When our study population was divided into lonely and nonlonely groups, there was a significant association between preference for Spanish language and loneliness (P = .001). This may be because the communication barrier makes a person perceive a lack of social support. Speaking Spanish, however, was not statistically associated with increased total visits to the ED (P = 0.15). This may in part be because of the relatively small number (40) of Spanish-speaking patients enrolled in our study. There may also have been some undetected change to the questionnaire when it was translated into Spanish.
Limitations
The patients represented in our study reflect an ED population. Nevertheless, a recent study showed that patients who are lonely visit their primary doctors more often,9 which suggests that our results may be more generally applicable. The use of the UCLA Loneliness Scale creates limitations as well. It does not measure social isolation, and since some people may assume that loneliness is defined by social isolation, there may be confusion.
Conclusions
Our sOur study population of ED patients was not lonelier than the population at large. Lonely people did not have more chronic disease, hospital admissions, or different reasons for visiting the ED, yet they visited more often. Patients with a preference for Spanish may have been lonelier than English-speaking patients, but they did not use the ED more often. The average lonely patient used the ED 60% more than the average nonlonely patient. Loneliness, therefore, seems to be a meaningful independent predictor of ED use. Further studies to discover other associations with loneliness could be beneficial to our understanding of its social and medical implications.
Acknowledgments
The author would like to thank Evelyn Cora, Yvonne Monge, Carrol Bradlee, Harvey Zarren, MD, Dean Kleghorn, and the Lawrence General Hospital Emergency Department staff.