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 isolation are known to be bad for our health generally.  In this project we are using statistical analysis of cohort study data to understand how social isolation and loneliness are correlated with a range of physical health conditions – cardiovascular disease, falls, respiratory disease and more – across the lifespan.

Specifically, we are working to understand how loneliness and isolation contribute to modifiable risk factors for these conditions (including behavioural and biological risk factors). We are also linking data from cohort studies with hospital episode statistics to understand the relationship with health service utilisation. We’re also applying various theories from social psychology and social epidemiology to explore different definitions of isolation, including living alone, having a lack of social contact with other people, and being disengaged from community activities.

Key findings so far:

  • Social factors are associated with a range of modifiable risk factors for chronic disease. For example, loneliness is a risk factor for cardiovascular disease, including through modulating levels of stress, depression, neuroendocrine responses to stress, inflammation, and harmful behaviours such as smoking, drinking alcohol, and poor diet
  • Aspects of social engagement are associated with lower levels of inflammation whilst loneliness was inversely related to the regulation of inflammation, suggesting there could be different biological pathways involved in objective and subjective aspects of social connections.
  • Social factors are associated with an increased risk of adverse outcomes in older age including falls, poor physical performance, and onset of cardiovascular disease and respiratory disease, but this varies depending on whether it is subjective measures of social connections such as loneliness vs objective measures such as living alone and social disengagement.
  • Social factors are associated with hospital admissions for different conditions, including living alone and social disengagement being related to admissions for respiratory disease, living alone and low social contact related to admissions for falls, and loneliness related to admissions for cardiovascular disease



Programme areas

Epidemiology, behavioural science

UCL team

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



Key contact





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]