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

Abstract

This study aims to examine the prevalence and factors associated with social isolation and loneliness among U.S. adults with self-reported hospitalization. Cross-sectional survey data from adults aged ≥18 years in the 2021 Medical Expenditure Panel Survey who reported at least 1 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. Social isolation and loneliness 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 with those aged 18-44 years. More than 1 in 5 U.S. adults with self-reported hospitalization experienced social isolation and 1 in 4 reported loneliness. Routine screening during hospitalization may help identify at-risk individuals.