Loneliness correlates and associations with health variables in the general population in Indonesia

Karl Peltzer,Supa Pengpid

doi:10.1186/s13033-019-0281-z

Abstract

BackgroundLoneliness has been commonly reported in high-income countries, while less is known about loneliness in Association of the Southeast Asian Nations (ASEAN) member states, in particular in Indonesia.ObjectiveThe aim of the study was to estimate the prevalence of loneliness, its correlates and associations with health variables in a national survey in the general population in Indonesia.MethodsIn the Indonesia Family Life Survey (IFLS-5) in 2014–2015, 31,447 participants 15 years and older (median age 35.0 years, interquartile range = 22.0) were interviewed and examined in a national population-based cross-sectional study. The self-reported prevalence of loneliness, blood pressure, body height and weight, physical and mental health, health behaviour and psychosocial variables were measured. Multinomial logistic regression analyses were used to estimate determinants of loneliness and logistic and linear regression analyses were applied to estimate the associations of loneliness with physical, mental and health risk behaviour variables.ResultsThe self-reported prevalence of loneliness (occasionally or all of the time or 3–7 days per week) was 10.6% (11.0% for females and 10.1% for males), and 8.0% reported sometimes (1–2 days/week) to be lonely. Loneliness was distributed in a slight U-shaped form, with adolescents and the oldest old having the highest prevalence of loneliness. In adjusted multinomial logistic regression analysis, lower education, lower economic status, adverse childhood experiences, having one or more chronic conditions, functional disability and low neighbourhood trust were associated with loneliness. Loneliness was significantly associated with most health variables, including self-reported unhealthy health status (AOR 1.70, CI 1.57, 1.84), cognitive functioning (Beta: − 0.72, CI − 0.90 to − 0.54), having one or more chronic medical conditions (AOR 1.25, CI 1.16, 1.35), having had a stroke (AOR 1.58, CI 1.08, 2.29), depression symptoms (Beta: 5.19, CI 4.98–5.39), sleep disturbance (Beta: 0.34, CI 0.31–0.37), sleep related impairment (Beta: 0.69, CI 0.64–0.73), low life satisfaction (AOR 1.78, CI 1.64, 1.93), out-patient health care utilization in the past 4 weeks (AOR 1.11, CI 1.01, 1.21), current tobacco use (AOR 1.42, CI 1.28, 1.58), and one or more days in the past week soft drink consumption (AOR 1.20, CI 1.10, 1.31).ConclusionLoneliness was found to be prevalent across the life span and was associated with a number of poorer health variables. Several factors associated with loneliness were identified, which warrant further research in Indonesia.

Highlights

According to Hawkley and Cacioppo ([1], p. 218), loneliness is a “distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships.” A loneliness model by Hawkley and Cacioppo ([1], p. 222) “posits that perceived social isolation is tantamount to feeling unsafe, and this sets off implicit hypervigilance for social threat in the environment
Loneliness was found to be prevalent across the life span and was associated with a number of poorer health variables
The prevalence of loneliness was highest in the age groups 15–24 years, followed by the oldest old (80 years or more) and the 70–74 years age group, while the lowest feelings of loneliness were reported among the 75–70 year-olds and the 55–59 year-olds

Summary

Introduction

According to Hawkley and Cacioppo ([1], p. 218), loneliness is a “distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships.” A loneliness model by Hawkley and Cacioppo ([1], p. 222) “posits that perceived social isolation is tantamount to feeling unsafe, and this sets off implicit hypervigilance for (additional) social threat in the environment. Negative social expectations tend to elicit behaviors from others that confirm the lonely persons’ expectations, thereby setting in motion a self-fulfilling prophecy in which lonely people actively distance themselves from would-be social partners even as they believe that the cause of the social distance is attributable to others and is beyond their own control. This self-reinforcing loneliness loop is accompanied by feelings of hostility, stress, pessimism, anxiety, and low self-esteem and represents a dispositional tendency that activates neurobiological and behavioral mechanisms that contribute to adverse health outcomes.”. Loneliness has been commonly reported in high-income countries, while less is known about loneliness in Association of the Southeast Asian Nations (ASEAN) member states, in particular in Indonesia

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Discussion

Conclusion