Loneliness Status and Related Factors among the Hakka Elderly in Fujian, China: Based on the Health Ecological Model

Abstract

There are few studies estimating the loneliness of the Hakka elderly in China. This study aims to examine the loneliness status and related factors among the Hakka elderly in Fujian, China. The short-form UCLA Loneliness Scale (ULS-8) was used to assess the loneliness of the Hakka elderly. Factors associated with loneliness were classified as individual indicators, behavioral indicators, interpersonal indicators, and social indicators according to the health ecological model (HEM). Hierarchical linear regression models were established to identify the main factors that were most predictive of loneliness. A sample of 1,262 Hakka elderly people was included in this study. Females (β = 0.631, $P=0.012$ ), those with ≥2 chronic diseases (β = 1.340, $P<0.001$ ), those who were currently living in rural areas (β = 4.863, $P<0.001$ ) or suburban areas (β = 2.027, $P<0.001$ ), those with parents both died (β = 0.886, $P=0.001$ ), and those with the Urban Employees Basic Medical Insurance (UEBMI; β = 0.852, $P=0.030$ ) obtained a higher score of ULS-8. Those exercised regularly (β = −2.494, $P<0.001$ ), those had leisure activities (β = −1.937, $P<0.001$ ), those ate healthy (β = −1.270, $P<0.001$ ), and those with better self-rated financial status and higher education level received a lower score of ULS-8. There are differences in loneliness among different Hakka elderly population subgroups, and healthy behaviors and lifestyles may reduce the loneliness of the Hakka elderly. Relevant interventions should be implemented in a targeted manner, focusing on susceptible populations. This is most evident among those who were female, living in rural areas, with parents both died, with lower education, and with multiple chronic diseases.