Skip to main content
Top

Open Access 28-09-2024 | Original Paper

The societal cost of ‘unwanted’ loneliness in Spain

Authors: Bruno Casal, Eva Rodríguez-Miguez, Berta Rivera

Published in: The European Journal of Health Economics

Login to get access

Abstract

Unwanted loneliness negatively affects people’s health and quality of life, increasing morbidity and the risk of premature death; this situation can generate major social costs. The aim of this study is to estimate the social costs of loneliness in Spain for 2021: both tangible costs –monetary value of health costs and production losses– and intangible costs –Quality Adjusted Life Years (QALYs). To estimate costs not derived from mortality, information from a sample of 400 people with unwanted loneliness was compared with that derived from two samples of the general population obtained from the Spanish National Health Surveys. To estimate the costs associated with premature deaths, the population attributable fraction was calculated using the relative risks estimated in previous survival studies. In the baseline scenario, the tangible costs of unwanted loneliness are estimated to be around 14,129 million euros in 2021, representing 1.2% of Spain’s GDP. Approximately 56.8% of the tangible costs correspond to production losses due to reduced working time, and 43.2% are due to healthcare costs related with increased consultation frequency in healthcare services and higher consumption of medicines related to loneliness. In addition, loneliness generates a reduction in quality of life equivalent to 1.04 million QALYs, which corresponds to 2.8% of the total stock of QALYs of the Spanish population over 15 years of age.
Appendix
Available only for authorised users
Literature
3.
go back to reference McPherson, M., Smith-Lovin, L., Brashears, M.E.: Social isolation in America: Changes in core discussion networks over two decades. Am. Sociol. Rev. 71(3), 353–375 (2006)CrossRef McPherson, M., Smith-Lovin, L., Brashears, M.E.: Social isolation in America: Changes in core discussion networks over two decades. Am. Sociol. Rev. 71(3), 353–375 (2006)CrossRef
4.
go back to reference Putnam, R.D.: Bowling Alone: The Collapse and Revival of American Community. Simon and Schuster, New York (2006) Putnam, R.D.: Bowling Alone: The Collapse and Revival of American Community. Simon and Schuster, New York (2006)
5.
go back to reference Peplau, L.A., Perlman, D.: Loneliness: A Sourcebook of Current Theory, Research, and Therapy. Wiley (1982) Peplau, L.A., Perlman, D.: Loneliness: A Sourcebook of Current Theory, Research, and Therapy. Wiley (1982)
6.
7.
go back to reference Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Verhagen, M.: Loneliness across the life span. Perspect. Psychol. Sci. 10(2), 250–264 (2015)PubMedCrossRef Qualter, P., Vanhalst, J., Harris, R., Van Roekel, E., Lodder, G., Bangee, M., Verhagen, M.: Loneliness across the life span. Perspect. Psychol. Sci. 10(2), 250–264 (2015)PubMedCrossRef
8.
go back to reference Hwang, T.J., Rabheru, K., Peisah, C., Reichman, W., Ikeda, M.: Loneliness and social isolation during the COVID-19 pandemic. Int. Psychogeriatr. 32(10), 1217–1220 (2020)PubMedCrossRef Hwang, T.J., Rabheru, K., Peisah, C., Reichman, W., Ikeda, M.: Loneliness and social isolation during the COVID-19 pandemic. Int. Psychogeriatr. 32(10), 1217–1220 (2020)PubMedCrossRef
9.
go back to reference Ward, M., McGarrigle, C., Hever, A., O’Mahoney, P., Moynihan, S., Loughran, G., Kenny, R.A.: Loneliness and Social Isolation in the COVID-19 Pandemic among the over 70s: Data from the Irish Longitudinal Study on Ageing (TILDA) and ALONE. The Irish Longitudinal Study on Ageing, Trinity College Dublin (2020) Ward, M., McGarrigle, C., Hever, A., O’Mahoney, P., Moynihan, S., Loughran, G., Kenny, R.A.: Loneliness and Social Isolation in the COVID-19 Pandemic among the over 70s: Data from the Irish Longitudinal Study on Ageing (TILDA) and ALONE. The Irish Longitudinal Study on Ageing, Trinity College Dublin (2020)
11.
