Objective To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design Quasi-experimental design, namely, a difference-in-differences approach. Setting Local authorities across England. Participants Older adults aged 65 and over participating in waves 4-8 (2008-2017) of the English Longitudinal Study of Aging (ELSA) and waves 1-9 (2009-2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented anti-loneliness strategies led to no change in loneliness scores (estimate=0.044, SE=0.085), social isolation caseness (estimate=0.038, SE=0.020) or levels of depressive symptoms (estimate=0.130, SE=0.165). Heterogeneity analyses indicate that anti-loneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions Anti-loneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.
Has the {UK} Campaign to end loneliness reduced loneliness and improved mental health in older age? A difference-in-differences design
Ludovico Carrino;
2023-01-01
Abstract
Objective To estimate the impact of the UK nationwide campaign to End loneliness on loneliness and mental health outcomes among older people in England. Design Quasi-experimental design, namely, a difference-in-differences approach. Setting Local authorities across England. Participants Older adults aged 65 and over participating in waves 4-8 (2008-2017) of the English Longitudinal Study of Aging (ELSA) and waves 1-9 (2009-2019) of the UK Household Longitudinal Study (UKHLS). Main outcome measures Loneliness was measured through the UCLA Loneliness scale. A social isolation scale with components of household composition, social contact and participation was constructed. Mental health was measured by The Centre for Epidemiological Studies of Depression (CES-D) score, the General Health Questionnaire (GHQ-12) score, and the Short-Form-12 Mental Component Summary (SF-12 MCS) score. Results There was no evidence of change in loneliness scores over the study period. Difference-in-differences estimates suggest that explicitly developed and implemented anti-loneliness strategies led to no change in loneliness scores (estimate=0.044, SE=0.085), social isolation caseness (estimate=0.038, SE=0.020) or levels of depressive symptoms (estimate=0.130, SE=0.165). Heterogeneity analyses indicate that anti-loneliness strategies produced little impact on loneliness or mental health overall, despite small reductions in loneliness and increases in social engagement among well-educated and higher-income older adults. The results were robust to various sensitivity and robustness analyses. Conclusions Anti-loneliness strategies implemented by local authorities have not generated a significant change in loneliness or mental health in older adults in England. Generating changes in loneliness in the older population might require longer periods of exposure, larger scope of intervention or more targeted strategies.Pubblicazioni consigliate
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