Do Social Isolation and Loneliness Affect Healthcare Spending and Utilization in Japan?
Main Article Content
Abstract
Social isolation and loneliness are associated with worse health outcomes, and there is a growing literature that studies the economic cost of these conditions in terms of increased healthcare spending and utilization. However, a handful of existing studies mostly focus on Western countries. This article analyses the issue in the case of Japan using the Japanese Study of Aging and Retirement (JSTAR) dataset with the help of generalized linear and probit models. The results show that social isolation is associated with reduced healthcare spending, while loneliness does not have any statistically significant effect. Neither social isolation (living alone) nor loneliness has a statistically significant effect on healthcare utilization; that is, these measures are not associated with increased or decreased inpatient or outpatient visits. Therefore, care should be taken when launching social programs to tackle social isolation and loneliness to reduce healthcare spending and utilization because these two conditions might not be associated with increased healthcare spending universally.
JEL Codes: D00, I10, H51
Keywords: Social isolation, Loneliness, Healthcare spending, Healthcare utilization
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How to Cite
Yüksel, Ü. F. (2023) “Do Social Isolation and Loneliness Affect Healthcare Spending and Utilization in Japan?”, World Journal of Applied Economics, 9(2), pp. 149-162. doi: 10.22440/wjae.9.2.3.
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Research Articles
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References
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Nelder, J. A., & Wedderburn, R. W. (1972). Generalized Linear Models. Journal of the Royal Statistical Society, 135, 370-384. doi:10.2307/2344614
Prieto, D. C., Saez, M. P., & Fernandez, C. B. (2019). Does social isolation affect medical doctor visits? New evidence among European older adults. Applied Research in Quality of Life, 16, 787–804. doi:10.1007/s11482-019-09795-0
Shaw, J. G., Farid, M., Noel-Miller, C., Joseph, N., Houser, A., Asch, S. M., ... Flowers, L. (2017). Social isolation and Medicare spending: Among older adults, objective isolation increases expenditures while loneliness does not. Journal of Aging and Health, 29, 1119–1143. doi:10.1177/0898264317703559
Taylor, H. O. (2020). Social isolation’s influence on loneliness among older adults. Clinical Social Work Journal, 48, 140–151. doi:10.1007/s10615-019-00737-9
Valtorta, N., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart, 102, 1009–1016. doi:10.1136/heartjnl-2015-308790
Valtorta, N., Moore, D., Barron, L. L., Stow, D., & Hanratty, B. (2018). Older Adults' Social Relationships and Health Care Utilization: A Systematic Review. American Journal of Public Health, 108, e1–e10. doi:10.2105/ajph.2017.304256
Cacioppo, J. T., Cacioppo, S., & Boomsma, D. I. (2014). Evolutionary mechanisms for loneliness. Cognition & Emotion, 28, 3-21. doi:10.1080/02699931.2013.837379
Cacioppo, J. T., Hughes, M. E., Waite, L. J., Hawkley, L. C., & Thisted, R. A. (2006). Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychology and Aging, 21, 140–151. doi:10.1037/0882-7974.21.1.140
Campaign to End Loneliness. (2013). Family doctors ill-equipped for loneliness epidemic. Family doctors ill-equipped for loneliness epidemic.
Cornwell, E. Y., & Waite, L. J. (2009). Measuring social isolation among older adults using multiple indicators from the NSHAP study. The Journals of Gerontology: Series B, 64B, i38–i46. doi:10.1093/geronb/gbp037
Cornwell, E. Y., & Waite, L. J. (2009). Social Disconnectedness, Perceived Isolation, and Health among Older Adults. Journal of Health and Social Behavior, 50, 31–48. doi:10.1177/002214650905000103
Coyle, C., & Dugan, E. (2012). Social isolation, loneliness and health among older adults. Journal of Aging and Health, 24, 1346–1363. doi:10.1177/0898264312460275
Ellaway, A., Wood, S., & Macintyre, S. (1999). Someone to talk to? The role of loneliness as a factor in the frequency of GP consultations. Br J Gen Pract, 49, 363–367.
Fulton, L., & Jupp, B. (2015). Investing to tackle loneliness: A discussion paper. Investing to tackle loneliness: A discussion paper.
Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social Relationships and Mortality Risk: A Meta-analytic review. PLOS Medicine, 7, e1000316. doi:10.1371/journal.pmed.1000316
Holt-Lunstad, J., Smith, T. B., Baker, M. D., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality. Perspectives on Psychological Science, 10, 227–237. doi:10.1177/1745691614568352
Holwerda, T. J., Beekman, A. T., Deeg, D. J., Stek, M. L., Van Tilburg, T., Visser, P. J., ... Schoevers, R. A. (2011). Increased risk of mortality associated with social isolation in older men: only when feeling lonely? Results from the Amsterdam Study of the Elderly (AMSTEL). Psychological Medicine, 42, 843–853. doi:10.1017/s0033291711001772
Landeiro, F., Leal, J., & Gray, A. (2015). The impact of social isolation on delayed hospital discharges of older hip fracture patients and associated costs. Osteoporosis International, 27, 737–745. doi:10.1007/s00198-015-3293-9
Leigh-Hunt, N., Bagguley, D., Bash, K., Turner, V., Turnbull, S., Valtorta, N., & Caan, W. (2017). An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152, 157–171. doi:10.1016/j.puhe.2017.07.035
McDaid, D., Park, A. L., & Fernandez, J.-L. (2016). Reconnections Evaluation Interim Report. Report, Personal Social Services Research Unit (PSSRU), London School of Economics and Political Science.
Mihalopoulos, C., Le, L. K., Chatterton, M. L., Bucholc, J., Holt-Lunstad, J., Lim, M. H., & Engel, L. (2019). The economic costs of loneliness: a review of cost-of-illness and economic evaluation studies. Social Psychiatry and Psychiatric Epidemiology, 55, 823–836. doi:10.1007/s00127-019-01733-7
Mistry, R., Rosansky, J., McGuire, J., McDermott, C., & Jarvik, L. F. (2001). Social isolation predicts re-hospitalization in a group of older American veterans enrolled in the UPBEAT Program. International Journal of Geriatric Psychiatry, 16, 950–959. doi:10.1002/gps.447
Mitsutake, S., Koike, T., Ishizaki, T., Nishi, M., Kobayashi, E., Hasebe, M., ... Fujiwara, Y. (2018). The associations of social isolation with medical and long-term care utilization among older adults in Japan. Innovation in Aging, 2, 1017. doi:10.1093/geroni/igy031.3754
Molloy, G. J., McGee, H., O'Neill, D., & Conroy, R. (2010). Loneliness and emergency and planned hospitalizations in a community sample of older adults. Journal of the American Geriatrics Society, 58, 1538–1541. doi:10.1111/j.1532-5415.2010.02960.x
Mosen, D. M., Banegas, M. P., Tucker-Seeley, R., Keast, E., Hu, W., Ertz-Berger, B. L., & Brooks, N. (2021). Social Isolation Associated with Future Health Care Utilization. Population Health Management, 24, 333–337. doi:10.1089/pop.2020.0106
National Academies of Sciences, Engineering, and Medicine. (2020). Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Consensus Study Report.
Nelder, J. A., & Wedderburn, R. W. (1972). Generalized Linear Models. Journal of the Royal Statistical Society, 135, 370-384. doi:10.2307/2344614
Prieto, D. C., Saez, M. P., & Fernandez, C. B. (2019). Does social isolation affect medical doctor visits? New evidence among European older adults. Applied Research in Quality of Life, 16, 787–804. doi:10.1007/s11482-019-09795-0
Shaw, J. G., Farid, M., Noel-Miller, C., Joseph, N., Houser, A., Asch, S. M., ... Flowers, L. (2017). Social isolation and Medicare spending: Among older adults, objective isolation increases expenditures while loneliness does not. Journal of Aging and Health, 29, 1119–1143. doi:10.1177/0898264317703559
Taylor, H. O. (2020). Social isolation’s influence on loneliness among older adults. Clinical Social Work Journal, 48, 140–151. doi:10.1007/s10615-019-00737-9
Valtorta, N., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart, 102, 1009–1016. doi:10.1136/heartjnl-2015-308790
Valtorta, N., Moore, D., Barron, L. L., Stow, D., & Hanratty, B. (2018). Older Adults' Social Relationships and Health Care Utilization: A Systematic Review. American Journal of Public Health, 108, e1–e10. doi:10.2105/ajph.2017.304256