Social Isolation and Loneliness Among U.S. Adults with Self-Reported Hospitalization.

Abstract

Introduction: This study aimed to examine the prevalence and factors associated with social isolation and loneliness among U.S. adults with self-reported hospitalization.

Methods: Cross-sectional survey data from adults aged ≥18 years in the 2021 Medical Expenditure Panel Survey who reported at least one hospitalization were obtained and analyzed in 2025-2026. Weighted descriptive analyses and multivariable logistic regression models were conducted to identify factors independently associated with social isolation and loneliness.

Results: Social isolation and isolation were present in 22.6% and 26.6% of the study participants, respectively. Factors independently associated with higher odds of social isolation were middle income (aOR 2.35, 95%CI 1.43-3.86) and low income (aOR 4.50, 95%CI 2.82-7.18), public insurance (aOR 2.02, 95%CI 1.44-2.85), depression (aOR 2.27, 95%CI 1.49-3.46), and prior hospitalizations (aOR 1.21, 95%CI 1.01-1.45). Adults aged 45-64 years (aOR 0.45, 95%CI 0.29-0.69) and ≥65 years (aOR 0.49, 95%CI 0.31-0.77), and Non-Hispanic Black individuals (aOR 0.52, 95%CI 0.32-0.84) had lower odds of social isolation. Factors independently associated with higher odds of loneliness were being widowed, divorced, or separated (aOR 2.03, 95%CI 1.31-3.15) or never married (aOR 2.58, 95%CI 1.57-4.24), depression (aOR 3.86, 95%CI 2.48-5.99), and having fair or poor perceived health status (aOR 1.92, 95%CI 1.34-2.75). Adults aged ≥65 years had lower odds of loneliness (aOR 0.55, 95%CI 0.31-0.95) compared to those aged 18-44 years.

Conclusions: Over one in five US adults with self-reported hospitalization experienced social isolation and one in four reported loneliness. Routine screening during hospitalization may help identify at-risk individuals.