Gender differences in the association between living alone, chronic disease and health service use

Objectives: To evaluate the associations between living alone, chronic physical and mental health problems, health services use and how it varies across gender. Methods: A secondary analysis of the nationally representative sample of older adults from the South Australian Monitoring and Surveillance Survey (SAMSS) data (n= 20,522). Chi-square analysis was conducted to examine differences in associations between living arrangements and prevalence of chronic health conditions; and living arrangements and health service use. These analyses were stratified by gender. Results: Urban residence, female gender, increasing age (80+), and lower educational attainment were significantly associated with lonely living among older adults. Living alone was associated with higher burden of physical and mental health conditions, marked by gender differences. While males who were living alone reported higher prevalence of physical health conditions, their female counterparts had higher prevalence of depressive and anxiety symptoms. However, suicide ideation was more common in males than females who were living alone. Importantly, older people who were living alone significantly used higher health services than those who lived with others. Conclusion: Living alone is a risk marker for physical and mental health conditions, particularly suicide ideation. There were gender differences in the association between living alone, chronic health conditions and healthcare demand among older people.