Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

Drew Eleanor Meehan; Anne Grunseit; Jenna Condie; Neta HaGani; Dafna Merom

doi:10.1186/s12877-023-04418-8

Social-ecological factors influencing loneliness and social isolation in older people: a scoping review

BMC Geriatr. 2023 Nov 9;23(1):726. doi: 10.1186/s12877-023-04418-8.

Authors

Drew Eleanor Meehan¹, Anne Grunseit², Jenna Condie³, Neta HaGani⁴, Dafna Merom⁵

Affiliations

¹ School of Health Sciences, Western Sydney University, Campbelltown, Australia. d.meehan2@westernsydney.edu.au.
² School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
³ School of Social Sciences, Western Sydney University, Paramatta, Australia.
⁴ Prevention Research Collaboration, School of Public Health, University of Sydney, Camperdown, Australia.
⁵ School of Health Sciences, Western Sydney University, Campbelltown, Australia.

Abstract

There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.

Keywords: Ageing; Community; Loneliness; Scoping review; Social isolation; Social-ecological model; Societal.

Publication types

Review

MeSH terms

Aged
Cross-Sectional Studies
Humans
Loneliness*
Social Environment
Social Isolation*