July 6, 2023 – Loneliness, once considered a mere longing for connection, is gaining recognition from doctors and scientists as something much more dangerous: a risk for heart disease, dementia, certain cancers, and even death.
A growing body of research points to strong links between social isolation, or lack of social connections, and loneliness, the feeling of being disconnected regardless of human contact. Researchers have found a 26% increase in the risk of early death for people who are socially isolated and a 14% increase for those who are lonely, according to a new meta-analysis published in Nature Human Behaviour.
Loneliness also increases the risk of dementia by 50%, heart disease by 29%, and stroke by 32%, according to a 2020 report from the National Academies of Sciences, Engineering, and Medicine (NASEM). If a person with heart disease experiences loneliness, they face four times the risk of early death and a 68% higher risk of hospitalization.
“In recent years, people have recognized that loneliness, as well as social isolation, are related to worse health status,” said Sarah Goodlin, MD, a geriatrician, palliative care doctor, and professor of medicine at Oregon Health & Science University. “And it’s a common condition. Even people who are not socially isolated can feel lonely.”
Increased Focus on Loneliness
In May, U.S. Surgeon General Vivek Murthy, MD, issued an advisory on the dangers of loneliness as a public health issue.
“Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health,” he said. “Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders.”
The American Medical Association adopted a policy last month to “encourage research to assess how forming networks earlier in life helps to reduce loneliness and social isolation for adults, with a special focus on marginalized populations and communities with limited access to resources.”
Among groups most at risk are low-income adults, young adults, older adults, people with chronic diseases and disabilities, migrants, and those in the LGBTQ community.
Link Between Loneliness and Illness Still a Mystery
Research indicates loneliness and social isolation may be linked to higher levels of inflammatory chemicals in the body: C-reactive protein, fibrinogen and interleukin-6.
People who are lonely may also have active pituitary hypothalamus hormones that are released under stress, which could account for negative heart effects, Goodlin said.
But for now, these are only potential links.
“The actual causation is just proposed – it has not been determined,” Goodlin said. “There are no answers right now.”
Social Isolation vs. Loneliness
Loneliness is the feeling of being alone or disconnected, despite having human contact, while social isolation is having little interaction with other people and few social connections.
“Someone can appear isolated but not feel lonely, and maybe they prefer being by themselves,” said Tiffani Bell Washington, MD, a psychiatrist, public health specialist, and obesity medicine/lifestyle medicine specialist.
“Finding ways to minimize loneliness is not simply an ask to live like a socialite or change your entire life or become an extrovert and party all night," she continued. "This is about your health.”
What Can Be Done?
While there is plenty of research on the health effects of loneliness, there has been little exploration into solutions.
The U.S. health care reimbursement system is not set up to treat loneliness as a health issue, Goodlin said, so even if doctors addressed the problem at routine visits, there would still be few options for intervention.
But some researchers are beginning to examine how people can address feelings of loneliness. One study published in Leisure Sciences last year looked at two particularly vulnerable populations – international students and nursing home residents during the COVID-19 pandemic – and found that activities that require focus and engagement reduced feelings of loneliness, even in the face of isolation.
“Loneliness isn't as strong when we engage in activities that are meaningful for us, that give us the opportunity to be authentic,” said John Dattilo, PhD, a professor in Penn State University’s Recreation, Park and Tourism Management Department, and a co-author of the paper.
Researchers found that when people are absorbed in an activity that challenges them and leads to skill development, time passes faster and loneliness eases.
“One of the first steps is to understand ourselves. What is it that brings us joy?” Dattilo said. “People get into a routine, into a pattern, and do things out of a sense of obligation rather than a sense of joy. Being self-aware is one of the first steps.”