AUTHOR=Meisters Rachelle , Westra Daan , Putrik Polina , Bosma Hans , Ruwaard Dirk , Jansen Maria 

TITLE=Does Loneliness Have a Cost? A Population-Wide Study of the Association Between Loneliness and Healthcare Expenditure

JOURNAL=International Journal of Public Health

VOLUME=66

YEAR=2021

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2021.581286

DOI=10.3389/ijph.2021.581286

ISSN=1661-8564

ABSTRACT=<p><bold>Objectives:</bold> Loneliness has been associated with unhealthy behavior, poorer health, and increased morbidity. However, the costs of loneliness are poorly understood.</p><p><bold>Methods:</bold> Multiple sources were combined into a dataset containing a nationally representative sample (<italic>n</italic> = 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.</p><p><bold>Results:</bold> 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).</p><p><bold>Conclusion:</bold> Loneliness contributes to health expenditure both directly and indirectly, particularly in younger age groups. This implies a strong financial imperative to address this issue.</p>