Loneliness, Cardiovascular Disease, and Diabetes Prevalence in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

  • Samantha A. FotiEmail author
  • Tasneem Khambaty
  • Orit Birnbaum-Weitzman
  • William Arguelles
  • Frank Penedo
  • Rebeca A. Espinoza Giacinto
  • Angela P. Gutierrez
  • Linda C. Gallo
  • Aida L. Giachello
  • Neil Schneiderman
  • Maria M. Llabre
Original Paper


The relationship between loneliness and both cardiovascular disease (CVD) and diabetes mellitus (DM) has been understudied in U.S. Hispanics, a group at high risk for DM. We examined whether loneliness was associated with CVD and DM, and whether age, sex, marital status, and years in U.S moderated these associations. Participants were 5,313 adults (M (SD) age = 42.39 (15.01)) enrolled in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study. Loneliness was assessed via the 3-item Revised UCLA Loneliness Scale. Level of reported loneliness was low. Loneliness was significantly associated with CVD: OR 1.10 (CI 1.01–1.20) and DM: OR 1.08 (CI 1.00–1.16) after adjusting for depression, demographics, body mass index, and smoking status. Age, sex, marital status, and years in U.S. did not moderate associations. Given that increased loneliness is associated with higher cardiometabolic disease prevalence beyond depressive symptoms, regardless of age, sex, marital status, or years in the U.S., Hispanic adults experiencing high levels of loneliness may be a subgroup at particularly elevated risk for CVD and DM.


Loneliness Diabetes Cardiovascular disease Hispanics Latinos 



HCHS/SOL was supported by contracts from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (Grant No. N01-HC65233), University of Miami (Grant No. N01-HC65234), Albert Einstein College of Medicine (Grant No. N01-HC65235), Northwestern University (Grant No. N01-HC65236), and San Diego State University (Grant No. N01-HC65237). The HCHS/SOL Sociocultural Ancillary Study was supported by Grant 1 RC2 HL101649 (Gallo/Penedo) from the NIH/NHLBI. SAF was supported by NHLBI T32 institutional training Grant HL007426-37. Authors thank staff and participants of HCHS/SOL for their important contributions.


