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Loneliness in adults with cardiovascular disease and their social and emotional support needs: Implications for Hispanic adults from the 2023 Behavioral Risk Factor Surveillance System

Falk, D. S.; Melgoza, E.; Cabrera, A.; Vazquez, C. E.

2025-03-20 epidemiology
10.1101/2025.03.19.25324276 medRxiv
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ObjectivesLoneliness and social isolation pose significant risks for an individuals 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. DesignUsing the 2023 Behavioral Risk Factor Surveillance Systems 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. ResultsThe 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. ConclusionThis 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.

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