Association between social isolation and health service use

Project Rationale

Social isolation has been identified as a potential risk factors for poor health outcomes and inappropriate or inadequate service use. The prevalence, among older people in Australia, for social isolation is 17% and living alone is 25% and increasing. A meta-analytical review found premature mortality rates of 29% for those who are socially isolated and 32% for those living alone. The role social isolation and living alone play in health service use, morbidity and mortality for older Australians is not clear, nor is the magnitude of its effect.

Project Aim/s

To identify the independent factors associated with social isolation and living alone and the impact of social isolation and living alone on health service use and mortality.

Project Design and Method

The study had two elements the first being a cross-sectional analysis and the second being a prospective cohort design. We used the CES-P&CH data linkage resource. We identified factors associated with social isolation and living alone. We also identified factors associated with, health service use (2009-2011) and 5-year mortality (2010 to 2015) for those who were/were not socially isolated, and those who did/did not live alone. Adjusted prevalence ratios were calculated by including all the factors into multivariable generalised linear models.

Outcomes/Outputs

The demographic, social and health characteristics associated with living alone appear to differ substantially from those associated with socially isolation. The only independent factors associated with both were being more likely to self-report poor quality of life, and less likely to be a parent or need help with daily activities. Participants who lived alone were more likely to be higher health service users (any ED attendances and any overnight hospitalisations), than those who were socially isolated. We did not find any associations with 5-year mortality, nor did other Australian authors who looked at living alone in older people.