  1. 1.
    Peplau LA, Padesky C, Hamilton M. Satisfaction in lesbian relationships. J Homosex. 1982;8(2):23–35.CrossRefGoogle Scholar
  2. 2.
    Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995;117(3):497–529.CrossRefGoogle Scholar
  3. 3.
    Perissinotto CM, Stijacic Cenzer I, Covinsky KE. Loneliness in older persons: a predictor of functional decline and death. Arch Intern Med. 2012;172(14):1078–83.CrossRefGoogle Scholar
  4. 4.
    Donovan NJ, Wu Q, Rentz DM, Sperling RA, Marshall GA, Glymour MM. Loneliness, depression and cognitive function in older U.S. adults. Int J Geriatr Psychiatry. 2017;32(5):564–73.CrossRefGoogle Scholar
  5. 5.
    Murthy V. Work and the Loneliness Epidemic. Harvard Business Review. 2017.Google Scholar
  6. 6.
    Brody JE. The surprising effects of loneliness on health. New York: The New York Times; 2017.Google Scholar
  7. 7.
    Yeginsu C. U.K. appoints a minister for loneliness. New York: The New York Times; 2018.Google Scholar
  8. 8.
    Caplan S. Latinos, acculturation, and acculturative stress: a dimensional concept analysis. Policy, politics & nursing practice. 2007;8(2):93–106.CrossRefGoogle Scholar
  9. 9.
    Chang EC, Sanna LJ, Hirsch JK, Jeglic EL. Loneliness and negative life events as predictors of hopelessness and suicidal behaviors in Hispanics: evidence for a diathesis-stress model. J Clin Psychol. 2010;66(12):1242–53.CrossRefGoogle Scholar
  10. 10.
    Chang EC, Hirsch JK, Sanna LJ, Jeglic EL, Fabian CG. A preliminary study of perfectionism and loneliness as predictors of depressive and anxious symptoms in Latinas: a top-down test of a model. J Couns Psychol. 2011;58(3):441–8.CrossRefGoogle Scholar
  11. 11.
    Triandis HC, Marin G, Betancourt H, Lisansky J, Chang B. Dimensions of familism among Hispanic and mainstream Navy recruits. Champaign: University of Illinois, Department of Psychology; 1982.CrossRefGoogle Scholar
  12. 12.
    Gerst-Emerson K, Shovali TE, Markides KS. Loneliness among very old Mexican Americans: findings from the Hispanic established populations epidemiologic studies of the elderly. Arch Gerontol Geriatr. 2014;59(1):145–9.CrossRefGoogle Scholar
  13. 13.
    Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012;74(6):907–14.CrossRefGoogle Scholar
  14. 14.
    Thurston RC, Kubzansky LD. Women, loneliness, and incident coronary heart disease. Psychosom Med. 2009;71(8):836–42.CrossRefGoogle Scholar
  15. 15.
    Whisman MA, Uebelacker LA. A longitudinal investigation of marital adjustment as a risk factor for metabolic syndrome. Health Psychol: Off J Div Health Psychol, Am Psychol Assoc. 2012;31(1):80–6.CrossRefGoogle Scholar
  16. 16.
    Nonogaki K, Nozue K, Oka Y. Social isolation affects the development of obesity and type 2 diabetes in mice. Endocrinology. 2007;148(10):4658–66.CrossRefGoogle Scholar
  17. 17.
    Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102(13):1009–116.CrossRefGoogle Scholar
  18. 18.
    Schneiderman N, Llabre M, Cowie CC, Barnhart J, Carnethon M, Gallo LC, et al. Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic community health study/study of Latinos (HCHS/SOL). Diabetes Care. 2014;37(8):2233–9.CrossRefGoogle Scholar
  19. 19.
    Tomaka J, Thompson S, Palacios R. The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health. 2006;18(3):359–84.CrossRefGoogle Scholar
  20. 20.
    Borys S, Perlman D. Gender differences in loneliness. Pers Soc Psychol Bull. 1985;11(1):63–74.CrossRefGoogle Scholar
  21. 21.
    Daviglus ML, Talavera GA, Aviles-Santa ML, Allison M, Cai J, Criqui MH, et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA. 2012;308(17):1775–84.CrossRefGoogle Scholar
  22. 22.
    Pinquart M. Loneliness in married, widowed, divorced, and never-married older adults. J Soc Pers Relationsh. 2003;20(1):31–53.CrossRefGoogle Scholar
  23. 23.
    Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010;40(2):218–27. Scholar
  24. 24.
    Gallo LC, Penedo FJ, Carnethon M, Isasi CR, Sotres-Alvarez D, Malcarne VL, et al. The Hispanic community health study/study of Latinos sociocultural ancillary study: sample, design, and procedures. Ethn Dis. 2014;24(1):77–83.Google Scholar
  25. 25.
