Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020.

BACKGROUND: Experiencing loneliness can be distressing and increasing evidence indicates that being lonely is associated with poor physical and mental health outcomes. Cross-sectional studies have demonstrated that people with disability have increased risk of experiencing loneliness compared to people without disability. However, we do not know if these inequalities have changed over time. This study investigated the prevalence of loneliness for people with disability in Australia annually from 2003 to 2020 to examine whether disability-related inequalities in loneliness have changed over time, and disaggregated results for subgroups of people with disability by age group, sex, and disability group. METHODS: We used annual data (2003-2020) from the Household, Income and Labour Dynamics in Australia Survey. Loneliness was measured by a single question assessing the subjective experience of loneliness. For each wave, we calculated population-weighted age-standardised estimates of the proportion of people experiencing loneliness for people with and without disability. We then calculated the absolute and relative inequalities in loneliness between people with and without disability for each wave. Analyses were stratified by 10-year age groups, sex, and disability group (sensory or speech, physical, intellectual or learning, psychological, brain injury or stroke, other). RESULTS: From 2003 to 2020, the prevalence of loneliness was greater for people with disability, such that people with disability were 1.5 to 1.9 times more likely to experience loneliness than people without disability. While the prevalence of loneliness decreased for people without disability between 2003 and 2020, the prevalence of loneliness did not decrease for people with disability during this period. Inequalities in loneliness were more substantial for people with intellectual or learning disabilities, psychological disability, and brain injury or stroke. CONCLUSION: This study confirms that people with disability have increased risk of loneliness compared to people without disability. We add to the existing evidence by demonstrating that disability-related inequalities in loneliness have persisted for two decades in Australia without improvement. Our findings indicate that addressing inequalities in loneliness for people with disability is a critical public health concern given that loneliness is associated with a wide range of poor health outcomes.

Disability and loneliness in the United Kingdom: cross-sectional and longitudinal analyses of trends and transitions.

BACKGROUND: Loneliness can have a detrimental impact on health, yet little is known about the association between disability and loneliness. METHODS: Secondary analysis of three waves of data collected between 2017 and 2020 by the UK's annual household panel study, Understanding Society. Direct age-standardisation was used to compare the prevalence of loneliness at each wave and the persistence of loneliness across all three waves for participants with/without disabilities aged 16-65 years. Transitional probabilities for the stability of loneliness, the stability of non-loneliness, the onset of loneliness and the offset of loneliness between consecutive waves were also estimated. RESULTS: At each wave, the prevalence of loneliness was significantly higher among respondents with disabilities than respondents without disabilities; these inequalities persisted with no evidence of change over time. The prevalence of persistent loneliness was 46% for respondents with disabilities compared with 22% for respondents without disabilities. Risk factors for the likelihood of persistent loneliness included disability, financial stress, not living as a couple, living in rented accommodation, being female and not being employed. The probability of the onset and stability of loneliness between successive waves were markedly higher for people with disabilities compared with people without disabilities. CONCLUSION: Adults with disabilities were more likely to experience loneliness, become lonely and remain lonely over time than their peers. Policies and interventions aimed at reducing loneliness should ensure that they are accessible and effective for people with disabilities. Further research is needed to explore the health outcomes of persistent loneliness among people with/without disabilities.

Self-Harm Among 17-Year-Old Adolescents With/Without Disabilities in the United Kingdom.

Background: Self-harm is a critical public health issue for adolescents/young adults. Aims: To estimate the prevalence of self-harm among adolescents with/without disabilities in the United Kingdom. Method: Secondary analysis of data collected at age 17 in the UK's Millennium Cohort Study. Results: Prevalence of self-harm was significantly greater among adolescents with disabilities for suicide attempts and six forms of self-harming behaviors. The lifetime prevalence of suicide attempts was 5.3% (4.5-6.3) among adolescents without disabilities, 21.9% (18.2-26.2) among adolescents with less limiting disabilities, and 25.5% (17.2-35.9) among adolescents with more limiting disabilities. Adjusted prevalence rate ratios ranged from 5.13 (3.58-7.36) for those with mental health limitations to 1.48 (0.65-3.35) for those with mobility limitations. Similar patterns were observed for the 12-month prevalence of six self-harming behaviors. Limitations: Further studies are needed to identify potential mediators of the association between disability and self-harm that are potentially modifiable. Conclusion: Adolescents with disabilities are at markedly greater probability of suicide attempts and self-harming behaviors than their peers.

Better Health, Better Lives: research priorities: supporting the European Declaration on Children and Young People with Intellectual Disabilities and their Families

Across Europe, children with intellectual disability experience broad ranging and pervasive inequalities in their health and intheir life experiences and opportunities. These inequalities are, to a large extent, avoidable and unjust. This paper relates tothe priority areas identified in the European Declaration on Children and Young People with Intellectual Disabilities and theirFamilies.One of the challenges facing this field is the lack of knowledge and the absence of evidence for interventions. This gap canbecome an excuse for inaction, even if a will to change exists. This paper service an important purpose by outlining thepresent situation, and indicating a way forward. For each area the authors (1) briefly summarize the state of existingevidence that would support action in relation to the priority area; and (2) identify three priorities for further research.