go back to reference Steed, L., Boldy, D., Grenade, L., Iredell, H.: The demographics of loneliness among older people in Perth, Western Australia. Australas. J. Ageing. 26(2), 81–86 (2007)CrossRef Steed, L., Boldy, D., Grenade, L., Iredell, H.: The demographics of loneliness among older people in Perth, Western Australia. Australas. J. Ageing. 26(2), 81–86 (2007)CrossRef
12.
go back to reference Stokes, A.C., Xie, W., Lundberg, D.J., Glei, D.A., Weinstein, M.A.: Loneliness, social isolation, and all-cause mortality in the United States. SSM-Mental Health. 1, 100014 (2021)PubMedPubMedCentralCrossRef Stokes, A.C., Xie, W., Lundberg, D.J., Glei, D.A., Weinstein, M.A.: Loneliness, social isolation, and all-cause mortality in the United States. SSM-Mental Health. 1, 100014 (2021)PubMedPubMedCentralCrossRef
13.
go back to reference Rico-Uribe, L.A., Caballero, F.F., Martín-María, N., Cabello, M., Ayuso-Mateos, J.L., Miret, M.: Association of loneliness with all-cause mortality: A meta-analysis. PloS One. 13(1), e0190033 (2018)PubMedPubMedCentralCrossRef Rico-Uribe, L.A., Caballero, F.F., Martín-María, N., Cabello, M., Ayuso-Mateos, J.L., Miret, M.: Association of loneliness with all-cause mortality: A meta-analysis. PloS One. 13(1), e0190033 (2018)PubMedPubMedCentralCrossRef
14.
go back to reference Luo, Y., Hawkley, L.C., Waite, L.J., Cacioppo, J.T.: Loneliness, health, and mortality in old age: A national longitudinal study. Soc. Sci. Med. 74(6), 907–914 (2012)PubMedPubMedCentralCrossRef Luo, Y., Hawkley, L.C., Waite, L.J., Cacioppo, J.T.: Loneliness, health, and mortality in old age: A national longitudinal study. Soc. Sci. Med. 74(6), 907–914 (2012)PubMedPubMedCentralCrossRef
15.
go back to reference Elovainio, M., Hakulinen, C., Pulkki-Råback, L., Virtanen, M., Josefsson, K., Jokela, M., Kivimäki, M.: Contribution of risk factors to excess mortality in isolated and lonely individuals: An analysis of data from the UK Biobank cohort study. Lancet Public. Health. 2(6), e260–e266 (2017)PubMedPubMedCentralCrossRef Elovainio, M., Hakulinen, C., Pulkki-Råback, L., Virtanen, M., Josefsson, K., Jokela, M., Kivimäki, M.: Contribution of risk factors to excess mortality in isolated and lonely individuals: An analysis of data from the UK Biobank cohort study. Lancet Public. Health. 2(6), e260–e266 (2017)PubMedPubMedCentralCrossRef
16.
go back to reference Shiovitz-Ezra, S., Ayalon, L.: Use of direct versus indirect approaches to measure loneliness in later life. Res. Aging. 34(5), 572–591 (2012)CrossRef Shiovitz-Ezra, S., Ayalon, L.: Use of direct versus indirect approaches to measure loneliness in later life. Res. Aging. 34(5), 572–591 (2012)CrossRef
17.
go back to reference Holwerda, T.J., Van Tilburg, T.G., Deeg, D.J., Schutter, N., Van, R., Dekker, J., Schoevers, R.A.: Impact of loneliness and depression on mortality: Results from the Longitudinal Ageing Study Amsterdam. Br. J. Psychiatry. 209(2), 127–134 (2016)PubMedCrossRef Holwerda, T.J., Van Tilburg, T.G., Deeg, D.J., Schutter, N., Van, R., Dekker, J., Schoevers, R.A.: Impact of loneliness and depression on mortality: Results from the Longitudinal Ageing Study Amsterdam. Br. J. Psychiatry. 209(2), 127–134 (2016)PubMedCrossRef
18.
go back to reference Holt-Lunstad, J., Smith, T.B., Layton, J.B.: Social relationships and mortality risk: A meta-analytic review. PLoS Med., 7(7), 1–20 (2010) Holt-Lunstad, J., Smith, T.B., Layton, J.B.: Social relationships and mortality risk: A meta-analytic review. PLoS Med., 7(7), 1–20 (2010)
19.
go back to reference Erzen, E., Çikrikci, Ö.: The effect of loneliness on depression: A meta-analysis. Int. J. Soc. Psychiatry. 64(5), 427–435 (2018)PubMedCrossRef Erzen, E., Çikrikci, Ö.: The effect of loneliness on depression: A meta-analysis. Int. J. Soc. Psychiatry. 64(5), 427–435 (2018)PubMedCrossRef
20.
