The loneliness epidemic threatens our health and happiness

The writer is a scientific commentator

There is a sense of deep shame attached to being alone. No one wants to be seen as unpopular or unlikable.

One consequence of that stigma, according to US surgeon general Vivek Murthy, is a silent epidemic of loneliness. Murthy, now in his second stint as the nation’s doctor, recently admitted he felt deeply lonely after being fired the first time. Research suggests that loneliness rivals smoking and excessive alcohol consumption in terms of damage to health and shortening life. This is not a trivial and delicate matter: an aging population can also mean that it is a growing epidemic.

Professor Andrea Wigfield, director of the Center for Loneliness Studies at Sheffield Hallam University in the UK, points out that loneliness is different from social isolation. The latter is an objective measure of whether a person lives alone, has friends and family, and belongs to social groups. Loneliness, on the other hand, is the self-reported subjective feeling that one’s social relationships are failing in some way, either in quantity or intimacy or both. It generally follows a U-shaped curve with age: high among teens and young adults (the group who have felt the most lonely during the Covid-19 lockdowns), falling into midlife and then rising again. It can be triggered by significant life events such as going to college, bereavement, retirement, moving house, or becoming a caregiver.

Murthy says loneliness is equivalent to smoking 15 cigarettes a day. The captivating analogy can be traced back to a 2010 meta-analysis of 148 separate studies that included more than 300,000 people. The study concluded that people with stronger social relationships had a 50% greater chance of survival than those with weaker relationships, regardless of age, gender, underlying health, length of follow-up period, and cause of death.

The same research identified loneliness as a stronger risk factor for death than physical inactivity and obesity, comparable to smoking and heavy drinking. The condition has also been linked to an increased risk of cardiovascular disease, type 2 diabetes, rheumatoid arthritis, autoimmune diseases and cancer.

The English Longitudinal Study of Aging points in the same unwelcome direction. The Long-Term Elsa Study, which began in 2002 and questioned thousands of people over 50 at two-year intervals about their health, weight, income and social activities, found that loneliness or social isolation was associated with conditions such as depression, dementia, heart attacks, long-term lung disease and frailty.

Could the correlation be causality? One theory is that our evolution as a social species bequeathed a fundamental craving for human companionship, a hangover similar to our evolved preference for sweet and fatty foods. Left unsatisfied, craving causes psychological stress, which induces physiological effects such as elevated levels of the stress hormone cortisol. As Wigfield explained, loneliness appears to trigger the “fight or flight” response, which results in inflammation and increased white blood cell production (a response to inflammation). Andrew Steptoe, the University College London professor who guides Elsa, stressed in an email that “the other important pathway is through behaviour, not biology. Socially isolated and lonely people often follow less healthy lifestyles in terms of smoking, physical inactivity and food choices. They can delay seeking medical help when they get sick.

It is clear that tackling loneliness is critical to improving the health of the nation and, ideally, before temporary setbacks turn into chronic isolation. “Some argue that the longer you experience loneliness, the harder it is to get out of it [it]”, says Wigfield. “Lonely people may begin to perceive themselves and others’ opinions of themselves more negatively and misinterpret others’ signals.”

UK-based organization Campaign to End Loneliness recommends first steps like saying goodbye to a neighbor. Local interest or hobby groups, ranging from art to sports, provide like-minded interaction. Volunteering may particularly appeal to men who may avoid receiving support but are more open to helping others. Wigfield’s other suggestions, even for young people prone to judge each other harshly against glossy social media feeds, include meeting face-to-face and putting the devices away.

The campaign group estimates that the number of over 50s experiencing loneliness in the UK will reach 2 million by 2026. We cannot end loneliness but, by simply saying goodbye, we can all help banish shame.