Associations of Social and Physical Isolation With Material Deprivation and Inadequate Use of Preventive Care in the United States

A better understanding of the association of isolation with preventive care uptake and material deprivation-2 potential drivers of worse health outcomes among isolated individuals-could inform health policy to mitigate the health harms of isolation.

We analyzed data from the 2022 Behavioral Risk Factor Surveillance System. Our exposures were self-reported social isolation and physical isolation (assessed from transportation barriers). We examined the association of each form of isolation with indicators of material deprivation and with the uptake of 6 recommended preventive care services (COVID, influenza, and pneumococcal vaccinations, and cervical, colorectal, and breast cancer screenings).

Our population included 281,592 adult respondents; 82,816 (31.9%) reported social isolation and 18,181 (8.2%) reported physical isolation. In unadjusted analyses, each form of isolation was associated with reduced uptake of preventive care services. After multivariate adjustment, social isolation remained associated with reduced uptake of 2 services-breast cancer screening (adjusted odds ratio [AOR] = 0.70; 95% CI, 0.65-0.76) and colorectal cancer screening (AOR = 0.91; 95% CI, 0.85-0.97)-and physical isolation remained associated with reduced uptake of 3 services-influenza vaccination (AOR = 0.89; 95% CI, 0.82-0.97), breast cancer screening (AOR = 0.57; 95% CI, 0.49-0.66), and colorectal cancer screening (AOR = 0.81; 95% CI, 0.71-0.93).

Social isolation and physical isolation are associated with reduced preventive care use, but adjustment for material deprivation substantially attenuates these associations. Policies to foster social connectedness and alleviate transportation barriers may improve health outcomes, but intervention on socioeconomic factors will likely also be necessary.