go back to reference Martín-María, N., Caballero, F.F., Miret, M., Tyrovolas, S., Haro, J.M., Ayuso-Mateos, J.L., Chatterji, S.: Differential impact of transient and chronic loneliness on health status. A longitudinal study. Psychol. Health. 35(2), 177–195 (2020)PubMedCrossRef Martín-María, N., Caballero, F.F., Miret, M., Tyrovolas, S., Haro, J.M., Ayuso-Mateos, J.L., Chatterji, S.: Differential impact of transient and chronic loneliness on health status. A longitudinal study. Psychol. Health. 35(2), 177–195 (2020)PubMedCrossRef
21.
go back to reference Domènech-Abella, J., Mundó, J., Haro, J.M., Rubio-Valera, M.: Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from the Irish longitudinal study on Ageing (TILDA). J. Affect. Disord. 246, 82–88 (2019)PubMedCrossRef Domènech-Abella, J., Mundó, J., Haro, J.M., Rubio-Valera, M.: Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from the Irish longitudinal study on Ageing (TILDA). J. Affect. Disord. 246, 82–88 (2019)PubMedCrossRef
22.
go back to reference Lim, M.H., Rodebaugh, T.L., Zyphur, M.J., Gleeson, J.F.: Loneliness over time: The crucial role of social anxiety. J. Abnorm. Psychol. 125(5), 620 (2016)PubMedCrossRef Lim, M.H., Rodebaugh, T.L., Zyphur, M.J., Gleeson, J.F.: Loneliness over time: The crucial role of social anxiety. J. Abnorm. Psychol. 125(5), 620 (2016)PubMedCrossRef
23.
go back to reference Lee, S.L., Pearce, E., Ajnakina, O., Johnson, S., Lewis, G., Mann, F., Lewis, G.: The association between loneliness and depressive symptoms among adults aged 50 years and older: A 12-year population-based cohort study. Lancet Psychiatry. 8(1), 48–57 (2021)PubMedPubMedCentralCrossRef Lee, S.L., Pearce, E., Ajnakina, O., Johnson, S., Lewis, G., Mann, F., Lewis, G.: The association between loneliness and depressive symptoms among adults aged 50 years and older: A 12-year population-based cohort study. Lancet Psychiatry. 8(1), 48–57 (2021)PubMedPubMedCentralCrossRef
24.
go back to reference Cuijpers, P., Smit, F.: Excess mortality in depression: A meta-analysis of community studies. J. Affect. Disord. 72(3), 227–236 (2002)PubMedCrossRef Cuijpers, P., Smit, F.: Excess mortality in depression: A meta-analysis of community studies. J. Affect. Disord. 72(3), 227–236 (2002)PubMedCrossRef
25.
go back to reference Valtorta, N.K., Kanaan, M., Gilbody, S., Hanratty, B.: Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing. Eur. J. Prev. Cardiol. 25(13), 1387–1396 (2018)PubMedCrossRef Valtorta, N.K., Kanaan, M., Gilbody, S., Hanratty, B.: Loneliness, social isolation and risk of cardiovascular disease in the English Longitudinal Study of Ageing. Eur. J. Prev. Cardiol. 25(13), 1387–1396 (2018)PubMedCrossRef
26.
go back to reference Kraav, S.L., Awoyemi, O., Junttila, N., Vornanen, R., Kauhanen, J., Toikko, T., Tolmunen, T.: The effects of loneliness and social isolation on all-cause, injury, cancer, and CVD mortality in a cohort of middle-aged Finnish men. A prospective study. Aging Ment. Health. 25(12), 2219–2228 (2021)PubMedCrossRef Kraav, S.L., Awoyemi, O., Junttila, N., Vornanen, R., Kauhanen, J., Toikko, T., Tolmunen, T.: The effects of loneliness and social isolation on all-cause, injury, cancer, and CVD mortality in a cohort of middle-aged Finnish men. A prospective study. Aging Ment. Health. 25(12), 2219–2228 (2021)PubMedCrossRef
27.
