Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Aug 19, 2023
Date Accepted: Jul 1, 2024
Loneliness and social isolation factors under the prolonged COVID-19 pandemic in Japan: A two-year longitudinal study
ABSTRACT
Background:
Worsening loneliness and social isolation during the coronavirus disease 2019 (COVID-19) pandemic have become serious public health concerns worldwide. despite previous research reporting persistent loneliness and social isolation under repeated emergency declarations and prolonged pandemic, long-term studies are needed to identify the actual conditions of loneliness and social isolation, and the factors that explain them.
Objective:
In this study, three online surveys were conducted at one-year intervals during the two years after the first state of emergency to examine changes in loneliness and social isolation and the psychosocial factors associated with them, in the Japanese population.
Methods:
The first survey period (Phase 1, May 11-12, 2020) was conducted at the end of the first emergency declaration period, the second survey (Phase 2, June 15-20, 2021) was conducted at the end of the third emergency declaration period, and the third survey (Phase 3, May 13-30, 2022) was conducted when the state of emergency had not been declared but many COVID-19 positive cases occurred during this period. We collected data on 3892 inhabitants (1813 women, 50.3±13.4 years old) living in the four prefectures where emergency declaration measures were applied in phases 1 and 2. A linear mixed model analysis was performed to examine the association between psychosocial variables as explanatory variables and loneliness scores as the dependent variable in each phase.
Results:
While many psychosocial and physical variables showed improvement for the two years, loneliness, social isolation, and the relationship with familiar people deteriorated, and the opportunities for exercise, favorite activities, and online interaction with familiar people decreased. Nearly half of social isolation in phase 1 remained throughout the two-year period, and a greater number of people developed social isolation than those who were able to resolve it. The results of the linear mixed model analysis showed that most psychosocial and physical variables were related to loneliness regardless of the phase. Regarding the variables that showed a significant interaction with the phase, increased altruistic preventive behavior and a negative outlook for the future were more strongly associated with severe loneliness in phase 3, while association between fewer social networks and stronger loneliness tended to be more pronounced in phase 2. Although the interaction was not significant, the association between less face-to-face interaction, worse relationships with familiar people, and worse loneliness tended to be stronger in phase 3.
Conclusions:
This study showed that the problems of loneliness and social isolation have remained unresolved during the long-term COVID-19 pandemic, and a variety of factors are more strongly related to loneliness and are more complex in the last survey phase than in earlier phases.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.