Abstract

Disparities in persistent loneliness during the COVID-19 pandemic: A prospective cohort study

Rachel O'Conor, PhD MPH¹, Stephanie Batio, MS¹, Michael Wolf, PhD MPH MA¹, Kenneth Covinsky, MD MPH², Julia Yoshino Benavente, MPH¹, Carla Perissinotto, MD, MHS², Ashwin Kotwal, MD, MS² (1)Northwestern University Feinberg School of Medicine, (2)University of California, San Francisco

APHA 2022 Annual Meeting and Expo

Background. Loneliness was common early in the COVID-19 pandemic, but little is known about how loneliness persisted into later stages of the pandemic. We examined longitudinal trajectories of loneliness over 18 months of the pandemic and subgroups at risk for persistent loneliness.
Methods. We used six waves of data from the COVID-19 & Chronic Conditions study (March 27, 2020 to December 10, 2021) including 641 predominantly older adults with ≥1 chronic condition. We used trajectory mixture models to identify clusters of individuals following similar trajectories of loneliness, then multiple regression to determine subgroups likely to be classified in different trajectories.
Results. Participants were on average 63 years old, 61% female, 30% Black, 20% Latinx, and 29% were living below the poverty level. Overall, loneliness decreased over time (March/2020: 51% to December/2021: 31%, p=.01). Four trajectory groups emerged: 1) “Persistent Loneliness (n=101, 16%, lonely at most time points) 2) “Adapted (n=141, 22%, early pandemic loneliness which decreased over time), 3) “Occasional loneliness (n=189, 29%), and 4) “Never lonely (n=211, 33%). Subgroups at highest risk of “Persistently Loneliness included Hispanic/Latinx (aOR 2.5, 95% CI: 1.2, 5.2), or living in poverty (aOR 2.5; 95% CI: 1.4, 4.6).
Conclusions. Loneliness declined overall in our sample, but persistent loneliness was common (1 in 6 adults), particularly among participants identifying as Hispanic/Latinx or living in poverty. Interventions addressing loneliness can ease pandemic-related suffering, and may mitigate long-term mental and physical health consequences.