go back to reference Novak, M., Waern, M., Johansson, L., Zettergren, A., Ryden, L., Wetterberg, H., Skoog, I.: Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women. BMC Geriatr. 20(1), 1–7 (2020)CrossRef Novak, M., Waern, M., Johansson, L., Zettergren, A., Ryden, L., Wetterberg, H., Skoog, I.: Cardiovascular and all-cause mortality attributable to loneliness in older Swedish men and women. BMC Geriatr. 20(1), 1–7 (2020)CrossRef
29.
go back to reference Altevers, J., Lukaschek, K., Baumert, J., Kruse, J., Meisinger, C., Emeny, R.T., Ladwig, K.H.: Poor structural social support is associated with an increased risk of type 2 diabetes mellitus: Findings from the MONICA/KORA Augsburg cohort study. Diabet. Med. 33(1), 47–54 (2016)PubMedCrossRef Altevers, J., Lukaschek, K., Baumert, J., Kruse, J., Meisinger, C., Emeny, R.T., Ladwig, K.H.: Poor structural social support is associated with an increased risk of type 2 diabetes mellitus: Findings from the MONICA/KORA Augsburg cohort study. Diabet. Med. 33(1), 47–54 (2016)PubMedCrossRef
30.
go back to reference Hackett, R.A., Hudson, J.L., Chilcot, J.: Loneliness and type 2 diabetes incidence: Findings from the English Longitudinal Study of Ageing. Diabetologia. 63, 2329–2338 (2020)PubMedPubMedCentralCrossRef Hackett, R.A., Hudson, J.L., Chilcot, J.: Loneliness and type 2 diabetes incidence: Findings from the English Longitudinal Study of Ageing. Diabetologia. 63, 2329–2338 (2020)PubMedPubMedCentralCrossRef
31.
go back to reference Laursen, K.R., Hulman, A., Witte, D.R., Maindal, H.T.: Social relations, depressive symptoms, and incident type 2 diabetes mellitus: The English longitudinal study of ageing. Diabetes Res. Clin. Pract. 126, 86–94 (2017)PubMedCrossRef Laursen, K.R., Hulman, A., Witte, D.R., Maindal, H.T.: Social relations, depressive symptoms, and incident type 2 diabetes mellitus: The English longitudinal study of ageing. Diabetes Res. Clin. Pract. 126, 86–94 (2017)PubMedCrossRef
32.
go back to reference Cohen, S., Doyle, W.J., Skoner, D.P., Rabin, B.S., Gwaltney, J.M.: Social ties and susceptibility to the common cold. JAMA. 277(24), 1940–1944 (1997)PubMedCrossRef Cohen, S., Doyle, W.J., Skoner, D.P., Rabin, B.S., Gwaltney, J.M.: Social ties and susceptibility to the common cold. JAMA. 277(24), 1940–1944 (1997)PubMedCrossRef
33.
go back to reference DiMatteo, M.R.: Social support and patient adherence to medical treatment: A meta-analysis. Health Psychol. 23(2), 207 (2004)PubMedCrossRef DiMatteo, M.R.: Social support and patient adherence to medical treatment: A meta-analysis. Health Psychol. 23(2), 207 (2004)PubMedCrossRef
34.
go back to reference Murphy, B.M., Elliott, P.C., Grande, L., Higgins, M.R., Ernest, R.O., Goble, C.S., Worcester, A.J.: Living alone predicts 30-day hospital readmission after coronary artery bypass graft surgery. Eur. J. Prev. Cardiol. 15(2), 210–215 (2008)CrossRef Murphy, B.M., Elliott, P.C., Grande, L., Higgins, M.R., Ernest, R.O., Goble, C.S., Worcester, A.J.: Living alone predicts 30-day hospital readmission after coronary artery bypass graft surgery. Eur. J. Prev. Cardiol. 15(2), 210–215 (2008)CrossRef
35.
go back to reference Lett, H.S., Blumenthal, J.A., Babyak, M.A., Catellier, D.J., Carney, R.M., Berkman, L.F., Schneiderman, N.: Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction. Health Psychol. 26(4), 418 (2007)PubMedCrossRef Lett, H.S., Blumenthal, J.A., Babyak, M.A., Catellier, D.J., Carney, R.M., Berkman, L.F., Schneiderman, N.: Social support and prognosis in patients at increased psychosocial risk recovering from myocardial infarction. Health Psychol. 26(4), 418 (2007)PubMedCrossRef
36.
