Abstract
BackgroundLoneliness is a public health concern and its influence on morbidity and mortality are well documented. The association between loneliness and emergency department visits is less clear. Further, while sex and gender-related factors are known to be associated with loneliness and health services use, little research looks at the relationship by gender. Our study aimed to estimate the association between loneliness and emergency department use in the previous 12 months. We aimed to determine if this association differed based on gender identity and gender-related characteristics.MethodsWe used a retrospective cohort study design to analyze population-based survey data from the Canadian Longitudinal Study on Aging (CLSA). We analysed data from the baseline and follow-up 1 survey respondents (2015-2018) from both the tracking (telephone interviews) and comprehensive (in-home data collection) cohorts (n=44816). Loneliness was assessed using a dichotomous measure (lonely/not lonely) from a validated scale. Emergency department visits were dichotomous (yes/no) by self-reported emergency department use in the 12 months prior to the survey date. Multivariable logistic regression analyses using analytic weights examined the association between loneliness and emergency department visit, controlling for other demographic, social, and health related factors.ResultsWe identified 44,413 respondents to the baseline and follow-up 1 survey. The prevalence of loneliness in our sample was 23.1% (n=10263). Of those who had been to the emergency department in the previous year, 27.2% (n=2793) were lonely. Lonely respondents had higher odds of an emergency department visit (aOR: 1.13, 95% CI: 1.05-1.21), adjusted for various demographic and health factors. Loneliness was associated with emergency department visits more so in women (aOR: 1.15, 95% CI: 1.05-1.25) than in men (aOR: 1.10, 95% CI: 0.99-1.22).ConclusionsIn our study, loneliness was associated with emergency department visits in the previous 12 months. When our analysis was disaggregated by gender, we found differences in the odds of emergency department visit for men, women, and gender-diverse respondents. The odds of ED visit were higher in women than men. These findings highlight the general importance of identifying loneliness in both primary care and hospital. Care providers in ED need resources to refer patients who present in this setting with health issues complicated by social conditions such as loneliness.
Highlights
Loneliness is a public health concern and its influence on morbidity and mortality are well documented
In our study, loneliness was associated with emergency department visits in the previous 12 months
When our analysis was disaggregated by gender, we found differences in the odds of emergency department visit for men, women, and gender-diverse respondents
Summary
Loneliness is a public health concern and its influence on morbidity and mortality are well documented. While sex and gender-related factors are known to be associated with loneliness and health services use, little research looks at the relationship by gender. Loneliness itself is influenced by age, sex (biological) and gender-related (socio-cultural) characteristics and these factors are associated with health service use [4]. Population based studies can be a useful way to look at issues of loneliness, risk factors and use of health services; sex is often included as a covariate, few analyses are disaggregated by sex and even fewer consider the influence of gender identity or genderrelated characteristics [4]. Factors that predict loneliness and reporting of loneliness often differ between men and women [5] Social problems such as loneliness may have an effect on older adults’ use of health services and their health outcomes. As the number of older adults increases, research identifying how loneliness may contribute to service use in different populations is urgently needed
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