    Sorlie PD, Aviles-Santa LM, Wassertheil-Smoller S, Kaplan RC, Daviglus ML, Giachello AL, et al. Design and implementation of the Hispanic community health study/study of Latinos. Ann Epidemiol. 2010;20(8):629–41.CrossRefGoogle Scholar
  26. 26.
    Lavange LM, Kalsbeek WD, Sorlie PD, Aviles-Santa LM, Kaplan RC, Barnhart J, et al. Sample design and cohort selection in the Hispanic community health study/study of Latinos. Ann Epidemiol. 2010;20(8):642–9.CrossRefGoogle Scholar
  27. 27.
    Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT. A short scale for measuring loneliness in large surveys: results from two population-based studies. Res Aging. 2004;26(6):655–72.CrossRefGoogle Scholar
  28. 28.
    Russell D, Peplau LA, Cutrona CE. The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Pers Soc Psychol. 1980;39(3):472–80.CrossRefGoogle Scholar
  29. 29.
    Russell DW. UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure. J Pers Assess. 2010;66(1):20–40.CrossRefGoogle Scholar
  30. 30.
    Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.CrossRefGoogle Scholar
  31. 31.
    Gonzalez P, Nunez A, Merz E, Brintz C, Weitzman O, Navas EL, et al. Measurement properties of the Center for Epidemiologic Studies Depression Scale (CES-D 10): findings from HCHS/SOL. Psychol Assess. 2016;29(4):372–81.CrossRefGoogle Scholar
  32. 32.
    Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med. 1999;159(15):1701–4.CrossRefGoogle Scholar
  33. 33.
    Schafer JL, Graham JW. Missing data: our view of the state of the art. Psychol Methods. 2002;7(2):147–77.CrossRefGoogle Scholar
  34. 34.
    Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics–2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–292.Google Scholar
  35. 35.
    Radloff LS. The CES-D Scale: a Self-Report Depression Scale for Research in the General Population. Appl Psychol Meas. 1977;1:385–401.CrossRefGoogle Scholar
  36. 36.
    Wassertheil-Smoller S, Arredondo EM, Cai J, Castaneda SF, Choca JP, Gallo LC, et al. Depression, anxiety, antidepressant use, and cardiovascular disease among Hispanic men and women of different national backgrounds: results from the Hispanic Community Health Study/Study of Latinos. Ann Epidemiol. 2014;24(11):822–30.CrossRefGoogle Scholar
  37. 37.
    Chen H, Cohen P, Chen S. How big is a big odds ratio? interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat-Simul Comput. 2010;39(4):860–4.CrossRefGoogle Scholar
  38. 38.
    Holmen K, Furukawa H. Loneliness, health and social network among elderly people–a follow-up study. Arch Gerontol Geriatr. 2002;35(3):261–74.CrossRefGoogle Scholar
  39. 39.
    Golden SH, Lazo M, Carnethon M, Bertoni AG, Schreiner PJ, Diez Roux AV, et al. Examining a bidirectional association between depressive symptoms and diabetes. JAMA. 2008;299(23):2751–9.CrossRefGoogle Scholar
  40. 40.
    Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care. 2003;26(10):2822–8.CrossRefGoogle Scholar
  41. 41.
    Hermes GL, Rosenthal L, Montag A, McClintock MK. Social isolation and the inflammatory response: sex differences in the enduring effects of a prior stressor. Am J Physiol Regul Integr Comp Physiol. 2006;290(2):R273–82.CrossRefGoogle Scholar
  42. 42.
    Kaplan MS, Marks G. Adverse effects of acculturation: psychological distress among Mexican American young adults. Soc Sci Med. 1990;31(12):1313–9.CrossRefGoogle Scholar
  43. 43.
    Penninx BW, van Tilburg T, Kriegsman DM, Boeke AJ, Deeg DJ, van Eijk JT. Social network, social support, and loneliness in older persons with different chronic diseases. J Aging Health. 1999;11(2):151–68.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Samantha A. Foti
    • 1
    Email author
  • Tasneem Khambaty
    • 1
  • Orit Birnbaum-Weitzman
    • 1
  • William Arguelles
    • 1
    • 2
  • Frank Penedo
    • 3
  • Rebeca A. Espinoza Giacinto
    • 4
  • Angela P. Gutierrez
    • 4
  • Linda C. Gallo
    • 4
  • Aida L. Giachello
    • 5
  • Neil Schneiderman
    • 1
  • Maria M. Llabre
    • 1
  1. 1.Department of PsychologyUniversity of MiamiCoral GablesUSA
  2. 2.Center for Research and Grants, Baptist Health South FloridaSouth MiamiUSA
  3. 3.Department of Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Department of PsychologySan Diego State UniversitySan DiegoUSA
  5. 5.Department of PsychologyUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations