Loneliness Epidemic

 

The US health authorities are calling for social isolation to be treated as seriously as obesity or drug abuse. 

Now, men have fewer friends than ever. Half of Americans say they experience loneliness. Less than 40 percent said in a 2022 study that they felt very connected to others.

In fact, the trends were already underway well before the Covid-19 pandemic, though living through three years of a public health crisis has likely accelerated them by reducing the size of their social circles.  

A report from the US Surgeon General Vivek Murthy says that social isolation’s effects on mortality are equivalent to smoking up to 15 cigarettes every day. Social isolation (an objective measure of lacking connection to families, friends and community) and loneliness (a subjective measure of feeling disconnected) contribute to a person having a higher risk of heart disease, stroke, anxiety, hypertension, diabetes, depression and dementia, and make people more susceptible to infectious diseases. 

People with stronger social connections are correspondingly less likely to be readmitted to a hospital after being treated for heart failure and they are generally better at managing chronic conditions like diabetes than people who are more isolated. And loneliness is reported to increase the risk of premature death by almost 30% - through health conditions including diabetes, heart attacks, insomnia and dementia. People with a low amount of social connection were more than twice as likely to die. A high level of social connection led people to be 50 percent more likely to survive over a long follow-up period, which averaged 7.5 years across the nearly 150 studies. In addition, people who live alone are twice as likely to die by suicide. 

Indeed, the effects of social connection, isolation, and loneliness on mortality are comparable, and in some cases greater, than those of many other risk factors including lifestyle factors (e.g., smoking, alcohol consumption, physical inactivity), traditional clinical risks factors (e.g., high blood pressure, body mass index, cholesterol levels), environmental factors (e.g., air pollution), and clinical interventions (e.g., flu vaccine, high blood pressure medication, rehabilitation).

Isolation can also lead to a person experiencing a higher amount of stress, which affects mental well-being as well as causing the body to release stress hormones. These hormones can contribute to higher levels of inflammation, which is associated with a wide spectrum of health problems. People with stronger social connections are also more likely to behave in ways that lead to better health: more physical activity, better nutrition and even better management of chronic diseases.

Lack of social connection is also linked to lower academic achievement and worse performance at work. 

Additionally, the individual health effects ripple out into the broader community. Communities with higher social capital — which can be linked to family structure and involvement, trust in community institutions, popularity of volunteerism, levels of participation in political discussions and voting efforts, and cohesion among community members — experience better health, have less disease and lower all-cause mortality than those with less so-called social capital. They are better prepared for natural disasters and experience less violence.

One study found that a 10 percent increase in the number of people in an area who say they feel connected to others was associated with an 8 percent drop in all-cause mortality. A county-level analysis of deaths during the Covid-19 pandemic found that lower levels of social capital were associated with a higher number of cases and deaths from COVID-19 infection.

Loneliness is subjective, and the report notes that a certain amount of solitude, even undesired solitude, can help people become more resilient. But more objective measures also reveal a country in which people are increasingly isolated from one another. 

In the 1970s, almost half of Americans (45 percent) said they could generally trust other people. Today, less than a third say the same. The amount of time that Americans say they spend alone every day had risen by nearly 30 minutes from 2003 to 2019 and increased another 20-plus minutes in 2020, the first year of the pandemic, which amounted to almost an additional full day of solitude over the course of a month. The amount of time that young people (ages 15-24) spend with their friends in person dropped by nearly 70 percent from 2003 to 2020, as long-running trends got worse when the pandemic set in. Half of the country says they have three or fewer close friends, double the number from 1990. Just 16 percent of Americans say they feel very attached to their local community.

The causes for this increasing isolation are complex. People are less likely to get married and are having fewer children. Americans are much less likely to belong to religious organizations, a historical source of community connection. These are legitimate lifestyle choices.

Other risk factors for loneliness include being a racial or ethnic minority or experiencing discrimination, having a lower income, and living alone. Being in poor physical or mental health is also associated with more isolation, suggesting a feedback loop in which loneliness not only contributes to poor health but perpetuates it. The percentage of households that comprise a single person living by themselves has doubled from 1960 to 2022. 

The role of technology in fostering loneliness has been scrutinized lately. Social media can create opportunities for people to connect with others, but it can also exacerbate loneliness. People who spend more than two hours a day on social media or who are the targets of online harassment report feeling more isolated from other people. 

Surgeon General Vivek Murthy said that there "are steps we can take as individuals", such as spending 15 minutes with loved ones, avoiding distractions such as devices while speaking to people, "and looking for ways to help one another". 

"Service is a powerful antidote to loneliness," he said. "These can all help".