Whose Care Matters? The Protective Role of Perceived Care in the Long-Term Physical Health Consequences of Adolescent Loneliness.

INTRODUCTION: Loneliness has been associated with physical health outcomes, including an increased risk of cardiovascular disease (CVD). While much of the research has focused on older adults, less is known about whether loneliness during adolescence is related to CVD risk later in life. This study addresses this gap by investigating the relationship between adolescent loneliness and CVD risk in adulthood, as well as the moderating role of different sources of perceived care.

METHODS: Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study estimates school fixed effects models to examine the association between adolescent loneliness and adult CVD risk, measured using predicted 30-year hard CVD risk (major cardiovascular events) and full CVD risk (broader cardiovascular morbidity). School fixed effects models account for unobserved environmental confounders at the school and neighborhood levels. Interaction models were conducted to examine whether different sources of perceived care moderate the longitudinal relationship between loneliness and adult CVD risk.

RESULTS: Loneliness during adolescence is positively associated with both hard and full CVD risk in adulthood. Perceived care from parents significantly attenuates this association, highlighting the distinct protective role of parental care in reducing the long-term health risks of adolescent loneliness. In contrast, perceived care from friends and teachers showed no significant moderating role.

CONCLUSIONS: Family-based interventions that strengthen parental emotional support and monitoring may be particularly effective in mitigating the cardiovascular risks associated with adolescent loneliness. Integrating family- and school-based strategies may further support adolescents' long-term physical health and well-being.