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Objectives <p>Social determinants of health (SDoH) are increasingly recognized as fundamental determinants of mental and social well-being. However, the extent to which cumulative, domainal, and individual SDoH shape loneliness trajectories in middle and later life remains unclear.</p> Methods <p>This study employed longitudinal data from the China Family Panel Studies (2012–2022). Group-based trajectory modeling (GBTM) was used to classify distinct loneliness trajectories. Logistic regression analyses evaluated the associations between SDoH and trajectory groups. To further explore interrelationships, network analysis was applied to identify central nodes of SDoH.</p> Results <p>A total of 11,877 participants were analyzed. GBTM revealed two patterns of loneliness: persistently low and persistently high. Participants with greater cumulative exposure to SDoH (OR = 1.26, 95% CI: 1.22–1.30) were significantly more likely to exhibit persistently high loneliness trajectories. Network analysis identified “residence” and “education level” as the most central nodes.</p> Discussion <p>This study underscores the importance of addressing cumulative disadvantages across the life course. Efforts to promote healthy aging should prioritize narrowing urban–rural gaps in social infrastructure and ensuring equitable lifelong learning opportunities, which may mitigate the persistently high loneliness trajectory.</p>

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Associations between social determinants of health and loneliness trajectories among middle-aged and older adults: a network perspective

  • 期刊论文

  • 发表日期：

    2025年11月25日

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  • Xue Wang,
  • Liping Wei,
  • Peng Zhao,
  • Yaoyao Zhou,
  • Wendie Zhou,
  • Jiaqi Yu,
  • Hejing Chen,
  • Cuili Wang

摘要

Objectives

Social determinants of health (SDoH) are increasingly recognized as fundamental determinants of mental and social well-being. However, the extent to which cumulative, domainal, and individual SDoH shape loneliness trajectories in middle and later life remains unclear.

Methods

This study employed longitudinal data from the China Family Panel Studies (2012–2022). Group-based trajectory modeling (GBTM) was used to classify distinct loneliness trajectories. Logistic regression analyses evaluated the associations between SDoH and trajectory groups. To further explore interrelationships, network analysis was applied to identify central nodes of SDoH.

Results

A total of 11,877 participants were analyzed. GBTM revealed two patterns of loneliness: persistently low and persistently high. Participants with greater cumulative exposure to SDoH (OR = 1.26, 95% CI: 1.22–1.30) were significantly more likely to exhibit persistently high loneliness trajectories. Network analysis identified “residence” and “education level” as the most central nodes.

Discussion

This study underscores the importance of addressing cumulative disadvantages across the life course. Efforts to promote healthy aging should prioritize narrowing urban–rural gaps in social infrastructure and ensuring equitable lifelong learning opportunities, which may mitigate the persistently high loneliness trajectory.