Social Isolation as a Risk Factor in Cardiovascular Disease

Multiple academic sites have reported that social isolation can pose a public health hazard, specifically premature cardiovascular disease and cerebrovascular disease. This article reports on cardiovascular complications discovered by clinicians and public health researchers. In addition, there are reports that social isolation is associated with pulmonary disease, cancer, autoimmune disease, and even adverse outcomes during pregnancy. Social isolation has been a known factor for serious adverse outcomes in psychiatric circles since the time of Emil Kraepelin, Paul Eugen Bleuler, and Emile Durkheim before the 20th century. In the past, there have also been sporadic case reports from biologically oriented psychiatrists reporting severe medical conditions in these patients, mostly regarded as due to poor access to medical assessments of patients with social isolation. While still a valid pathway for the explanation of some findings, recently, there has been a great deal of interest in the discovery of pathophysiological mechanisms as causative of deadly outcomes in victims of social isolation. This is based on the robust association between social isolation and the development of premature cardiovascular disease. Using Scopus, PubMed, and the Bernard Becker Medical Library at Washington University, the authors reviewed articles from Europe, England, North America, and East Asia published within the past 2 years. Descriptions of pathophysiological mechanisms published in the past 20 years are included in this paper.