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Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting

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  • Gustafsson, Per E.
  • Fonseca-Rodríguez, Osvaldo
  • Nilsson, Ingeborg
  • San Sebastián, Miguel

Abstract

Loneliness among older adults is a public health problem that has received particular attention since the emergence of the COVID-19 pandemic. Studies to date have however found a rather modest psychosocial impact of the pandemic on older adults, and scarce research has analyzed this impact using a comprehensive equity lens. The present study used an intersectional approach to examine social inequalities in loneliness before and during the early phase of the pandemic among older adults receiving eldercare in Sweden. The study population (analytical N = 205,529) came from two waves (2019 and 2020) of a total population survey to all older adult (>65 years of age) home care recipients and nursing home residents in Sweden. Loneliness was self-reported by a single-item measure, and survey data were linked to population register data on age, gender, residential setting, income, and country of birth. Additive binomial regression models were used to estimate prevalence differences and discriminatory accuracy according to an analysis of individual heterogeneity and discriminatory accuracy (AIHDA) approach. Results showed inequalities in loneliness arising particularly in the intersection of country of birth, income, and residential setting. The inequalities widened slightly but ubiquitously following the emergence of the pandemic in 2020, with particularly nursing home residents emerging as a risk group. The discriminatory accuracy of inequalities was consistently low to moderate throughout the analyses but increased marginally during the pandemic in 2020. The study illustrates how social inequalities engenders heterogeneity in the psychosocial risk of older adults before and during the pandemic. These findings should stimulate more nuanced and equity-oriented depictions, research and policies about loneliness among older adults in the peri-pandemic era.

Suggested Citation

  • Gustafsson, Per E. & Fonseca-Rodríguez, Osvaldo & Nilsson, Ingeborg & San Sebastián, Miguel, 2022. "Intersectional inequalities in loneliness among older adults before and during the early phase of the COVID-19 pandemic: A total population survey in the Swedish eldercare setting," Social Science & Medicine, Elsevier, vol. 314(C).
  • Handle: RePEc:eee:socmed:v:314:y:2022:i:c:s0277953622007535
    DOI: 10.1016/j.socscimed.2022.115447
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    References listed on IDEAS

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    1. Bauer, Greta R. & Scheim, Ayden I., 2019. "Methods for analytic intercategorical intersectionality in quantitative research: Discrimination as a mediator of health inequalities," Social Science & Medicine, Elsevier, vol. 226(C), pages 236-245.
    2. Bauer, Greta R., 2014. "Incorporating intersectionality theory into population health research methodology: Challenges and the potential to advance health equity," Social Science & Medicine, Elsevier, vol. 110(C), pages 10-17.
    3. Kavita Chawla & Tafadzwa Patience Kunonga & Daniel Stow & Robert Barker & Dawn Craig & Barbara Hanratty, 2021. "Prevalence of loneliness amongst older people in high-income countries: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(7), pages 1-15, July.
    4. Marie Kivi & Isabelle Hansson & Pär Bjälkebring & Derek M Isaacowitz, 2021. "Up and About: Older Adults’ Well-being During the COVID-19 Pandemic in a Swedish Longitudinal Study," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(2), pages 4-9.
    5. Alexander Seifert & Shelia R Cotten & Bo Xie & Deborah Carr, 2021. "A Double Burden of Exclusion? Digital and Social Exclusion of Older Adults in Times of COVID-19 [Attitudes towards and limitations to ICT use in assisted and independent living communities: Finding," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(3), pages 99-103.
    6. Synnøve Caspari & Maj‐Britt Råholm & Berit Sæteren & Arne Rehnsfeldt & Britt Lillestø & Vibeke Lohne & Åshild Slettebø & Anne Kari T. Heggestad & Bente Høy & Lillemor Lindwall & Dagfinn Nåden, 2018. "Tension between freedom and dependence—A challenge for residents who live in nursing homes," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(21-22), pages 4119-4127, November.
    7. Thomas Hansen & Marcela Petrová Kafková & Ruth Katz & Ariela Lowenstein & Sigal Naim & George Pavlidis & Feliciano Villar & Kieran Walsh & Marja Aartsen, 2021. "Exclusion from Social Relations in Later Life: Micro- and Macro-Level Patterns and Correlations in a European Perspective," IJERPH, MDPI, vol. 18(23), pages 1-16, November.
    8. Per E Gustafsson & Julia Schröders & Ingeborg Nilsson & Miguel San Sebastián & Jessica Kelley, 2022. "Surviving Through Solitude: A Prospective National Study of the Impact of the Early COVID-19 Pandemic and a Visiting Ban on Loneliness Among Nursing Home Residents in Sweden [Social interactions of," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 77(12), pages 2286-2295.
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    1. Gustafsson, Per E. & Fonseca-Rodríguez, Osvaldo & Castel Feced, Sara & San Sebastián, Miguel & Bastos, João Luiz & Mosquera, Paola A., 2024. "A novel application of interrupted time series analysis to identify the impact of a primary health care reform on intersectional inequities in avoidable hospitalizations in the adult Swedish populatio," Social Science & Medicine, Elsevier, vol. 343(C).

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