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- Elovainio, Marko, et al.
(author)
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Association of social isolation and loneliness with risk of incident hospital-treated infections : an analysis of data from the UK Biobank and Finnish Health and Social Support studies
- 2023
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In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 8:2, s. e109-e118
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Journal article (peer-reviewed)abstract
- Background: Although loneliness and social isolation have been linked to an increased risk of non-communicable diseases such as cardiovascular disease and dementia, their association with the risk of severe infection is uncertain. We aimed to examine the associations between loneliness and social isolation and the risk of hospital-treated infections using data from two independent cohort studies. Methods: We assessed the association between loneliness and social isolation and incident hospital-treated infections using data for participants from the UK Biobank study aged 38–73 years at baseline and participants from the nationwide population-based Finnish Health and Social Support (HeSSup) study aged 20–54 years at baseline. For inclusion in the study, participants had to be linked to national health registries, have no history of hospital-treated infections at or before baseline, and have complete data on loneliness or social isolation. Participants with missing data on hospital-treated infections, loneliness, and social isolation were excluded from both cohorts. The outcome was defined as a hospital admission with a primary diagnosis of infection, ascertained via linkage to electronic health records. Findings: After exclusion of 8·6 million participants for not responding or not providing appropriate consent, the UK Biobank cohort consisted of 456 905 participants (249 586 women and 207 319 men). 26 860 (6·2%) of 436 001 participants with available data were reported as being lonely and 40 428 (9·0%) of 448 114 participants with available data were socially isolated. During a median 8·9 years (IQR 8·0–9·6) of follow-up, 51 361 participants were admitted to hospital due to an infectious disease. After adjustment for age, sex, demographic and lifestyle factors, and morbidities, loneliness was associated with an increased risk of a hospital-treated infection (hazard ratio [HR] 1·12 [95% CI 1·07–1·16]), whereas social isolation was not (HR 1·01 [95% CI 0·97–1·04]). Of 64 797 individuals in the HeSSup cohort, 18 468 (11 367 women and 7101 men) were eligible for inclusion. 4466 (24·4%) of 18 296 were lonely and 1776 (9·7%) of 18 376 socially isolated. During a median follow-up of 10·0 years (IQR 10·0–10·1), 814 (4·4%) participants were admitted to hospital for an infectious disease. The HRs for the HeSSup study replicated those in the UK Biobank (multivariable-adjusted HR for loneliness 1·32 [95% CI 1·06–1·64]; 1·08 [0·87–1·35] for social isolation). Interpretation: Loneliness might increase susceptibility to severe infections, although the magnitude of this effect appears modest and residual confounding cannot be excluded. Interventional studies are required before policy recommendations can advance. Funding: Academy of Finland, the UK Medical Research Council, and Wellcome Trust UK.
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| 2. |
- Weimer, Kerstin, et al.
(author)
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Values, attitudes, moral judgment competence, locus of control and sense of coherence as determinants of pro-environmental behaviors and behavioral intentions
- 2017
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In: Journal of Multidisciplinary Engineering Science and Technology. - 2458-9403. ; 4:5, s. 2568-2583
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Journal article (peer-reviewed)abstract
- Based on a survey completed by 463 residents in two Swedish cities, the predictive power of value orientations, awareness of consequences, environmental concern, moral judgment competence, locus of control and sense of coherence were examined on eight types of pro-environmental behaviors and behavioral intentions. The best fitting causal model confirms partly the hypothetical model. Values indirect and direct affect pro-environmental behaviors and behavioral intentions with awareness of consequences and environmental concern as intermediate or transmitting variables. Neither pro-environmental behaviors nor behavioral intentions are affected by awareness of consequences, environmental concern, locus of control, moral judgment competence or sense of coherence. The need of more environmentally specific measures of the predictors in relation to specific behaviors is discussed.
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