Highlights • Meta-analysis shows flatter diurnal cortisol slopes are associated with worse health. • Results are significant for 10 out of 12 health outcomes and across multiple age groups. • ...Strongest effects are found for Inflammation and immune system outcomes. • Effects are found across most types of diurnal cortisol slope measurement. • Use of objective compliance monitors is associated with larger effect sizes
Having associations with a range of adverse physical health outcomes including mortality, loneliness is increasingly recognized as a pressing public health concern, but the mechanisms studied to date ...do not yet explain all loneliness-related health risk. We sought to evaluate whether epigenetic influences on DNA methylation could help explain the relationship between loneliness and health. To do so, we first estimated associations between loneliness and epigenetic age acceleration (EAA) in a subsample of participants in the study of midlife in the United States (n = 1,310), before testing whether EAA mediated and/or moderated the association between loneliness and the onset of chronic health conditions in older adulthood (n = 445 completing longitudinal follow-ups). Greater loneliness was weakly associated with greater EAA in the Horvath, DunedinPACE, and GrimAge measures after accounting for demographic (0.08 ≤ β ≤ 0.11) and behavioral (0.06 ≤ β ≤ 0.08) covariates. Loneliness also predicted increases in chronic condition counts and these effects were more pronounced for individuals with higher DunedinPACE EAA values (interaction term β = 0.09, p = .009), suggesting possible synergistic impacts. EAA measures appear to be promising in helping to understand individual variations in the health impacts of loneliness, but the specific mechanisms involved require further research.
Public Significance Statement
Lonely individuals face poorer health outcomes than nonlonely individuals. These data support the notion that loneliness is associated with accelerated epigenetic aging which may amplify the impact of loneliness on physical health in older adulthood.
This study re-examines the healthy migrant phenomenon in China’s internal migration process and investigates the different trajectories of place of origin on migrants’ self-rated physical health and ...psychological distress. Data came from a household survey (N = 1474) conducted in Beijing between May and October in 2009. Multiple regression techniques were used to model the associations between self-rated physical health, psychological distress, and migration experience, controlling for sociodemographic characteristics. The healthy migrant phenomenon was observed among migrants on self-rated physical health but not on psychological distress. Different health status trajectories existed between physical health versus mental health and between rural-to-urban migrants versus urban-to-urban migrants. The study draws particular attention to the diminishing physical health advantage and the initial high level of psychological distress among urban-to-urban migrants. The initial physical health advantage indicates that it is necessary to reach out to the migrant population and provide equal access to health services in the urban area. The high level of psychological distress suggests that efforts targeting mental health promotion and mental disorder prevention among the migrant population are an urgent need. The findings of the study underline the necessity to make fundamental changes to the restrictive hukou system and the unequal distribution of resources and opportunities in urban and rural areas. These changes will lessen the pressure on big cities and improve the living conditions and opportunities of residents in townships/small cities and the countryside.
Purpose
Loneliness is increasingly recognised as the next critical public health issue. A plausible reason for this concern may be related to emerging societal trends affecting the way we relate, ...communicate, and function in our social environment. In 2006, a prominent review of the clinical significance of loneliness was published. However, there has not been a comprehensive update on known and emerging risk factors and correlates of loneliness since then. Furthermore, there is no conceptual model that has been developed to better account for the complexity of loneliness and to inform the development of evidence-based solutions as we challenge the issues of the twenty-first century.
Methods
We reviewed the current literature to identify either known or emerging risk factors and correlates of loneliness since 2006. This includes new or known evidence on: (1) demography; (2) health, including physical health; mental health; cognitive health; brain, biology, and genetics; and (3) socio-environmental factors including digital communication and the workplace.
Results
We synthesized the literature according to a new proposed conceptual model of loneliness which showed the interplay between known and emerging correlates and risk factors from demography, health, to socio-environmental factors. In the conceptual model of loneliness, we illustrated how solutions can be delivered and tailored to an individual based on their life circumstances and preferences.
Conclusion
We concluded by making specific recommendations in advancing our scientific understanding of loneliness. Our knowledge can only be deepened if we increase scientific rigour via accounting for confounding variables and using longitudinal, multi-disciplinary, and multiple methodologies in research. We also call for the rigorous evaluation of programs targeting loneliness.
In recent decades, numerous studies have suggested a positive relationship between prosociality and well-being. What remains less clear are (a) what the magnitude of this relationship is, and (b) ...what the moderators that influence it are. To address these questions, we conducted a meta-analysis to examine the strength of the prosociality to well-being link under different operationalizations, and how a set of theoretical, demographic, and methodological variables moderate the link. While the results revealed a modest overall mean effect size (r = .13, K = 201, N = 198,213) between prosociality and well-being, this masked the substantial variability in the effect as a function of numerous moderators. In particular, the effect of prosociality on eudaimonic well-being was stronger than that on hedonic well-being. Prosociality was most strongly related to psychological functioning-showing a more modest relationship with psychological malfunctioning and physical health. Using prosociality scales was more strongly associated with well-being than using measures of volunteering/helping frequency or status. In addition, informal helping (vs. formal helping) was linked to more well-being benefits. Demographically, younger givers exhibited higher levels of well-being other than physical health, while older and retired givers reported better physical health only. Female givers showed stronger relationships between prosociality and eudaimonic well-being, psychological malfunctioning, and physical health. Methodologically, the magnitude of the link was stronger in studies using primary (vs. secondary) data and with higher methodological rigor (i.e., measurement reliability and validity). We discussed all of these results and implications and suggested directions for future research.
