Changes in well-being among socially isolated older people during the COVID-19 pandemic: An outcome-wide analysis.

Older adults experienced major changes during the COVID-19 pandemic and ensuing restrictions, and it might be expected that those who were already socially isolated before the pandemic were particularly vulnerable. We apply an outcome-wide longitudinal design on 4,636 participants (mean age 66.8 y) from the English Longitudinal Study of Ageing, observed in 2018/19 and early (June/July 2020) and later (November/December 2020) in the pandemic. Social isolation is defined using an index including marital status, social contact, and social participation in 2018/19. Using mixed models, we compare changes in well-being, health, health behaviors, financial well-being, and Internet use, between isolated and nonisolated participants. From before to during the pandemic, isolated participants (29%) experienced smaller declines in life satisfaction and quality of life and a smaller increase in loneliness. They showed greater declines in smoking and physical activity and were more likely to remain worried about their future financial situation. They also did not change in their likelihood of regular Internet use, contrasting with nonisolated participants who increased in this regard. The groups followed a similar trend for general health and sleep quality (no change), depression and anxiety (increase), and expectations of future financial difficulties (decrease). Although isolated older adults generally show poorer outcomes than their socially connected counterparts, they were somewhat protected during the pandemic on some fronts. Our findings highlight the need to continually care for isolated older adults but also to be attentive in times of unexpected crises to those experiencing extreme changes related to necessary policy responses.

Changes in retirement plans in the English older population during the COVID-19 pandemic: The roles of health factors and financial insecurity.

Over the course of 2020 and 2021, the COVID-19 pandemic disrupted lives globally. In the UK, unemployment rate continued to increase during and post-lockdown periods, and job security and financial wellbeing deteriorated. It is important to understand whether individual decisions related to retirement plans have changed systematically as a result of the pandemic, especially among older adults who experienced greater rates of pandemic unemployment. Using the English Longitudinal Study of Ageing, this article examines changes in retirement plans of older adults during the COVID-19 pandemic and estimates the impact of health and financial circumstances on these changes. In June/July 2020, 5% of 2095 participants reported planning earlier retirement, while 9% reported planning later retirement. We found that poor self-rated health and financial insecurity were associated with intentions to postpone retirement. Additional risk of later retirement associated with poor health was detected among those experiencing financial insecurity. In November/December 2020, 7% of 1845 participants reported planning earlier retirement, while 12% reported planning later retirement. We found that poor health was predictive of a lower relative risk of later retirement, while depressive symptomology and financial insecurity predicted a higher relative risk of later retirement. The findings imply a contextual role of health factors in, and a persistent influence of financial insecurity on, retirement planning in the older population.

Changes in Internet use patterns among older adults in England from before to after the outbreak of the COVID-19 pandemic.

The COVID-19 pandemic brought about an increased reliance on the Internet for various daily activities. Given the known digital divide, it is important to understand whether older adults changed their Internet use patterns, but current evidence is limited to cross-sectional studies. This study documents changes in frequency and types of Internet use among older adults from before to shortly after the outbreak of the COVID-19 pandemic (2018/2019 to June/July 2020), and the factors predicting regular use during these early days of the pandemic. Using data on 6,840 adults aged 50 + from the nationally representative English Longitudinal Study of Ageing, we apply longitudinal fixed-effects models to examine within-individual changes in Internet use behaviour. There was no change in the likelihood of daily Internet use between 2018/2019 and June/July 2020, despite the increased digitalisation of services over the pandemic. Daily use in June/July 2020 was negatively related to age, neighbourhood deprivation, and loneliness, and positively related to partnership status, education, employment, income, and organisation membership. Using the Internet for making calls and getting information about Government services increased, which was important given the social restrictions and overall uncertainty. However, Internet use for finding health-related information decreased. As the world moves towards digital alternatives post-pandemic, it is important to continually ensure older adults are not at risk of exclusion.

COVID-19 lockdowns and changes in loneliness among young people in the U.K.

RATIONALE: There has been growing concern that loneliness has increased throughout the COVID-19 lockdowns, and that the burden has fallen heavily on young people. This is important because loneliness is strongly linked to worse health outcomes. OBJECTIVE: We examine whether and how loneliness among young people changed during the pandemic across the different lockdown periods in 2020 and 2021. We also assess differences by gender, socioeconomic status, and economic activity before the COVID-19 outbreak. METHODS: We use nine waves of longitudinal data from the COVID-19 supplement of the UK Household Longitudinal Study (Understanding Society), collected between April 2020 and September 2021. We apply an individual fixed-effects event study design, which compares the loneliness reported by the same individual over lockdown transitions. We focus on loneliness reported by 1870 respondents aged between 16 and 24 years and compare it with pre-pandemic baselines. RESULTS: We find that the loneliness of young people tracked the extent of lockdown restrictions but had returned to baseline levels by September 2021. This loneliness response was more pronounced for females than males but similar for young people across higher and lower socioeconomic backgrounds. CONCLUSIONS: These results suggest that policy interventions aimed at increasing opportunities for in-person social interactions for young people in 'normal' times, might have some success in tackling loneliness, particularly for young females.