go back to reference Gerst-Emerson, K., Jayawardhana, J.: Loneliness as a public health issue: The impact of loneliness on health care utilization among older adults. Am. J. Public Health. 105(5), 1013–1019 (2015)PubMedPubMedCentralCrossRef Gerst-Emerson, K., Jayawardhana, J.: Loneliness as a public health issue: The impact of loneliness on health care utilization among older adults. Am. J. Public Health. 105(5), 1013–1019 (2015)PubMedPubMedCentralCrossRef
37.
go back to reference Manemann, S.M., Chamberlain, A.M., Roger, V.L., Griffin, J.M., Boyd, C.M., Cudjoe, T.K., Finney Rutten, L.J.: Perceived social isolation and outcomes in patients with heart failure. J. Am. Heart Association 7(11), 1–7. (2018) Manemann, S.M., Chamberlain, A.M., Roger, V.L., Griffin, J.M., Boyd, C.M., Cudjoe, T.K., Finney Rutten, L.J.: Perceived social isolation and outcomes in patients with heart failure. J. Am. Heart Association 7(11), 1–7. (2018)
39.
go back to reference Geller, J., Janson, P., McGovern, E., Valdini, A.: Loneliness as a predictor of hospital emergency department use. J. Fam. Pract. 48(10), 801–804 (1999)PubMed Geller, J., Janson, P., McGovern, E., Valdini, A.: Loneliness as a predictor of hospital emergency department use. J. Fam. Pract. 48(10), 801–804 (1999)PubMed
40.
go back to reference Landeiro, F., Leal, J., Gray, A.M.: The impact of social isolation on delayed hospital discharges of older hip fracture patients and associated costs. Osteoporos. Int. 27(2), 737–745 (2016)PubMedCrossRef Landeiro, F., Leal, J., Gray, A.M.: The impact of social isolation on delayed hospital discharges of older hip fracture patients and associated costs. Osteoporos. Int. 27(2), 737–745 (2016)PubMedCrossRef
41.
go back to reference Landeiro, F., Barrows, P., Nuttall, E., MGray, A., Leal, J.: Reducing social isolation and loneliness in older people: A systematic review protocol. Br. Med. J. Open. 7, 1–5 (2017) Landeiro, F., Barrows, P., Nuttall, E., MGray, A., Leal, J.: Reducing social isolation and loneliness in older people: A systematic review protocol. Br. Med. J. Open. 7, 1–5 (2017)
42.
go back to reference Michaelson, J., Jeffrey, K., Abdallah, S.: The Cost of Loneliness to UK Employers. The Impact of Loneliness upon Businesses across the UK. The Economics Foundation, London (2017) Michaelson, J., Jeffrey, K., Abdallah, S.: The Cost of Loneliness to UK Employers. The Impact of Loneliness upon Businesses across the UK. The Economics Foundation, London (2017)
43.
go back to reference Peytrignet, S., Garforth-Bles, S., Keohane, G.: Loneliness Monetization Report. Analysis for the Department for Digital, Culture, Media & Sport, Simetrica Jacobs (2020) Peytrignet, S., Garforth-Bles, S., Keohane, G.: Loneliness Monetization Report. Analysis for the Department for Digital, Culture, Media & Sport, Simetrica Jacobs (2020)
44.
go back to reference Fulton, L., Jupp, B.: Investing to tackle loneliness- a discussion paper. London: Social Finance (2015) Fulton, L., Jupp, B.: Investing to tackle loneliness- a discussion paper. London: Social Finance (2015)
45.
go back to reference McDaid, D., Park, A.L., Fernandez, J.L.: Reconnections Evaluation Interim Report. London School of Economics and Political Science, London (2016) McDaid, D., Park, A.L., Fernandez, J.L.: Reconnections Evaluation Interim Report. London School of Economics and Political Science, London (2016)
46.
go back to reference Shaw, J.G., Farid, M., Noel-Miller, C., Joseph, N., Houser, A., Asch, S.M., Flowers, L.: Social isolation and Medicare spending: Among older adults, objective isolation increases expenditures while loneliness does not. J. Aging Health. 29(7), 1119–1143 (2017)PubMedPubMedCentralCrossRef Shaw, J.G., Farid, M., Noel-Miller, C., Joseph, N., Houser, A., Asch, S.M., Flowers, L.: Social isolation and Medicare spending: Among older adults, objective isolation increases expenditures while loneliness does not. J. Aging Health. 29(7), 1119–1143 (2017)PubMedPubMedCentralCrossRef
47.
