Loneliness, isolation and physical health

Using cohort study data and hospital admission records to establish how loneliness & isolation are linked to health outcomes.

Loneliness and social isolation are known to be generally harmful to health. In this project, we conduct statistical analyses of cohort study data to understand how social isolation and loneliness are linked to a range of physical health conditions – including cardiovascular disease, falls, respiratory disease, and others.

Specifically, we are working to understand how loneliness and isolation contribute to these conditions and their mechanisms (including behavioural and biological factors). We also link cohort study data with hospital records to understand the relationship with health service use. Furthermore, we apply theories from social psychology and social epidemiology to explore different aspects and dimensions of the broader concept of social connection, which includes loneliness, social isolation, and other related factors.

Key findings so far:

  • Social factors affect health through multiple psychological, biological and behavioural pathways. For example, loneliness is a risk factor for cardiovascular disease by affecting stress levels, depression, neuroendocrine responses to stress, inflammation, and harmful behaviours such as smoking, excessive alcohol drinking, and poor diet.
  • Social engagement is linked to lower levels of inflammation, whilst loneliness is negatively related to the regulation of inflammation, suggesting that objective and subjective aspects of social connection may involve different biological pathways.
  • Social factors are associated with a range of adverse health outcomes in older age, including falls, poor physical function, and cardiovascular or respiratory disease, but this depends on whether we measure subjective (e.g. loneliness) or objective aspects (e.g. living alone, social disengagement).
  • Social factors are associated with hospital admissions for different conditions, with evidence linking living alone and social disengagement to admissions for respiratory disease, living alone and low social contact to admissions for falls, and loneliness to admissions for cardiovascular disease.

Funder

Various

Programme areas

Epidemiology, behavioural science

UCL team

Dr Daisy Fancourt
Prof Andrew Steptoe
Dr Feifei Bu
Dr Elise Paul

Status

Ongoing

Key contact

d.fancourt@ucl.ac.uk

Timescale

Ongoing

Publications

Piot, A., Fancourt, D., Bloomberg, M., Steptoe, A., & Bu, F. (2026). Loneliness and social isolation as predictors of pain medication use transitions in older adults. Scientific Reports. (2026). [DOI]

Philip, K E J., Bu, F., Buttery, S C., Brighton L J., Polkey M I., Hopkinson N S., Fancourt, D. Relationship of breathlessness with social isolation and loneliness: a nationally representative cohort study of older adults in England. BMJ Public Health 4, 2 (2026). [DOI]

Paul, E., Bu, F. & Fancourt, D. Loneliness and Risk for Cardiovascular Disease: Mechanisms and Future Directions. Current Cardiology Reports 23, 68 (2021). [DOI]

Bu F, Steptoe A, Fancourt D., Relationships between loneliness, social isolation and modifiable risk factors for cardiovascular disease: a latent class analysis J Epidemiology Community Health 2021;75:749-754 (2021). [DOI]

Bu F, Philip K, Fancourt D, Social isolation and loneliness as risk factors for hospital admissions for respiratory disease among older adults, Thorax (2020); 75:597-599. [DOI]

Bu F, Zaninotto P, Fancourt D, Longitudinal associations between loneliness, social isolation and cardiovascular events, Heart 2020; 106:1394-1399 (2020). [DOI]

Bu, F., Abell, J., Zaninotto, P. et al. A longitudinal analysis of loneliness, social isolation and falls amongst older people in England. Sci Rep 10, 20064 (2020). [DOI]

Philip, K.E.J., Polkey, M.I., Hopkinson, N.S. et al. Social isolation, loneliness and physical performance in older-adults: fixed effects analyses of a cohort study. Sci Rep 10, 13908 (2020). [DOI]

Walker E, Ploubidis G, Fancourt D, Social engagement and loneliness are differentially associated with neuro-immune markers in older age: Time-varying associations from the English Longitudinal Study of Ageing, Brain, Behavior, and Immunity, 82, 2019, 224-229 (2019). [DOI]