Longitudinal Investigation of Social Isolation, Loneliness, and Health Outcomes Among Refugees in a Low-Resource Setting

BackgroundSocial isolation and loneliness are global public health concerns, adversely impacting mental and physical health. There is an urgent need to expand the evidence base with studies focused on at-risk populations in low-resource contexts. This study aimed to examine the longitudinal association of social isolation and loneliness and health outcomes (probable depression and post-traumatic stress disorder (PTSD), and general health), and to identify individual and social determinants of social isolation and loneliness among refugees in a low-resource context. MethodA longitudinal study involving 1,235 culturally and linguistically diverse refugees was conducted over a two-year period across four time points. Social isolation and loneliness, probable depression and PTSD, and general health were measured using self-report instruments across four time points over two years (six-month intervals). Generalised Linear Mixed Models were used to examine the association between social disconnection and health outcomes over time. Linear regression was used to identify individual, social, and contextual factors associated with social isolation and loneliness. ResultsSocial isolation and loneliness were associated with increased risk of probable depression, PTSD, and poor health over two years. Younger age, higher education, family separation, traumatic experiences, longer time in the protracted displacement setting, and post-displacement stressors significantly predicted higher social isolation and loneliness at baseline. ConclusionThe present findings indicate a dose-response relationship between social isolation and loneliness and mental health outcomes among refugees in a low-resource setting. Multilevel interventions addressing individual, social, and contextual factors are needed to tackle social disconnection and improve health among refugees.