Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents

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Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents Publisher

Naito R^{1, 2} ; Leong DP^{1, 2} ; Bangdiwala SI^{1, 3} ; Mckee M⁴ ; Subramanian SV⁵ ; Rangarajan S^{1, 2} ; Islam S^{1, 2} ; Avezum A⁶ ; Yeates KE⁷ ; Lear SA⁸ ; Gupta R⁹ ; Yusufali A¹⁰ ; Dans AL¹¹ ; Szuba A¹² Show All Authors

Naito R^{1, 2}
Leong DP^{1, 2}
Bangdiwala SI^{1, 3}
Mckee M⁴
Subramanian SV⁵
Rangarajan S^{1, 2}
Islam S^{1, 2}
Avezum A⁶
Yeates KE⁷
Lear SA⁸
Gupta R⁹
Yusufali A¹⁰
Dans AL¹¹
Szuba A¹²
Alhabib KF¹³
Kaur M¹⁴
Rahman O¹⁵
Seron P¹⁶
Diaz R¹⁷
Puoane T¹⁸
Liu W¹⁹
Zhu Y²⁰
Sheng Y²¹
Lopezjaramillo P²²
Chifamba J²³
Rosnah I²⁴
Karsidag K²⁵
Kelishadi R²⁶
Rosengren A²⁷
Khatib R^{28, 29}
Amma LIKR^{30, 31}
Azam SI³²
Teo K^{1, 2}
Yusuf S^{1, 2}

Show Affiliations

1. Population Health Research Institute, Hamilton, ON, Canada
2. Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
3. Department of Health Research Methods Evidence and Impact, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
4. Ecohost, Lshtm, London, United Kingdom
5. Harvard Center for Population and Development Studies, Department of Society and Human Development, Harvard T.H. Chan School of Public Health, Boston, MA, United States
6. International Research Center, Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil
7. Department of Medicine, Queen's University, Kingston, ON, Canada
8. Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
9. Eternal Heart Care Centre and Research Institute, Jaipur, India
10. Hatta Hospital, Dubai Medical College, Dubai Health Authority, Dubai, United Arab Emirates
11. Adult Medicine Research Unit, Philippine General Hospital, Manila, Philippines
12. Department of Angiology Hypertension and Diabetology, Wroclaw Medical University, Wroclaw, Dolnoslaskie, Poland
13. Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
14. School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
15. University of Liberal Arts Bangladesh, Dhaka, Dhaka District, Bangladesh
16. Universidad de la Frontera, Temuco, Chile
17. ECLA-Academic Research Organization, Rosario, Argentina
18. School of Public Health, University of Western Cape, Cape Town, Western Cape, South Africa
19. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of Medical Sciences, Xicheng District, Beijing, China
20. Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
21. Jiangxinzhou Community Health Service Center, Nanjing, China
22. Masira Research Institute, Universidad de Santander (UDES), Bucaramanga, Colombia
23. Department of Physiology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
24. Community Health Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia, Malaysia
25. Division of Endocrinology, Medical Faculty of Istanbul University, Fatih, Turkiye
26. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
27. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Region Vastra Gotaland, Sahlgrenska University Hospital, Goteborg, Sweden
28. Advocate Aurora Research Institute, Downers Grove, IL, United States
29. Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
30. Health Action by People, Thiruvananthapuram, Kerala, India
31. Department of Community Medicine, Sree Mookambika Institute of Medical Sciences, Kulasekharam, India
32. Community Health Sciences (CHS) Department, The Aga Khan University, Karachi, Pakistan

