title: Loneliness, Social Networks, and Health: A Cross-Sectional Study in Three Countries.
abstract: OBJECTIVE
  It is widely recognized that social networks and loneliness have effects on health. The present study assesses the differential association that the components of the social network and the subjective perception of loneliness have with health, and analyzes whether this association is different across different countries.
  
  
  METHODS
  A total of 10 800 adults were interviewed in Finland, Poland and Spain. Loneliness was assessed by means of the 3-item UCLA Loneliness Scale. Individuals' social networks were measured by asking about the number of members in the network, how often they had contacts with these members, and whether they had a close relationship. The differential association of loneliness and the components of the social network with health was assessed by means of hierarchical linear regression models, controlling for relevant covariates.
  
  
  RESULTS
  In all three countries, loneliness was the variable most strongly correlated with health after controlling for depression, age, and other covariates. Loneliness contributed more strongly to health than any component of the social network. The relationship between loneliness and health was stronger in Finland (|β| = 0.25) than in Poland (|β| = 0.16) and Spain (|β| = 0.18). Frequency of contact was the only component of the social network that was moderately correlated with health.
  
  
  CONCLUSIONS
  Loneliness has a stronger association with health than the components of the social network. This association is similar in three different European countries with different socio-economic and health characteristics and welfare systems. The importance of evaluating and screening feelings of loneliness in individuals with health problems should be taken into account. Further studies are needed in order to be able to confirm the associations found in the present study and infer causality.
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.
authors.forename: Laura Alejandra
authors.initials: LA
authors.lastname: Rico-Uribe
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
authors.forename: Francisco Félix
authors.initials: FF
authors.lastname: Caballero
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Olaya
authors.affiliation: Department of Medical Sociology, Jagiellonian University Medical College, Krakow, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Tobiasz-Adamczyk
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Seppo
authors.initials: S
authors.lastname: Koskinen
authors.affiliation: Fondazione IRCCS, Neurological Institute Carlo Besta, Milano, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Leonardi
authors.affiliation: Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Parc Sanitari Sant Joan de Déu, Barcelona, Spain.|Universitat de Barcelona, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
authors.affiliation: Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland.
authors.forename: Somnath
authors.initials: S
authors.lastname: Chatterji
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ayuso-Mateos
authors.affiliation: Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.|Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.|Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Miret
mesh_terms: D000328:Adult; D017677:Age Distribution; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006262:Health; D006801:Humans; D016014:Linear Models; D008132:Loneliness; D008297:Male; D008875:Middle Aged; D011044:Poland; D060756:Social Networking; D013030:Spain