go back to reference Meisters, R., Westra, D., Putrik, P., Bosma, H., Ruwaard, D., Jansen, M.: Does loneliness have a cost? A population-wide study of the association between loneliness and healthcare expenditure. Int. J. Public. Health 2, 1–10 (2021) Meisters, R., Westra, D., Putrik, P., Bosma, H., Ruwaard, D., Jansen, M.: Does loneliness have a cost? A population-wide study of the association between loneliness and healthcare expenditure. Int. J. Public. Health 2, 1–10 (2021)
48.
go back to reference Kimberlee, R., Means, R.: Assessing the Impact of the Link-Age hub in Whitehall and St. George, Bristol: Briefing Report. University of the West of England, Bristol (2015) Kimberlee, R., Means, R.: Assessing the Impact of the Link-Age hub in Whitehall and St. George, Bristol: Briefing Report. University of the West of England, Bristol (2015)
49.
go back to reference Knapp, M., McDaid, D., Parsonage, M.: Mental Health Promotion and Prevention: The Economic case. Department of Health, London (2011) Knapp, M., McDaid, D., Parsonage, M.: Mental Health Promotion and Prevention: The Economic case. Department of Health, London (2011)
50.
go back to reference Willis, E., Semple, A.C., de Waal, H.: Quantifying the benefits of peer support for people with dementia: A Social Return on Investment (SROI) study. Dementia. 17(3), 266–278 (2018)PubMedCrossRef Willis, E., Semple, A.C., de Waal, H.: Quantifying the benefits of peer support for people with dementia: A Social Return on Investment (SROI) study. Dementia. 17(3), 266–278 (2018)PubMedCrossRef
51.
go back to reference Mihalopoulos, C., Le, L.K.D., Chatterton, M.L., Bucholc, J., Holt-Lunstad, J., Lim, M.H., Engel, L.: The economic costs of loneliness: A review of cost-of-illness and economic evaluation studies. Soc. Psychiatry Psychiatr. Epidemiol. 55, 823–836 (2020)PubMedCrossRef Mihalopoulos, C., Le, L.K.D., Chatterton, M.L., Bucholc, J., Holt-Lunstad, J., Lim, M.H., Engel, L.: The economic costs of loneliness: A review of cost-of-illness and economic evaluation studies. Soc. Psychiatry Psychiatr. Epidemiol. 55, 823–836 (2020)PubMedCrossRef
52.
go back to reference SNHS 2011/12: Spanish Nacional Health Survey. Ministerio de Sanidad, Madrid (2012) SNHS 2011/12: Spanish Nacional Health Survey. Ministerio de Sanidad, Madrid (2012)
53.
go back to reference SNHS: Spanish Nacional Health Survey. Ministerio de Sanidad. Madrid (2017) (2017) SNHS: Spanish Nacional Health Survey. Ministerio de Sanidad. Madrid (2017) (2017)
54.
go back to reference Broadhead, W.E., Gehlbach, S.H., Degruy, F.V., Kaplan, B.H.: The Duke-UNK functional social support questionnaire: Measurement of social support in family medicine patients. Med. Care. 26, 709–723 (1988)PubMedCrossRef Broadhead, W.E., Gehlbach, S.H., Degruy, F.V., Kaplan, B.H.: The Duke-UNK functional social support questionnaire: Measurement of social support in family medicine patients. Med. Care. 26, 709–723 (1988)PubMedCrossRef
55.
go back to reference Bellón, J.A., Delgado, A., Luna, J., Lardelli, P.: Validez y fiabilidad del cuestionario de apoyo social funcional Duke-UNC-11. Aten Primaria. 18, 153–163 (1996) Bellón, J.A., Delgado, A., Luna, J., Lardelli, P.: Validez y fiabilidad del cuestionario de apoyo social funcional Duke-UNC-11. Aten Primaria. 18, 153–163 (1996)
57.
go back to reference Pedroso-Chaparro, M.D.S., Márquez-González, M., Fernandes-Pires, J.A., Gallego-Alberto, L., Jiménez-Gonzalo, L., Nuevo, R., Losada, A.: Validation of the Spanish version of the three-item loneliness scale. Stud. Psychol. 43(2), 311–331 (2022) Pedroso-Chaparro, M.D.S., Márquez-González, M., Fernandes-Pires, J.A., Gallego-Alberto, L., Jiménez-Gonzalo, L., Nuevo, R., Losada, A.: Validation of the Spanish version of the three-item loneliness scale. Stud. Psychol. 43(2), 311–331 (2022)
58.
