Falk Derek S, Melgoza Esmeralda, Cabrera Alberto, Vazquez Christian E
medRxiv. 2025 Mar 20:2025.03.19.25324276. doi: 10.1101/2025.03.19.25324276.
Loneliness and social isolation pose significant risks for an individual's physical, mental, and social health including higher incidence of cardiovascular disease (CVD), poorer patient reported outcomes, and earlier mortality compared to those not experiencing loneliness or social isolation. The objective of this study was to assess loneliness and social and emotional support among adults aged 18 years and older who have CVD in the US.
Using the 2023 Behavioral Risk Factor Surveillance System's social determinants and health equity module, we examined the distribution of US adults with CVD, compared the prevalence of CVD by Hispanic ethnicity, and conducted multivariable logistic regressions assessing the relationship of independent variables with loneliness and social and emotional support.
The proportion of adults with CVD who felt lonely sometimes, usually, and always was 44.6%. Hispanic adults who felt lonely (56.3% vs. 43.0%; P<0.0001) and did not receive needed social and emotional support (13.7% vs. 9.8%; P=0.0162) experienced a higher prevalence of CVD than their non-Hispanic adult counterparts who felt lonely and did not receive needed social and emotional support. Adults with CVD who reported rarely or never receiving needed social and emotional support (odds ratio [OR]: 1.42; confidence interval [CI]: 1.14-1.77) had 42% higher odds of feeling lonely, compared to adults who indicated receiving social and emotional support sometimes, usually, or always. Among Hispanic adults with CVD, widowed/divorced/separated adults (OR: 2.30; CI: 1.46-3.61), urban residents (OR: 2.14; CI: 1.05-4.36), and unemployed adults (OR: 3.26; CI: 1.93-5.51) had higher odds of feeling lonely compared to married, rural, and employed adults.
This study demonstrates significant disparities in loneliness and social and emotional support in CVD among US adults, with Hispanics experiencing a disadvantage in both outcomes. Future studies should examine strategies to improve social connection for those experiencing disparities.
孤独和社会隔离对个体的身体、心理和社会健康构成重大风险，与未经历孤独或社会隔离的人相比，其心血管疾病（CVD）发病率更高、患者报告的结果更差且死亡率更早。本研究的目的是评估美国18岁及以上患有CVD的成年人中的孤独感以及社会和情感支持情况。
利用2023年行为危险因素监测系统的社会决定因素和健康公平模块，我们研究了患有CVD的美国成年人的分布情况，比较了西班牙裔种族的CVD患病率，并进行了多变量逻辑回归分析，评估自变量与孤独感以及社会和情感支持之间的关系。
有时、通常和总是感到孤独的患有CVD的成年人比例为44.6%。感到孤独（56.3%对43.0%；P<0.0001）且未获得所需社会和情感支持（13.7%对9.8%；P=0.0162）的西班牙裔成年人比未感到孤独且未获得所需社会和情感支持的非西班牙裔成年同龄人患CVD的患病率更高。报告很少或从未获得所需社会和情感支持的患有CVD的成年人（优势比[OR]：1.42；置信区间[CI]：1.14 - 1.77）感到孤独的几率比表示有时、通常或总是获得社会和情感支持的成年人高42%。在患有CVD的西班牙裔成年人中，丧偶/离婚/分居的成年人（OR：2.30；CI：1.46 - 3.61）、城市居民（OR：2.14；CI：1.05 - 4.36）和失业成年人（OR：3.26；CI：1.93 - 5.51）比已婚、农村和就业的成年人感到孤独的几率更高。
本研究表明美国成年人中CVD患者在孤独感以及社会和情感支持方面存在显著差异，西班牙裔在这两个结果方面都处于劣势。未来的研究应探讨改善那些存在差异人群社会联系的策略。