Public Significance Statement
The present meta-analysis suggests a small and significant association between prosocial behavior and well-being. It also provides researchers with important insights into what theoretical (i.e., types of prosociality and well-being), demographical (i.e., age, gender, and retirement status), and methodological factors (i.e., primary vs. secondary data collection and methodological rigor) may strengthen or weaken the link between prosociality and well-being.
•Depressive symptom trajectories are related to early health indicators.•Persistent symptoms are associated with pervasive adolescent health risks.•Screening for physical symptoms could identify ...early depressive symptoms.•Targeting physical symptoms, self-concept, and activity may deter depression.
We examine how depressive symptom trajectories are related to adolescent and young adult subjective health, health-promoting, health-risk, and sexual risk behaviors, as well as cardiometabolic risks.
Data came from a community-based sample of youth (N = 662; 52% female) followed biannually, six times across 10 years. Latent class growth analysis identified four depressive symptom trajectories which were compared on adolescent (T1; ages 12–18) and young adult (T6; ages 22–29) health indicators.
The Low stable trajectory (49%) showed the fewest health risks. The Persistent high trajectory (9%) reported higher physical symptoms, lower physical self-concept, less physical activity and sleep, and higher rates of smoking and sexual risk behaviors than the Low stable trajectory and risks for physical symptoms, physical self-concept, and physical activity worsened in young adulthood. Increasers (21%) showed risks for physical symptoms, physical activity, and sleep in adolescence and problems for physical symptoms and physical self-concept persisted in young adulthood. Decreasers (22%) showed risks for physical symptoms, physical self-concept, physical activity, and sleep in adolescence but these risks resolved into young adulthood.
Findings may not generalize to ethnic minorities. Sex differences were not examined due to sample size limitations and most variables, except cardiometabolic risks, were self-reported.
Findings suggest early treatment of depressive symptoms that includes strategies addressing physical symptoms, physical self-concept, and physical activity may prove beneficial. Screening youth for physical symptoms and declines in health-promoting behaviors may also identify youth at risk of depression onset and progression.
The coronavirus (COVID-19) pandemic has resulted in changes to the working arrangements of millions of employees who are now based at home and may continue to work at home, in some capacity, for the ...foreseeable future. Decisions on how to promote employees' health whilst working at home (WAH) need to be based on the best available evidence to optimise worker outcomes. The aim of this rapid review was to review the impact of WAH on individual workers' mental and physical health, and determine any gender difference, to develop recommendations for employers and employees to optimise workers' health.
A search was undertaken in three databases, PsychInfo, ProQuest, and Web of Science, from 2007 to May 2020. Selection criteria included studies which involved employees who regularly worked at home, and specifically reported on physical or mental health-related outcomes. Two review authors independently screened studies for inclusion, one author extracted data and conducted risk of bias assessments with review by a second author.
Twenty-three papers meet the selection criteria for this review. Ten health outcomes were reported: pain, self-reported health, safety, well-being, stress, depression, fatigue, quality of life, strain and happiness. The impact on health outcomes was strongly influenced by the degree of organisational support available to employees, colleague support, social connectedness (outside of work), and levels of work to family conflict. Overall, women were less likely to experience improved health outcomes when WAH.
This review identified several health outcomes affected by WAH. The health/work relationship is complex and requires consideration of broader system factors to optimise the effects of WAH on workers' health. It is likely mandated WAH will continue to some degree for the foreseeable future; organisations will need to implement formalised WAH policies that consider work-home boundary management support, role clarity, workload, performance indicators, technical support, facilitation of co-worker networking, and training for managers.
Exercise can improve clinical outcomes in people with severe mental illness (SMI). However, this population typically engages in low levels of physical activity with poor adherence to exercise ...interventions. Understanding the motivating factors and barriers towards exercise for people with SMI would help to maximize exercise participation. A search of major electronic databases was conducted from inception until May 2016. Quantitative studies providing proportional data on the motivating factors and/or barriers towards exercise among patients with SMI were eligible. Random-effects meta-analyses were undertaken to calculate proportional data and 95% confidence intervals (CI) for motivating factors and barriers toward exercise. From 1468 studies, 12 independent studies of 6431 psychiatric patients were eligible for inclusion. Meta-analyses showed that 91% of people with SMI endorsed ‘improving health’ as a reason for exercise (N = 6, n = 790, 95% CI 80–94). Among specific aspects of health and well-being, the most common motivations were ‘losing weight’ (83% of patients), ‘improving mood’ (81%) and ‘reducing stress’ (78%). However, low mood and stress were also identified as the most prevalent barriers towards exercise (61% of patients), followed by ‘lack of support’ (50%). Many of the desirable outcomes of exercise for people with SMI, such as mood improvement, stress reduction and increased energy, are inversely related to the barriers of depression, stress and fatigue which frequently restrict their participation in exercise. Providing patients with professional support to identify and achieve their exercise goals may enable them to overcome psychological barriers, and maintain motivation towards regular physical activity.
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