Source: BMJ Global Health Published:2021

Abstract

Objective To examine the association between social isolation and mortality and incident diseases in middle-aged adults in urban and rural communities from high-income, middle-income and low-income countries. Design Population-based prospective observational study. Setting Urban and rural communities in 20 high income, middle income and low income. Participants 119 894 community-dwelling middle-aged adults. Main outcome measures Associations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases. Results Social isolation was more common in middle-income and high-income countries compared with low-income countries, in urban areas than rural areas, in older individuals and among women, those with less education and the unemployed. It was more frequent among smokers and those with a poorer diet. Social isolation was associated with greater risk of mortality (HR of 1.26, 95% CI: 1.17 to 1.36), incident stroke (HR: 1.23, 95% CI: 1.07 to 1.40), cardiovascular disease (HR: 1.15, 95% CI: 1.05 to 1.25) and pneumonia (HR: 1.22, 95% CI: 1.09 to 1.37), but not cancer. The associations between social isolation and mortality were observed in populations in high-income, middle-income and low-income countries (HR (95% CI): 1.69 (1.32 to 2.17), 1.27 (1.15 to 1.40) and 1.47 (1.25 to 1.73), respectively, interaction p=0.02). The HR associated with social isolation was greater in men than women and in younger than older individuals. Mediation analyses for the association between social isolation and mortality showed that unhealthy behaviours and comorbidities may account for about one-fifth of the association. Conclusion Social isolation is associated with increased risk of mortality in countries at different economic levels. The increasing share of older people in populations in many countries argues for targeted strategies to mitigate its adverse effects. ©

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Style	Citing Format
MLA	Naito R, et al.. "Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents." BMJ Global Health, vol. 6, no. 3, 2021, pp. -.
APA	Naito R, Leong DP, Bangdiwala SI, Mckee M, Subramanian SV, Rangarajan S, Islam S, Avezum A, Yeates KE, Lear SA, Gupta R, Yusufali A, Dans AL, Szuba A, Alhabib KF, Kaur M, Rahman O, Seron P, Diaz R, ... Yusuf S (2021). Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents. BMJ Global Health, 6(3), -.
Chicago	Naito R, Leong DP, Bangdiwala SI, Mckee M, Subramanian SV, Rangarajan S, Islam S, et al.. "Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents." BMJ Global Health 6, no. 3 (2021): -.
Harvard	Naito R et al. (2021) 'Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents', BMJ Global Health, 6(3), pp. -.
Vancouver	Naito R, Leong DP, Bangdiwala SI, Mckee M, Subramanian SV, Rangarajan S, et al.. Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents. BMJ Global Health. 2021;6(3):-.
BibTex	@article{ author = {Naito R and Leong DP and Bangdiwala SI and Mckee M and Subramanian SV and Rangarajan S and Islam S and Avezum A and Yeates KE and Lear SA and Gupta R and Yusufali A and Dans AL and Szuba A and Alhabib KF and Kaur M and Rahman O and Seron P and Diaz R and Puoane T and Liu W and Zhu Y and Sheng Y and Lopezjaramillo P and Chifamba J and Rosnah I and Karsidag K and Kelishadi R and Rosengren A and Khatib R and Amma LIKR and Azam SI and Teo K and Yusuf S}, title = {Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents}, journal = {BMJ Global Health}, volume = {6}, number = {3}, pages = {-}, year = {2021} }
RIS	TY - JOUR AU - Naito R AU - Leong DP AU - Bangdiwala SI AU - Mckee M AU - Subramanian SV AU - Rangarajan S AU - Islam S AU - Avezum A AU - Yeates KE AU - Lear SA AU - Gupta R AU - Yusufali A AU - Dans AL AU - Szuba A AU - Alhabib KF AU - Kaur M AU - Rahman O AU - Seron P AU - Diaz R AU - Puoane T AU - Liu W AU - Zhu Y AU - Sheng Y AU - Lopezjaramillo P AU - Chifamba J AU - Rosnah I AU - Karsidag K AU - Kelishadi R AU - Rosengren A AU - Khatib R AU - Amma LIKR AU - Azam SI AU - Teo K AU - Yusuf S TI - Impact of Social Isolation on Mortality and Morbidity in 20 High-Income, Middle-Income and Low-Income Countries in Five Continents JO - BMJ Global Health VL - 6 IS - 3 SP - EP - PY - 2021 ER -

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