Taking on the Public Health Threat of Loneliness and Social Isolation
Loneliness is a significant and growing problem with substantial physical health and mental health impacts. Research has found that loneliness and social isolation may be as bad for your health as obesity or smoking 15 cigarettes a day and significantly impacts mental health. (1) The restrictions of the COVID-19 pandemic increased the problem and increased public awareness of the issue.
Loneliness is the subjective experience of feeling alone and dissatisfied with one’s social relationships and it is common across all ages. Social isolation is distinct from loneliness and is more objective, referring to a lack of social connections and infrequent social interactions. However, they are often experienced together.(2)
Persistent loneliness is associated with higher rates of heart disease, obesity, depression, anxiety, and dementia. While it impacts people of all ages and backgrounds, some people are more at risk than others. While much of the research and attention has focused on older adults, recent surveys suggest loneliness is especially high among teens and young adults.(3) The research on effective approaches is limited but growing and health professionals around the world are taking steps to help address loneliness and isolation.
People with poorer physical health, who have pre-existing mental health concerns and who live alone (even if by choice) are more likely to be lonely.(2) Life transitions and disruptions, such as going away to college, moving, becoming a parent, retiring, or losing a partner, can also increase the risk of loneliness and social isolation.(3)
Numerous national and international organizations have called for actions to prevent and address loneliness and social isolation, including the National Academies of Sciences, Engineering, and Medicine, the Centers for Disease Control and Prevention, the World Health Organization, the American Heart Association, and others.(3)
A variety of approaches can be used to address loneliness, including increasing availability and access to community activities. Health promotion efforts can raise awareness about the importance of social connection and emphasize the health benefits of maintaining social relationships. Efforts at the community level may require a range of systems, organizations and people. For example, transportation and digital technology systems can provide access, volunteers and community organizations can provide services, and networks of individuals, including health care professionals, can identify people in need.
Australia and the United Kingdom have been especially active in addressing the problem of loneliness. For example, in Australia, community volunteers visit isolated older adults as part of the National Community Visitors Scheme. In the United Kingdom, the Campaign to End Loneliness includes public awareness and health promotion, group interventions, support for individuals, and more. In the U.S., the Connect2Affect program, a collaborative effort of AARP, Gerontological Society of America, Give an Hour, the National Association of Area Agencies on Aging and UnitedHealth Group, is working to address the issue of social isolation among older adults. It offers an online assessment and links to resources, information and research.
“Although the health sector cannot solve this problem alone, the medical community does need to respond,” authors Phaedra Bell, Ph.D. and Brian Lawlor, M.D., write in the recently published “Loneliness: Science and Practice.” They suggest that health care professionals should understand the evidence, educate their patients and provide treatment options. They also suggest that “screening patients for loneliness and other aspects of social connection at each doctor visit is just as important as measuring their blood pressure and other vital signs.”(2)
- Holt-Lunstad, J., Smith, T. B., Baker, M., et al. (2015). Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352
- Bell, P. and Lawlor, B. 2023. Community Based Interventions for Loneliness, chapter in Loneliness: Science and Practice, Jeste, D.V., et al, editors. American Psychiatric Association Publishing, Washington, D.C.
- Holt-Lunstad, and parissinotto, C. (2023). Social Isolation and Loneliness as Medical Issues. N Engl J Med 2023; 388:193-195, DOI: 10.1056/NEJMp2208029. https://www.nejm.org/doi/full/10.1056/NEJMp2208029