go back to reference Russell, D., Peplau, L.A., Ferguson, M.L.: Developing a measure of loneliness. J. Pers. Assess. 42(3), 290–294 (1978)PubMedCrossRef Russell, D., Peplau, L.A., Ferguson, M.L.: Developing a measure of loneliness. J. Pers. Assess. 42(3), 290–294 (1978)PubMedCrossRef
59.
go back to reference Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., Badia, X.: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research. 20(10), 1727–1736 (2011) Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., Badia, X.: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research. 20(10), 1727–1736 (2011)
60.
go back to reference Ramos-Goñi, J.M., Craig, B.M., Oppe, M., Ramallo-Farina, Y., Pinto-Prades, J.L., Luo, N.: Rivero-Arias: Handling data quality issues to estimate the Spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 21(5), 596–604 (2018)PubMedCrossRef Ramos-Goñi, J.M., Craig, B.M., Oppe, M., Ramallo-Farina, Y., Pinto-Prades, J.L., Luo, N.: Rivero-Arias: Handling data quality issues to estimate the Spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 21(5), 596–604 (2018)PubMedCrossRef
61.
go back to reference Becker, G.S.: Human Capital. Columbia University, New York (1964) Becker, G.S.: Human Capital. Columbia University, New York (1964)
62.
go back to reference Grossman, M.: The Demand for Health: A Theoretical and Empirical Investigation. NBER, New York (1972) Grossman, M.: The Demand for Health: A Theoretical and Empirical Investigation. NBER, New York (1972)
63.
go back to reference Grossman, M.: The Human Capital Model of the Demand for Health. En AJ. Culyer y JP Newhouse (eds.). Handbook of Health Economics. Amsterdam: North-Holland (2000) Grossman, M.: The Human Capital Model of the Demand for Health. En AJ. Culyer y JP Newhouse (eds.). Handbook of Health Economics. Amsterdam: North-Holland (2000)
64.
go back to reference World Health Organization: Assessment of the Economic Costs of Smoking. WHO, Geneva (2011) World Health Organization: Assessment of the Economic Costs of Smoking. WHO, Geneva (2011)
65.
go back to reference Lara, E., Moreno-Agostino, D., Martín-María, N., Miret, M., Rico-Uribe, L. A., Olaya, B., Ayuso-Mateos, J. L.: Exploring the effect of loneliness on all-cause mortality: Are there differences between older adults and younger and middle-aged adults?. Soc. Sci. Med. 258, 113087 (2020) Lara, E., Moreno-Agostino, D., Martín-María, N., Miret, M., Rico-Uribe, L. A., Olaya, B., Ayuso-Mateos, J. L.: Exploring the effect of loneliness on all-cause mortality: Are there differences between older adults and younger and middle-aged adults?. Soc. Sci. Med. 258, 113087 (2020)
66.
go back to reference Shor, E., Roelfs, D., Vang, Z.M.: The hispanic mortality paradox revisited: Meta-analysis and meta-regression of life-course differentials in latin American and Caribbean immigrants’ mortality. Soc. Sci. Med. 186, 20–33 (2017)PubMedCrossRef Shor, E., Roelfs, D., Vang, Z.M.: The hispanic mortality paradox revisited: Meta-analysis and meta-regression of life-course differentials in latin American and Caribbean immigrants’ mortality. Soc. Sci. Med. 186, 20–33 (2017)PubMedCrossRef
67.
go back to reference Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T., Stephenson, D.: Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspect. Psychol. Sci. 10(2), 227–237 (2015)PubMedCrossRef Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T., Stephenson, D.: Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspect. Psychol. Sci. 10(2), 227–237 (2015)PubMedCrossRef
73.
go back to reference Ramos-Goñi, J.M., Craig, B.M., Oppe, M., Ramallo-Fariña, Y., Pinto-Prades, J.L., Luo, N., Rivero-Arias, O.: Handling data quality issues to estimate the Spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 21(5), 596–604 (2018)PubMedCrossRef Ramos-Goñi, J.M., Craig, B.M., Oppe, M., Ramallo-Fariña, Y., Pinto-Prades, J.L., Luo, N., Rivero-Arias, O.: Handling data quality issues to estimate the Spanish EQ-5D-5L value set using a hybrid interval regression approach. Value Health. 21(5), 596–604 (2018)PubMedCrossRef
74.
