National Institute of Occupational Safety and Health, Japan, Kawasaki, Japan.
Graduate School of Technology, Industrial and Social Sciences, Tokushima University, Tokushima, Japan.
JMIR Public Health Surveill. 2024 Sep 9;10:e51653. doi: 10.2196/51653.
Worsening loneliness and social isolation during the COVID-19 pandemic have become serious public health concerns worldwide. Despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemics, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them.
In this study, 3 web-based surveys were conducted at 1-year intervals during the 2 years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them in the Japanese population.
The first survey (phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (phase 2, June 14-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19-positive cases occurred during this period. We collected data on 3892 inhabitants (n=1813, 46.58% women; age: mean 50.3, SD 13.4 y) living in the 4 prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase.
While many psychosocial and physical variables showed improvement for the 2 years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and web-based interaction with familiar people decreased. Approximately half of those experiencing social isolation in phase 1 remained isolated throughout the 2-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3 (P=.01 to <.001), while the association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between reduced face-to-face interaction, poorer relationships with familiar people, and increased loneliness tended to be stronger in phase 3.
This study found that loneliness and social isolation remained unresolved throughout the long-term COVID-19 pandemic. Additionally, in the final survey phase, these issues were influenced by a broader and more complex set of factors compared to earlier phases.
在 COVID-19 大流行期间，孤独感和社会隔离的加剧已成为全球严重的公共卫生问题。尽管先前的研究报告表明，在多次紧急声明和长期大流行期间，孤独感和社会隔离持续存在，但仍需要进行长期研究，以确定孤独感和社会隔离的实际情况，以及解释这些情况的因素。
本研究在第一次紧急状态后的 2 年内，每隔 1 年进行 3 次基于网络的调查，以检查日本人群中孤独感和社会隔离的变化，以及与之相关的社会心理因素。
第一次调查（第 1 阶段，2020 年 5 月 11-12 日）在第一次紧急声明期间结束时进行，第二次调查（第 2 阶段，2021 年 6 月 14-20 日）在第三次紧急声明期间结束时进行，第三次调查（第 3 阶段，2022 年 5 月 13-30 日）在未宣布紧急状态但在此期间发生了许多 COVID-19 阳性病例的情况下进行。我们收集了在第 1 阶段和第 2 阶段实施紧急声明措施的 4 个县的 3892 名居民（n=1813，46.58%为女性；年龄：平均 50.3，SD 13.4 y）的数据。采用线性混合模型分析，以检查各阶段中社会心理变量作为解释变量与孤独感评分作为因变量之间的关系。
虽然许多社会心理和身体变量在这 2 年中有所改善，但孤独感、社会隔离以及与熟人的关系恶化，锻炼机会、喜爱的活动和与熟人的网络互动减少。第 1 阶段有社会隔离的人中，约有一半在整个 2 年期间一直处于隔离状态，而且出现社会隔离的人数多于能够解决社会隔离问题的人数。线性混合模型分析的结果表明，无论处于哪个阶段，大多数社会心理和身体变量都与孤独感有关。关于与阶段有显著相互作用的变量，利他预防性行为的增加和对未来的负面展望与第 3 阶段严重的孤独感更相关（P=.01 至<.001），而社交网络较少与孤独感更强之间的关联在第 2 阶段更为明显。虽然相互作用不显著，但面对面互动减少、与熟人关系恶化以及孤独感增加的关联在第 3 阶段更为明显。
本研究发现，在长期的 COVID-19 大流行期间，孤独感和社会隔离问题仍未得到解决。此外，在最后一个调查阶段，与早期阶段相比，这些问题受到了更广泛和更复杂因素的影响。
