Loneliness and health among the elderly. The role of cultural heritage and relationship quality

We estimate the direct causal effect of loneliness on a variety of health outcomes using a sample of second-generation immigrants drawn from the Survey of Health, Ageing and Retirement in Europe. In an effort to account for the endogeneity of self-declared loneliness, we explore the link between loneliness and a specific cultural trait strongly associated with quality of relations and use maternal cultural background as an instrument for loneliness. We thus also assess the importance of cultural heritage in shaping individuals' perceptions of loneliness. Additionally, we investigate one pathway by which some specific ancestral factors may influence the formation of cultural traits in the modern era. Our results suggest that loneliness has a significant impact on health, both mental and physical. Notably, our identification strategy allows us to uncover a more severe effect of loneliness on health than that found in an OLS setting. These findings are robust to a battery of sensitivity checks.