go back to reference Shiroiwa, T., Fukuda, T., Ikeda, S., Shimozuma, K.: QALY and productivity loss: Empirical evidence for double counting. Value Health. 16(4), 581–587 (2013)PubMedCrossRef Shiroiwa, T., Fukuda, T., Ikeda, S., Shimozuma, K.: QALY and productivity loss: Empirical evidence for double counting. Value Health. 16(4), 581–587 (2013)PubMedCrossRef
75.
go back to reference Tilling, C., Kro, M., Tsuchiya, A., Brazier, J., van Exel, J., Brouwer, W.: Does the EQ-5D reflect lost earnings? Pharmacoeconomics. 30(1), 47–61 (2012)PubMedCrossRef Tilling, C., Kro, M., Tsuchiya, A., Brazier, J., van Exel, J., Brouwer, W.: Does the EQ-5D reflect lost earnings? Pharmacoeconomics. 30(1), 47–61 (2012)PubMedCrossRef
77.
go back to reference Morris, Z.A.: Loneliness as a predictor of work disability onset among nondisabled, working older adults in 14 countries. J. Aging Health. 32(7–8), 554–563 (2020)PubMedCrossRef Morris, Z.A.: Loneliness as a predictor of work disability onset among nondisabled, working older adults in 14 countries. J. Aging Health. 32(7–8), 554–563 (2020)PubMedCrossRef
78.
go back to reference Von Soest, T., Luhmann, M., Gerstorf, D.: The development of loneliness through adolescence and young adulthood: Its nature, correlates, and midlife outcomes. Dev. Psychol. 56(10), 1919–1934 (2020)CrossRef Von Soest, T., Luhmann, M., Gerstorf, D.: The development of loneliness through adolescence and young adulthood: Its nature, correlates, and midlife outcomes. Dev. Psychol. 56(10), 1919–1934 (2020)CrossRef
79.
go back to reference Matthews, T., Danese, A., Caspi, A., Fisher, H.L., Goldman-Mellor, S., Kepa, A., et al.: Lonely young adults in modern Britain: Fndings from an epidemiological cohort study. Psychol. Med. 49(2), 268–277 (2019)PubMedCrossRef Matthews, T., Danese, A., Caspi, A., Fisher, H.L., Goldman-Mellor, S., Kepa, A., et al.: Lonely young adults in modern Britain: Fndings from an epidemiological cohort study. Psychol. Med. 49(2), 268–277 (2019)PubMedCrossRef
80.
go back to reference Masi, C.M., Chen, H.Y., Hawkley, L.C., Cacioppo, J.T.: A metaanalysis of interventions to reduce loneliness. Pers. Soc. Psychol. Rev. 15(3), 219–266 (2011)PubMedCrossRef Masi, C.M., Chen, H.Y., Hawkley, L.C., Cacioppo, J.T.: A metaanalysis of interventions to reduce loneliness. Pers. Soc. Psychol. Rev. 15(3), 219–266 (2011)PubMedCrossRef
81.
go back to reference Phang, J.K., Kwan, Y.H., Yoon, S., Goh, H., Yee, W.Q., Tan, C.S., Low, L.L.: Digital intergenerational program to reduce loneliness and social isolation among older adults: Realist review. JMIR Aging 6(1), 1–22 (2023) Phang, J.K., Kwan, Y.H., Yoon, S., Goh, H., Yee, W.Q., Tan, C.S., Low, L.L.: Digital intergenerational program to reduce loneliness and social isolation among older adults: Realist review. JMIR Aging 6(1), 1–22 (2023)
82.
go back to reference Day, A., Phelps, K., Maltby, J., Palmer, E., Snell, K., Raine, D., Conroy, S.: A realist evaluation of loneliness interventions for older people. Age Ageing. 50(6), 2246–2253 (2021)PubMedCrossRef Day, A., Phelps, K., Maltby, J., Palmer, E., Snell, K., Raine, D., Conroy, S.: A realist evaluation of loneliness interventions for older people. Age Ageing. 50(6), 2246–2253 (2021)PubMedCrossRef
Metadata
Title
The societal cost of ‘unwanted’ loneliness in Spain
Authors
Bruno Casal
Eva Rodríguez-Miguez
Berta Rivera
Publication date
28-09-2024
Publisher
Springer Berlin Heidelberg
Published in
The European Journal of Health Economics
Print ISSN: 1618-7598
Electronic ISSN: 1618-7601
DOI
https://doi.org/10.1007/s10198-024-01724-9