Observational studyBMJ global health2021
Impact of social isolation on mortality and morbidity in 20 high-income, middle-income and low-income countries in five continents.
Observational study in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- A meta-analysis of behaviour change techniques in social interventions targeting improved cognitive function in older adults.BMC public health · 2025Pooled it
- Loneliness, social isolation, and living alone: a comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults.Aging clinical and experimental research · 2025Pooled it
- Social isolation as a risk factor for all-cause mortality: Systematic review and meta-analysis of cohort studies.PloS one · 2023Pooled it
- Effects of Objective and Perceived Social Isolation on Cardiovascular and Brain Health: A Scientific Statement From the American Heart Association.Journal of the American Heart Association · 2022Pooled it
- Social Isolation in Adults Who Stutter: A Mixed-Methods Investigation of Risk and Correlates.American journal of speech-language pathology · 2026Article
- Loneliness, Social Isolation, and Chronic Disease Outcomes in Adults: A Systematic Review.Cureus · 2026Review
- Social isolation and 59 common health conditions: insights from observational and genetics analyses.BMC medicine · 2026Article
- Factors of pet ownership associated with human health: A representative cross-sectional survey of Switzerland.PloS one · 2026Article
- Article
- "I left my country and the people I love. It gave me hypertension": a qualitative study of social support and hypertension management in refugees.Frontiers in public health · 2026Article
- Effects of social isolation on all-cause mortality in older adults: do age, gender, and measurement matter?Innovation in aging · 2026Article
- Trajectories and influencing factors of social alienation in first-onset stroke patients: a prospective cohort study.BMC public health · 2025Article
- Assessing Social Determinants of Health in Transplantation and CAR-T Recipients: Expert Panel Recommendations from the Survivorship Special Interest Group of ASTCT.Transplantation and cellular therapy · 2025Review
- Observational
- Broadening dementia risk models: building on the 2024 Lancet Commission report for a more inclusive global framework.EBioMedicine · 2025Review
- In pain and lonely? A longitudinal study examining the associations between menstrual pain, physical functioning and loneliness.British journal of health psychology · 2025Article
- Social factors, health policy, and environment: implications for cardiovascular disease across the globe.European heart journal · 2025Review
- Theory of Mind Mediates the Association Between Autistic Traits and Social Isolation in Middle-Aged and Older Adults.Autism research : official journal of the International Society for Autism Research · 2025Article
- Epidemiology of loneliness & social isolation, an emerging public mental health predicament in India: a scoping review.Discover mental health · 2025Review
- Intrinsic functional connectivity brain networks mediate effect of age on sociability.PloS one · 2025Article
Corrections and comments
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Authors and funding
34 authors at 20 institutions in 24 countries.
Funding
Abstract
objectiveTo 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.
designPopulation-based prospective observational study.
settingUrban and rural communities in 20 high income, middle income and low income.
participants119 894 community-dwelling middle-aged adults.
main outcome measuresAssociations of social isolation with mortality, cardiovascular death, non-cardiovascular death and incident diseases.
resultsSocial 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.
conclusionSocial 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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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.