U of T study finds those who are dissatisfied with life need more high cost health care in future

Dissatisfaction with life is linked to future high cost health-care use, according to a new study by University of Toronto researchers.

“We have known for many years that factors outside the health-care system contribute to health and health-care utilization. Our study suggests that these factors can reach even beyond traditional health behaviours and social determinants,” said Vivek Goel, U of T’s vice-president, research and innovation.

“As we look to manage rising health-care costs, we need to consider a broader range of social policies,” said Goel (pictured left), who is also a professor at the Dalla Lana School of Public Health and scientist emeritus at the Institute for Clinical Evaluative Sciences.

In health-care systems worldwide, high cost health-care users disproportionately account for a majority of spending. High cost health-care users are defined as those who rank in the top five per cent of annual health-care spending.

The study, “The relationship between life satisfaction and health care utilization: a longitudinal study,” was published Thursday in the American Journal of Preventive Medicine. It examined more than 85,000 healthy Ontario adults whose self-reported life satisfaction was measured at baseline and then followed up for six years to determine if they had enough health-care use to put them in the highest category of health-care costs.  

After accounting for other factors associated with high health-care use, like demographic factors, co-morbidity (having two or more chronic diseases or conditions)  and socioeconomic factors, the researchers found that those studied with the lowest level of life satisfaction were three times more likely to be in the highest category of health-care costs compared to those who were satisfied with their life.

Read the research in the American Journal of Preventive Medicine

“There’s increasing focus on the upstream factors and health behaviours that influence health, and this study is the first to identify life satisfaction as a predictor of future high cost health-care users,” said co-author Laura Rosella (pictured left), an assistant professor of epidemiology at Dalla Lana and an adjunct scientist and site director at ICES U of T. She also holds a Canada Research Chair in Population Health Analytics.

Rosella and Goel found that the top five per cent of high cost health-care users used $27,636 in average annual health care costs, compared to $3,393 for those in the top six to 50 per cent and $386 for those in the bottom 50 per cent.

These findings suggest that addressing broader factors that influence well-being and happiness – such as strong social networks and community engagement – will have a positive impact on the health system.

This research was supported by the Ontario Ministry of Health and Long-Term Care.