risk of all-cause mortality. However, the magnitude of the association varies in different studies. Besides that, these studies were conducted mainly in high-income countries. METHODS: We conducted a systematic review and meta-analysis to examine the effect size of SI on mortality. Also, we examined the associated mortality risk using data from the Prospective Urban and Rural Epidemiology (PURE) study of over 140,000 middle-aged adults from 21 countries with different income levels. RESULTS: Our systematic review and meta-analysis showed that the pooled hazard ratio of SI for all-cause mortality was 1.37 (95% confidence interval (CI) 1.28-1.46). The PURE study showed that the hazard ratio of SI for all-cause mortality was 1.26 (95% CI 1.16-1.36). Similar associations of SI with cardiovascular- and non-cardiovascular mortality as well as with incident diseases including stroke, cardiovascular disease, and injury were observed. The associations between SI and health outcomes were observed in diverse populations with different social structures and different country income levels. CLINICAL IMPLICATIONS: The impact of SI on mortality would be expected to be greater in the future as the number of people with SI is projected to increase with population ageing in most societies. Our findings can be used by public health providers and policy makers to develop targeted strategies to reduce the risks associated with SI. / Thesis / Master of Health Sciences (MSc) / Social isolation (SI) is an emerging socioeconomic factor that could negatively affect health. Prior studies regarding SI were conducted mainly in high income countries. This thesis examines the effect of SI on mortality. This was done first in a systematic review and meta-analysis and, second, by examining the association between SI and health in an international large-scale cohort study (PURE: Prospective Urban Rural Epidemiology) conducted in 21 countries at different country income levels. Our systematic review and meta-analysis showed that SI was associated with 37% increased risk for mortality. The PURE study showed that the association of SI with mortality was seen in diverse populations with different social structures. The impact of SI on mortality would be expected to increase in the future as the number of people with SI is projected to increase with population ageing. This calls for measures to reduce mortality and morbidity in the socially isolated.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/25354 |
| Date | January 2020 |
| Creators | Naito, Ryo |
| Contributors | Yusuf, Salim, Health Research Methodology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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