The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Winter
2013

Living Alone, Popping Pills


Bryce J. Christensen and Nicole M. King


For some time, demographers in the United States and Western Europe have noted a remarkable increase in the number of single-person households, an increase only explicable in the context of high divorce rates, low fertility, and falling marriage rates. For a clearer understanding of the psychological implications of this trend toward solo living, Americans can consult a study recently completed by researchers from the United Kingdom and Finland, two European countries that have likewise seen a sharp rise in single-person households in recent decades. Conducted by researchers from University College London, from the University of Helsinki, and from Finnish public-health organizations, this new study raises serious questions about the mental well-being of men and women living alone.

The researchers began their study acutely aware that “an increasing proportion of the population lives in one-person households,” interpreting social developments in Finland against the backdrop of an international pattern: “the proportion of one-person households has doubled during the past three decades, with every third person in the U.S. and the U.K. [now] living alone.” “Never before in history has there been such a great proportion of people living alone,” researchers comment, adding that some demographers now estimate that “by 2020, nearly 40% of all households will have only one inhabitant.”

For the researchers, this upsurge in single-person households raises important questions about mental health. After all, in previous research “living alone has been associated with psychological disadvantages and an increased risk of mental health problems, higher rates of consumption of psychotropic drugs, and a higher risk of suicide.”

To gauge the psychological effects of solo living among Finland’s working class, the researchers analyzed data collected between 2000 and 2008 from a nationally representative sample of 3,471 working-class Finns between the ages of 30 and 65, looking specifically for statistical indications linking living alone to use of psychotropic drugs. Such indications did indeed emerge in the researchers’ analysis: “Participants [in the study] living alone had a 1.81-fold higher purchase rate of antidepressants during the follow-up period than those who did not live alone.”

When the researchers re-analyzed the data using a statistical model taking into account “sociodemographic factors” (such as education, income, urbanicity, etc.), they found that the gap in psychotropic-drug use separating those living solo from those living with others narrowed by 21%. But the gap still remained significant (Odds Ratio of 1.64 after adjustment). Similarly, when the researchers deployed a statistical model taking into account “psychosocial factors” (specifically, “social support, work climate, [and] hostility,” they discovered that the gap in psychotropic-drug use separating working-class Finns from peers living with others narrowed by 12%. But again the gap still remained significant (Odds Ratio of 1.71 after adjustment). And when the researchers looked at their data yet again with a statistical model taking into account differences in health habits (such as smoking, alcohol use, physical activity, etc.), they found the gap in psychotropic-drug use separating working-class Finns living solo from peers sharing a home with others narrowed by just 9%. Yet again, the gap remained significant (Odds Ratio of 1.74 after adjustment).

Taking the use of “antidepressant medication as a proxy measure for the most common mental disorders,” the researchers plausibly interpret their study as evidence that “people living alone may be at increased risk of developing mental health problems.” They speculate that this risk may reflect “psychosocial deficits such as feelings of isolation and a lack of social integration and trust, which, in turn, are risk factors for mental health.” They also conjecture that “single people may also face distress due to socioeconomic disadvantages, such as financial difficulties, and they may be prone to adverse health behaviors.” On the other hand, “Living with other persons may offer emotional support, feelings of social integration, as well as tangible factors that protect against mental health problems.”

At a time when the country’s marriage rate continues to fall, the divorce rate remains stubbornly high, and the fertility rate languishes below replacement level, Americans can expect to see single-person households multiply—and psychotropic-drug sales to rise.

(Laura Pulkki-Råback et al., “Living Alone and Antidepressant Medication Use: A Prospective Study in a Working-Age Population,” BMC Public Health 12 [March 2012]: 236.)

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