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1.
JAMA Netw Open ; 5(2): e2146461, 2022 02 01.
Article in English | MEDLINE | ID: covidwho-1669325

ABSTRACT

Importance: Social isolation and loneliness are increasing public health concerns and have been associated with increased risk of cardiovascular disease (CVD) among older adults. Objective: To examine the associations of social isolation and loneliness with incident CVD in a large cohort of postmenopausal women and whether social support moderated these associations. Design, Setting, and Participants: This prospective cohort study, conducted from March 2011 through March 2019, included community-living US women aged 65 to 99 years from the Women's Health Initiative Extension Study II who had no history of myocardial infarction, stroke, or coronary heart disease. Exposures: Social isolation and loneliness were ascertained using validated questionnaires. Main Outcomes and Measures: The main outcome was major CVD, which was physician adjudicated using medical records and included coronary heart disease, stroke, and death from CVD. Continuous scores of social isolation and loneliness were analyzed. Hazard ratios (HRs) and 95% CIs for CVD were calculated for women with high social isolation and loneliness scores (midpoint of the upper half of the distribution) vs those with low scores (midpoint of the lower half of the distribution) using multivariable Cox proportional hazards regression models adjusting for age, race and ethnicity, educational level, and depression and then adding relevant health behavior and health status variables. Questionnaire-assessed social support was tested as a potential effect modifier. Results: Among 57 825 women (mean [SD] age, 79.0 [6.1] years; 89.1% White), 1599 major CVD events occurred over 186 762 person-years. The HR for the association of high vs low social isolation scores with CVD was 1.18 (95% CI, 1.13-1.23), and the HR for the association of high vs low loneliness scores with CVD was 1.14 (95% CI, 1.10-1.18). The HRs after additional adjustment for health behaviors and health status were 1.08 (95% CI, 1.03-1.12; 8.0% higher risk) for social isolation and 1.05 (95% CI, 1.01-1.09; 5.0% higher risk) for loneliness. Women with both high social isolation and high loneliness scores had a 13.0% to 27.0% higher risk of incident CVD than did women with low social isolation and low loneliness scores. Social support was not a significant effect modifier of the associations (social isolation × social support: r, -0.18; P = .86; loneliness × social support: r, 0.78; P = .48). Conclusions and Relevance: In this cohort study, social isolation and loneliness were independently associated with modestly higher risk of CVD among postmenopausal women in the US, and women with both social isolation and loneliness had greater CVD risk than did those with either exposure alone. The findings suggest that these prevalent psychosocial processes merit increased attention for prevention of CVD in older women, particularly in the era of COVID-19.


Subject(s)
Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/psychology , Loneliness , Social Isolation , Social Support , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Incidence , Postmenopause , Prospective Studies , United States , Women's Health
2.
Data Policy ; 3: e33, 2021.
Article in English | MEDLINE | ID: covidwho-1545550

ABSTRACT

With the outbreak of COVID-19 across Europe, anonymized telecommunications data provides a key insight into population level mobility and assessing the impact and effectiveness of containment measures. Vodafone's response across its global footprint was fast and delivered key new metrics for the pandemic that have proven to be useful for a number of external entities. Cooperation with national governments and supra-national entities to help fight the COVID-19 pandemic was a key part of Vodafone's response, and in this article the different methodologies developed are analyzed, as well as the key collaborations established in this context. In this article we also analyze the regulatory challenges found, and how these can pose a risk of the full benefits of these insights not being harnessed, despite clear and efficient Privacy and Ethics assessments to ensure individual safety and data privacy.

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