Internet use and psychological wellbeing among older adults in England: a difference-in-differences analysis over the COVID-19 pandemic.

BACKGROUND: Longitudinal evidence on how Internet use affects the psychological wellbeing of older adults has been mixed. As policymakers invest in efforts to reduce the digital divide, it is important to have robust evidence on whether encouraging Internet use among older adults is beneficial, or potentially detrimental, to their wellbeing. METHODS: We observe depressive symptoms and loneliness of adults aged 50 + in the nationally representative English Longitudinal Study of Ageing, from before (2018/19) to during the coronavirus disease 2019 (COVID-19) pandemic (June/July and November/December 2020). Our quasi-experimental difference-in-differences strategy compares within-individual wellbeing changes between older adults who desired to use the Internet more but experienced barriers including lack of skills, access, and equipment, with regular Internet users who did not desire to use the Internet more. To reduce selection bias, we match both groups on demographic and socioeconomic characteristics that are predictive of Internet use. We assume that in the absence of COVID-19 - a period of increased reliance on the Internet - the wellbeing trajectories of both groups would have followed a common trend. RESULTS: Compared with matched controls (N = 2983), participants reporting barriers to Internet use (N = 802) experienced a greater increase in the likelihood of depressive symptoms from before to during the pandemic, but not worse loneliness levels. This effect was stronger for women, those aged above 65 years, and those from lower-income households. CONCLUSIONS: Besides enabling access to digital services, efforts to ensure older adults continue to be engaged members of an increasingly digital society could deliver returns in terms of a buffer against psychological distress.

Economic gradients in loneliness, social isolation and social support: Evidence from the UK Biobank.

Despite the substantial literature on how loneliness is associated with poor health and premature mortality, there is little detailed research on the extent of its economic gradients. We provide this evidence using a sample of around 400,000 respondents aged 40-70 years from the UK Biobank, who were assessed between 2006 and 2010. We focus on differences in loneliness, as well as social isolation and a lack of social support, across educational attainment, household income, local area deprivation, and recent experience of financial stress. We employ two statistical approaches, the first exploiting the large sample size and detailed geographical information about where respondents live, so we compare individuals who differ in their economic status but reside within the same postcode district. The second approach exploits the fact that for around 36,000 respondents we observe their social health and economic circumstances at two points in time (second wave of assessment conducted between 2014 and 2020), so we conduct a panel analysis that accounts for intercorrelations between the social health measures, and controls for incomplete follow-up of panel members. Across both approaches, we find a substantially higher probability of reporting loneliness, social isolation and a lack of social support, for men and women with lower economic status. Together with the existing health-loneliness literature, these findings establish a 'loneliness pathway' contributing to health inequalities, and consequently a need for effective interventions that might address loneliness and social isolation as part of a broad policy initiative on health inequalities.

Social Isolation, Social Support, and Loneliness Profiles Before and After Spousal Death and the Buffering Role of Financial Resources.

OBJECTIVES: We provide new evidence on the profiles of social isolation, social support, and loneliness before and after spousal death for older widows. We also examine the moderating effects of gender and financial resources on changes in social health before and after widowhood. METHODS: We use 19 waves of data from the Household, Income and Labour Dynamics in Australia Survey, including 749 widowed individuals and a comparison group of around 8,000 married individuals. We apply coarsened exact matching weights and control for age and time trends. Local polynomial smoothed plots show the profiles of social health from 3 years pre- to 3 years postspousal death. All analyses were stratified by gender. RESULTS: Spousal death was strongly associated with increased loneliness for women and men, but also an increase in interactions with friends and family not living with the bereaved. For men, financial resources (both income and asset wealth) provided some protection against loneliness. Spousal death was not associated with changes in social support or participation in community activities. DISCUSSION: We demonstrate that loneliness is a greater challenge of widowhood than social isolation or a lack of social support. Our findings suggest that interventions focusing only on increasing social interactions are unlikely to alleviate loneliness following spousal death. Moreover, policies that reduce the cost of formal social participation may have limited effectiveness in tackling loneliness, particularly for women. Alternative strategies, such as helping the bereaved form a new sense of identity and screening for loneliness around widowhood by health care workers, could be beneficial.

Who is resilient in a time of crisis? The importance of financial and non-financial resources.

