Unhappy young woman feels abandoned in the crowd and lonely due to lack of communication. Upset girl… [+] Fighting depression and mental disorders. Psychological problems. Flat vector illustration.
Getty
A pandemic is underway. And no, it has nothing to do with a virus or bacteria or any other pathogen at all. It's a silent pandemic — a pandemic of loneliness. But the health impacts are just as severe. Social isolation has a greater impact on mortality than smoking 15 cigarettes a day or drinking six alcoholic drinks a day. Pick your poison.
It is not surprising, therefore, that the World Health Organization declared loneliness a global public health threat, coming shortly after U.S. Surgeon General Dr. Vivek Murthy sounded the alarm about the harmful effects of social isolation and a lack of meaningful connections.
So what do we know about this silent pandemic, and what can we do about it?
Older people are especially lonely
One of the main findings of research on loneliness is that older people are especially susceptible to feeling neglected and alone. In fact, the experience of loneliness across the lifespan tends to follow a U-shaped curve: loneliness is highest during adolescence, as people grapple with life transitions and identity issues, drops somewhat in midlife as people begin to build families and solidify their social networks (through interactions at work and with other parents), and then rises sharply again as people enter old age.
There are many reasons why loneliness increases sharply with age, but one that stands out as a major cause is declining mobility. As we age, everyday activities like climbing stairs or carrying groceries become more difficult. In many cases, these activities are eliminated entirely, leaving older people physically inactive and impairing their ability to meet and interact with others. Older people are “trapped” in their bodies.
Hearing loss is also a big issue. Language is the gateway to community. We often get to know each other through conversation. Speaking helps bridge gaps and create bonds. But when a person's hearing is impaired, one side of the equation falls apart. Conversation is as much about listening as it is about speaking. Hearing loss creates a barrier to communication and puts people at risk of gradually becoming lonely. This is reflected in research on the subject, which suggests that hearing loss increases the risk of social isolation by up to 28%. This is not an abstract issue: up to two-thirds of older adults experience hearing loss, but only around 10-30% use hearing aids.
The U-shaped trajectory represents a global trend, although the prevalence of loneliness varies from country to country. Whether in the UK, Germany or Australia, most people start to feel increasingly lonely as they get older. However, it is important to point out that some groups, such as women, people with less education and people with lower incomes, are at higher risk of loneliness than others.
Middle age is no exception
Loneliness is highest among older adults, but it's also becoming a problem among middle-aged people. The usual U-shaped trend may not last long. This is especially true for middle-aged Americans, who are consistently lonelier than their European counterparts, according to a recent study.
After following 53,000 middle-aged adults from the US and 13 European countries for a total of 18 years, the researchers concluded that Americans ranked highest when it came to social isolation, followed closely by those from Mediterranean Europe and the UK, while middle-aged adults from continental and Nordic Europe, including Germany, Sweden and Norway, had the lowest levels of loneliness.
While the study doesn't say why Americans are more likely to be lonely, the authors do venture a guess: “We suspect that Americans' loneliness compared to other countries may be due to limited social safety nets and cultural norms that prioritize individualism over community.” Social isolation goes hand in hand with poverty, and the United States is an expert on poverty. In fact, the U.S. has one of the highest poverty rates among OECD countries.
Another plausible explanation is America's car-centric culture, which ignores public spaces and parks in favor of endless parking lots, large highways, and suburban development. “Transportation and land use policies across the United States have strongly prioritized automobile travel and suburban development,” said Dr. James F. Sallis, Distinguished Professor at the Herbert Wertheim School of Public Health, in a press release about the walkable neighborhoods study. “As a result, millions of Americans live in neighborhoods where they must drive to get anywhere, often alone, and have little or no opportunity to interact with their neighbors.”
The built environment we live in shapes our interactions, and when that environment is primarily geared towards car mobility, our cities become less walkable and have fewer public spaces, both of which limit the potential for social interaction and the development of deep community ties.
How harmful is loneliness really?
Yes, loneliness is on the rise across all age groups. That's not a good thing, but how worried should we really be? Aside from the mental health issues that come with prolonged social isolation, there are also many risks to our physical health.
For one, socially isolated people have a 25% increased risk of death from cancer and a 32% increased risk of stroke. They also have an astounding 29% increased risk of heart disease. And when it comes to dementia, socially isolated people are 1.5 times more likely to develop the problem than those who report having a rich social life.
Another study found that heart failure patients who described themselves as feeling very lonely had three times the risk of dying compared to those who didn't feel lonely, and a 68% higher risk of being hospitalized over a one-year period.
Clearly, loneliness and social isolation are very closely associated with poor health. But as always, trying to separate correlation from causation is tricky. It's not entirely clear that loneliness is causing these health problems. People with certain health problems or disabilities may be more prone to loneliness in the first place, in which case the two simply overlap. Still, it's hard to deny that social isolation is closely associated with increased mortality risk. Even if we can't say it's causing the health problems, it's a flare in the night sky that warns us that someone is in urgent need of help. We need to start paying attention.
Implications
Just as we need food, we need social interaction. Just as hunger is a signal that something is missing, so is loneliness. It is the brain's way of telling us that there is a deep need that is not being met. In fact, the two activate the same areas of the brain. When we are lonely, we are “starving” for meaningful contact. But increasingly, our need for contact is going unmet. And the risks that come with prolonged social isolation are beginning to emerge. We are in the midst of another pandemic, but this time it is demonstrated in silence.
As with any health crisis, the first step is to acknowledge what's happening. Nothing will change unless we acknowledge that this is an urgent issue that requires attention. The second step is to recognize that this is a systemic problem, which means that the long-term solutions lie at the policy level, not through individual intervention. Cholera was eradicated in London in the late 1800s not because of new medicines, but because of changes in waste management. Addressing the loneliness pandemic requires a similar approach. After all, public health issues are social issues, and vice versa.
