Morrish Nia, Spencer Anne, Medina-Lara Antonieta
Public Health Economics Group, Department of Public Health and Sport Sciences, University of Exeter, Faculty of Health and Life Sciences, St Luke's Campus, Exeter, United Kingdom.
Health Economics Group, Department of Health and Community Sciences, University of Exeter, Faculty of Health and Life Sciences, St Luke's Campus, Exeter, United Kingdom.
PLoS One. 2025 Sep 3;20(9):e0327671. doi: 10.1371/journal.pone.0327671. eCollection 2025.
Increasing evidence of its detrimental impact has brought loneliness to the forefront of public health in recent years. Loneliness has been recognised as a cross-cutting theme for Healthy Ageing by the World Health Organisation and there is increasing need to better understand its wide-ranging health, wellbeing, and economic impacts across the wider population. This study utilises data from wave 13(2021-2023) of the Understanding Society UK Household Longitudinal Study to evaluate health and economic outcomes associated to loneliness (UCLA 3-item scale). Outcomes include the General Health Questionnaire, Short Form Health Survey, Short Warwick-Edinburgh Mental Well-being Scale, and costed GP, outpatient, and inpatient visits. Generalised Linear Modelling is applied to adjust for demographic characteristics, and subgroup analysis is conducted to consider costs in different age groups. Complete data provided observations for 23,071 respondents. Average marginal effects found loneliness is associated to higher mental distress, lower positive mental wellbeing, poorer physical and mental functioning, and higher healthcare service use. Overall, there is approximately a £900 cost difference in healthcare use between lonely and non-lonely respondents. Cost difference increases with age, and for more severe loneliness forms a U-shape with the greatest costs in younger and older adults. Additionally, difference in mean is only statistically significant across all models for 16- to 24-year-olds, suggesting importance in targeting young adult healthcare resource use. This is the first study to consider age-based analysis of health-related costs of loneliness in the UK. It also adds to the literature by considering validated wellbeing and health-related outcomes in a large UK based population. Findings motivate tackling young adult loneliness to support their health, wellbeing, quality of life, and potential overuse of healthcare services. This study also supports the pressing need for greater economic evaluation of loneliness and loneliness interventions.
近年来,越来越多的证据表明孤独具有有害影响,这使其成为公共卫生领域的首要问题。世界卫生组织已将孤独视为健康老龄化的一个贯穿各领域的主题,并且越来越需要更好地了解其对更广泛人群在健康、幸福和经济方面的广泛影响。本研究利用英国理解社会家庭纵向研究第13轮(2021 - 2023年)的数据,以评估与孤独相关的健康和经济结果(加州大学洛杉矶分校3项量表)。结果包括一般健康问卷、简短健康调查、简短的沃里克 - 爱丁堡心理健康量表,以及计算成本的全科医生诊疗、门诊和住院就诊。应用广义线性模型来调整人口统计学特征,并进行亚组分析以考虑不同年龄组的成本。完整数据为23,071名受访者提供了观测结果。平均边际效应发现,孤独与更高的心理困扰、更低的积极心理健康、更差的身心功能以及更高的医疗服务使用相关。总体而言,孤独和非孤独受访者在医疗服务使用方面的成本差异约为900英镑。成本差异随年龄增加,对于更严重的孤独形式呈U形,在年轻人和老年人中成本最高。此外,均值差异仅在所有模型中对16至24岁人群具有统计学意义,这表明针对年轻成年人医疗资源使用进行干预很重要。这是英国第一项考虑基于年龄分析孤独相关健康成本的研究。它还通过在大量英国人群中考虑经过验证的幸福和健康相关结果,为该文献增添了内容。研究结果促使解决年轻成年人的孤独问题,以支持他们的健康、幸福、生活质量以及避免医疗服务的潜在过度使用。本研究还支持对孤独和孤独干预措施进行更深入经济评估的迫切需求。