Abstract
Objectives: Loneliness has been associated with unhealthy behavior, poorer health, and increased morbidity. However, the costs of loneliness are poorly understood. Methods: Multiple sources were combined into a dataset containing a nationally representative sample (n = 341,376) of Dutch adults (18+). The association between loneliness and total, general practitioner (GP), specialized, pharmaceutical, and mental healthcare expenditure was tested using Poisson and Zero-inflated negative binomial models, controlling for numerous potential confounders (i.e., demographic, socioeconomic, lifestyle-related factors, self-perceived health, and psychological distress), for four age groups. Results: Controlling for demographic, socioeconomic, and lifestyle-related factors, loneliness was indirectly (via poorer health) associated with higher expenditure in all categories. In fully adjusted models, it showed a direct association with higher expenditure for GP and mental healthcare (0.5 and 11.1%, respectively). The association with mental healthcare expenditure was stronger in younger than in older adults (for ages 19–40, the contribution of loneliness represented 61.8% of the overall association). Conclusion: Loneliness contributes to health expenditure both directly and indirectly, particularly in younger age groups. This implies a strong financial imperative to address this issue.
Highlights
Introduction10% of European citizens (18+) feel left out of society and the problem is greater for unemployed and low-income groups [1]
In recent years, loneliness has become a growing public health issue
As the impact of loneliness might differ between age groups and expenditure categories, we investigate the association between loneliness and general practitioner (GP), pharmaceutical, mental healthcare, specialized, and total curative healthcare expenditure in four different age groups (i.e., 19–40, 41–64, 65–80, and 81 years and older)
Summary
10% of European citizens (18+) feel left out of society and the problem is greater for unemployed and low-income groups [1]. While most modern Western societies perceive loneliness as a problem of old age [2], it is a growing problem in younger age groups [2, 3]. In addition to the social effects of loneliness, it can have a considerable impact on the ever-increasing healthcare costs of most Western countries [11]. While it is imperative for well-informed policy decisions, such economic consequences of loneliness remain poorly understood
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