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Brief ReportResearch Brief

Geographic Characteristics of Loneliness in Primary Care

Sebastian Tong, Rebecca A. Mullen, Camille J. Hochheimer, Roy T. Sabo, Winston R. Liaw, Donald E. Nease, Alex H. Krist and John J. Frey
The Annals of Family Medicine March 2019, 17 (2) 158-160; DOI: https://doi.org/10.1370/afm.2364
Sebastian Tong
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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  • For correspondence: sebastian.tc.tong@gmail.com
Rebecca A. Mullen
2Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
MD, MPH
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Camille J. Hochheimer
3Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
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Roy T. Sabo
3Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia
PhD
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Winston R. Liaw
4Department of Health Systems and Population Health Sciences, University of Houston, Houston, Texas
5Robert Graham Center for Policy Studies in Family Medicine and Primary Care, Washington, DC
MD, MPH
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Donald E. Nease Jr
2Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado
MD
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Alex H. Krist
1Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia
MD, MPH
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John J. Frey III
6Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
MD
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    Figure 1

    Mean loneliness score by zip code of residence in (A) Northern Virginia, (B) Metro Richmond, Virginia, and (C) Metro Denver, Colorado.

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    Table 1

    Associations Between Loneliness and Geospatial Variables, by Zip Code Tabulation Area of Residence

    Pearson CorrelationP Value
    Economic variables
    Poverty (<200% federal poverty line)0.350.02
    Social Deprivation Index scorea0.42<0.01
    Unemployed, %0.49<0.01
    Less than high school education, %0.45<0.01
    Median household income–0.290.02
    Demographic variables
    Median age–0.070.52
    Female/male ratio0.27<0.01
    Race (% black)0.18<0.01
    Ethnicity (% Hispanic)–0.130.27
    Linguistically isolated households, %b0.040.76
    Household size 1 person, %0.290.01
    Average household size–0.070.53
    Transportation variables
    Mean travel time to work0.15<0.01
    Households with no vehicle, %0.34<0.01
    Health care access variables
    Without health insurance, %0.12<0.01
    Without usual source of health care, %0.37<0.01
    • ↵a The Social Deprivation Index is a composite measure of social and material deprivation encompassing education, housing, transportation, and poverty.

    • ↵b Households are considered linguistically isolated if all individuals ages 14 years and older in the household speak a language other than English and none speaks English well.

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  • The Article in Brief

    Geographic Characteristics of Loneliness in Primary Care

    Sebastian Tong , and colleagues

    Background There is growing evidence of the effects of loneliness on aspects of health, but little is known about whether loneliness is associated with where we live. This study set out to determine the associations between community factors and loneliness.

    What This Study Found Living in zip codes with higher unemployment, poor access to health care, lower income, and poor transportation are associated with higher mean loneliness scores. The findings were based on responses to the Three-Item Loneliness Scale screening tool. Of 1,235 survey respondents, 20 percent were identified as lonely. Higher mean loneliness scores were associated with a number of neighborhood characteristics: greater poverty, higher social deprivation, higher proportions of unemployment, more one-person households, more female residents, more black residents, higher mean travel time to work, higher percentage of households with no vehicle, a higher percentage of residents without health insurance, and a higher percentage of residents with no usual source of medical care.

    Implications

    • Given the associations between loneliness and other community-level factors, screening for loneliness may be a proxy for other social needs, the authors suggest.
    • The authors call on primary care practices to take a leading role in developing and testing interventions for loneliness and to consider loneliness as an important social concern for their patients.
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The Annals of Family Medicine: 17 (2)
The Annals of Family Medicine: 17 (2)
Vol. 17, Issue 2
March/April 2019
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Geographic Characteristics of Loneliness in Primary Care
Sebastian Tong, Rebecca A. Mullen, Camille J. Hochheimer, Roy T. Sabo, Winston R. Liaw, Donald E. Nease, Alex H. Krist, John J. Frey
The Annals of Family Medicine Mar 2019, 17 (2) 158-160; DOI: 10.1370/afm.2364

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Geographic Characteristics of Loneliness in Primary Care
Sebastian Tong, Rebecca A. Mullen, Camille J. Hochheimer, Roy T. Sabo, Winston R. Liaw, Donald E. Nease, Alex H. Krist, John J. Frey
The Annals of Family Medicine Mar 2019, 17 (2) 158-160; DOI: 10.1370/afm.2364
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