Has the UK Campaign to End Loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design

Liming Li; Ludovico Carrino; Erica Reinhard; Mauricio Avendano Pabon

doi:10.1016/j.jagp.2023.10.007

Has the UK Campaign to End Loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design

Liming Li^*, Ludovico Carrino, Erica Reinhard, Mauricio Avendano Pabon

^*Corresponding author for this work

Global Health & Social Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design: Quasi-experimental design, namely, a difference-in-differences approach. Setting: Local authorities across England. Participants: Older adults aged 65 and over participating in waves 4–8 (2008–2017) of the English Longitudinal Study of Aging (ELSA) and waves 1–9 (2009–2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimate = 0.044, SE = 0.085), social isolation caseness (estimate = 0.038, SE = 0.020) or levels of depressive symptoms (estimate = 0.130, SE = 0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.

Original language	English
Pages (from-to)	S1064-7481
Journal	American Journal of Geriatric Psychiatry
Early online date	18 Oct 2023
DOIs	https://doi.org/10.1016/j.jagp.2023.10.007
Publication status	E-pub ahead of print - 18 Oct 2023

Keywords

loneliness, mental health, older people, UK

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jagp.2023.10.007Licence: CC BY

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@article{898fc0678db44128bd4840cc401dc8b6,

title = "Has the UK Campaign to End Loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design",

abstract = "Objective: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design: Quasi-experimental design, namely, a difference-in-differences approach. Setting: Local authorities across England. Participants: Older adults aged 65 and over participating in waves 4–8 (2008–2017) of the English Longitudinal Study of Aging (ELSA) and waves 1–9 (2009–2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimate = 0.044, SE = 0.085), social isolation caseness (estimate = 0.038, SE = 0.020) or levels of depressive symptoms (estimate = 0.130, SE = 0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.",

keywords = "loneliness, mental health, older people, UK",

author = "Liming Li and Ludovico Carrino and Erica Reinhard and {Avendano Pabon}, Mauricio",

note = "Funding Information: This work was supported by European Union Research and Innovation funding programme Horizon 2020 (Grant number: 667661). It also represents independent research supported by UK Economic and Social Research Council (ESRC Reference: ES/S012567/1). The authors report no conflicts with any product mentioned or concept discusssed in this article. This study uses data from the English Longitudinal Study of aging (ELSA) and the UK Household Longitudinal Study (UKHLS), also called Understanding Society. ELSA is funded by the National Institute on Aging (R01AG017644), and by UK Government Departments coordinated by the National Institute for Health and Care Research (NIHR). Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The research data are distributed by the UK Data Service. The use of the ELSA and UKHLS research data was approved by the UK Data Services and Research Ethics Office of King's College London. Funding Information: This work was supported by European Union Research and Innovation funding programme Horizon 2020 (Grant number: 667661 ). It also represents independent research supported by UK Economic and Social Research Council (ESRC Reference: ES/S012567/1 ). The authors report no conflicts with any product mentioned or concept discusssed in this article. Funding Information: This study uses data from the English Longitudinal Study of aging (ELSA) and the UK Household Longitudinal Study (UKHLS), also called Understanding Society. ELSA is funded by the National Institute on Aging ( R01AG017644 ), and by UK Government Departments coordinated by the National Institute for Health and Care Research (NIHR). Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The research data are distributed by the UK Data Service. The use of the ELSA and UKHLS research data was approved by the UK Data Services and Research Ethics Office of King's College London. Publisher Copyright: {\textcopyright} 2023 The Authors",

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doi = "10.1016/j.jagp.2023.10.007",

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T1 - Has the UK Campaign to End Loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design

AU - Li, Liming

AU - Carrino, Ludovico

AU - Reinhard, Erica

AU - Avendano Pabon, Mauricio

N1 - Funding Information: This work was supported by European Union Research and Innovation funding programme Horizon 2020 (Grant number: 667661). It also represents independent research supported by UK Economic and Social Research Council (ESRC Reference: ES/S012567/1). The authors report no conflicts with any product mentioned or concept discusssed in this article. This study uses data from the English Longitudinal Study of aging (ELSA) and the UK Household Longitudinal Study (UKHLS), also called Understanding Society. ELSA is funded by the National Institute on Aging (R01AG017644), and by UK Government Departments coordinated by the National Institute for Health and Care Research (NIHR). Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The research data are distributed by the UK Data Service. The use of the ELSA and UKHLS research data was approved by the UK Data Services and Research Ethics Office of King's College London. Funding Information: This work was supported by European Union Research and Innovation funding programme Horizon 2020 (Grant number: 667661 ). It also represents independent research supported by UK Economic and Social Research Council (ESRC Reference: ES/S012567/1 ). The authors report no conflicts with any product mentioned or concept discusssed in this article. Funding Information: This study uses data from the English Longitudinal Study of aging (ELSA) and the UK Household Longitudinal Study (UKHLS), also called Understanding Society. ELSA is funded by the National Institute on Aging ( R01AG017644 ), and by UK Government Departments coordinated by the National Institute for Health and Care Research (NIHR). Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The research data are distributed by the UK Data Service. The use of the ELSA and UKHLS research data was approved by the UK Data Services and Research Ethics Office of King's College London. Publisher Copyright: © 2023 The Authors

PY - 2023/10/18

Y1 - 2023/10/18

N2 - Objective: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design: Quasi-experimental design, namely, a difference-in-differences approach. Setting: Local authorities across England. Participants: Older adults aged 65 and over participating in waves 4–8 (2008–2017) of the English Longitudinal Study of Aging (ELSA) and waves 1–9 (2009–2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimate = 0.044, SE = 0.085), social isolation caseness (estimate = 0.038, SE = 0.020) or levels of depressive symptoms (estimate = 0.130, SE = 0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.

AB - Objective: To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design: Quasi-experimental design, namely, a difference-in-differences approach. Setting: Local authorities across England. Participants: Older adults aged 65 and over participating in waves 4–8 (2008–2017) of the English Longitudinal Study of Aging (ELSA) and waves 1–9 (2009–2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures: Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results: There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented antiloneliness strategies led to no change in loneliness scores (estimate = 0.044, SE = 0.085), social isolation caseness (estimate = 0.038, SE = 0.020) or levels of depressive symptoms (estimate = 0.130, SE = 0.165). Heterogeneity analyses indicate that antiloneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions: Antiloneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.

KW - loneliness, mental health, older people, UK

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U2 - 10.1016/j.jagp.2023.10.007

DO - 10.1016/j.jagp.2023.10.007

M3 - Article

SN - 1064-7481

SP - S1064-7481

JO - American Journal of Geriatric Psychiatry

JF - American Journal of Geriatric Psychiatry

ER -

Has the UK Campaign to End Loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design

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