Enhancing population resilience to adverse events is now a policy priority. Accordingly, there have been calls for more evidence on the determinants of resilience. We answer this call by identifying financial and non-financial resources associated with psychological resilience during the COVID-19 pandemic. Using longitudinal survey data, psychological resilience is measured by comparing distress reported pre-COVID-19 with distress reported during the outbreak and initial lockdown in April 2020. Methodologically, we compare differences in resilience and resources between people with identical gender, ethnicity, health, parenthood status, education, employment status, and region of residence (all measured pre-2020). We also provide estimates from within-household comparisons. Surprisingly, income, savings, and debt levels did not affect the likelihood of psychologically resilient outcomes. Cognitive ability, religiosity, and neighborhood social capital also had no protective effect. In contrast, we find robust evidence that non-cognitive skills, measured by self-efficacy, strongly protected against psychological distress. Self-efficacy also dampened the increase in distress caused by large earnings shocks. These findings support investments in non-cognitive skills that modify the damage-function from adverse events.

Economic Aspects of Loneliness in Australia.

We highlight the problem of loneliness, and argue that it is not only a public health issue but also an economic problem. We provide a brief review of findings from the key literature on the associations between loneliness, mental and physical health, and healthcare costs; and then present some evidence on its trends, the extent of socioeconomic inequalities and its links with health and healthcare usage, in Australia. We hope to encourage further economics research on loneliness, and related issues of social isolation and poor social support, to aid the design of policies and interventions to reduce loneliness.

The link between health and economic preferences: Evidence from 22 OECD countries.

We study the link between health status and economic preferences using survey data from 22 Organisation for Economic Co-operation and Development (OECD) countries. We hypothesize that there is a relationship between poor health and the preferences that people hold, and therefore their choices and decisions. We find that individuals with a limiting health condition are more risk averse and less patient, and that this is true for physical and mental health conditions. The magnitudes of the health gap are approximately 60% and 70% of the gender gap in risk and time preferences, respectively. Importantly, the health gaps are large for males, females, young, old, school dropouts, degree holders, employed, nonemployed, rich, and poor. They also hold for countries with different levels of gross domestic product (GDP), inequality, social expenditure, and disease burden.

Health in widowhood: The roles of social capital and economic resources.

A sizeable literature has demonstrated strong negative associations between widowhood and health, but longitudinal evidence on moderating factors has been mixed. This study assesses the roles of pre-existing social capital and wealth in moderating changes in health in the event of spousal death. Samples of widowed individuals (n = 796) and matched married controls (n = 8233) are employed from 17 consecutive waves of the Household, Income and Labour Dynamics in Australia Survey (2001-2017). Individual-level fixed-effects models are used to estimate changes in physical and mental health before and after spousal death, in reference to one's own health more than two years before widowhood. Results show a temporary physical health improvement in the year of spousal death, and a decline in mental health beginning up to two years before spousal death, lasting up to two years after spousal death. Using social capital-from children, club membership or volunteering status, and social connections-observed earlier than two years before spousal death, this study finds that widowed individuals with higher social capital show poorer mental health than those with less capital. This negative moderating role is more marked among widowed males than females. In contrast, greater wealth, particularly from non-financial assets, is associated with earlier psychological adjustment among males. For females, mental health in widowhood shows little difference by wealth. These findings suggest that social capital may not be sufficient to protect deteriorations in mental health among widowed individuals, and that the pursuit of alternative avenues may be especially important among the less wealthy.

Mental health and the response to financial incentives: Evidence from a survey incentives experiment.

Although mental health disorders such as anxiety and depression are common, there is little research on whether individuals in poor mental health react differently from others to financial incentives. This paper exploits an experiment from the UK Understanding Society Innovation Panel to assess how the participation response to randomly-assigned financial incentives differs by mental health status. We find that individuals in good mental health are more likely to respond when offered a higher financial incentive, whereas those in poor mental health are indifferent to the increased incentive. We find no comparable differences for physical health.

For richer, for poorer: the relationship between adolescent obesity and future household economic prosperity.

Adolescent obesity not only has serious long-term health implications, but also the potential to lead to a socioeconomic trajectory of lower earnings and household income. However, the magnitude and mechanisms of such outcomes across the life course are poorly understood. Using birth cohort data from the British National Child Development Study (1958 to 2008), we examined the relationship between adolescent obesity (at age 16) and future household income, employment, wages, marriage and spousal earnings when individuals were in their 30s, 40s and 50s. We additionally investigated the role of obesity persistence from childhood (age 11) through to adulthood (age 33). After adjusting for a rich set of childhood characteristics, compared to normal weight, obesity at age 16 was associated with significantly lower levels of future household income for women (by approximately 14%), but not men. This household income penalty was greater for women with obesity in both childhood and adulthood. The household income penalty for women appeared to be driven by a lower likelihood of marriage and lower spousal earnings for those who were married, and not by their own wage penalty in the labour market. The spousal earnings penalty occurred even when obesity did not persist into adulthood.