Has the UK Campaign to End Loneliness Reduced Loneliness and Improved Mental Health in Older Age? A Difference-in-Differences Design

Liming Li · Ludovico Carrino · Erica Reinhard · Mauricio Avendaño

13 citations0/0 files storedAmerican Journal of Geriatric Psychiatry

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Health disparities and outcomes Aging, Elder Care, and Social Issues Aging, Health, and Disability

Abstract

OBJECTIVE: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. DESIGN: Quasi-experimental design, namely, a difference-in-differences approach. SETTING: Local authorities across England. PARTICIPANTS: Older adults aged 65 and over participating in waves 4-8 (2008-2017) of the English Longitudinal Study of Aging (ELSA) and waves 1-9 (2009-2019) of the UK Household Longitudinal Study (UKHLS). MAIN OUTCOME MEASURES: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. RESULTS: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimate = 0.044, SE = 0.085), social isolation caseness (estimate = 0.038, SE = 0.020) or levels of depressive symptoms (estimate = 0.130, SE = 0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. CONCLUSIONS: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.

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References

1977The CES-D Scale 2010Social Relationships and Mortality Risk: A Meta-analytic Review 1980The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence.1997The validity of two versions of the GHQ in the WHO study of mental illness in general health care 2017An overview of systematic reviews on the public health consequences of social isolation and loneliness 1978Developing a Measure of Loneliness 2009Social Disconnectedness, Perceived Isolation, and Health among Older Adults 2010Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study.

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