Authored by Esha Shakthy
Art by Michelle Choi
In May 2023, United States Surgeon General Dr. Vivek Murthy released a new Surgeon General Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country [1]. Social isolation has been noted to affect our mental, physical, and societal health. Its negative consequences are most profound among the elderly, the poor, and minorities, however, it affects all ages. Alarmingly, more than one in three adults aged 45 and older feel lonely in the US, and one in four young adults feel lonely most of the time [2, 3]. This article presents some of the emerging research from scholarly articles around this topic.
Humans are inherently social beings, hence lack of meaningful connections with others can contribute to social isolation and loneliness. Social isolation refers to being cut off from social contact with others, including both physical and emotional isolation. Loneliness, on the other hand, is a feeling of being cut off from others, even when they have regular physical, and social contact. Loneliness and isolation could be shaped by various factors, including demographics, geography, culture, race, work etc. Seniors face a heightened risk of social isolation due to declining social connections and deteriorating health as they age [4]. However, young adults were the hardest hit by loneliness during the pandemic and even today, 24% of young adults feel lonely “a lot of the day” per a 2023 Gallup poll [5]. Out of those feeling lonely, 67% also experienced anger that same day, as compared to just 11% felt among those who were not lonely. Also, 33% of those who felt lonely currently have or are being treated for depression, nearly triple the level found among non-lonely participants [2]. Additionally, virtual social interactions and passive social media use have been linked with lower subjective well being [6]. Further, there is a stigma associated with social isolation, especially through social media.
Social isolation and mental health have a bidirectional relationship. Isolation and loneliness can lead to a poor support system which affects mental wellbeing. Conversely, isolation is sometimes the self-induced coping mechanism for individuals suffering from anxiety and depression [7]. Research has shown that greater loneliness is related to higher rates of clinically significant depression, anxiety, and suicidal ideation, independent of age, sex, partnership, and socioeconomic status [8]. While depression has been found to be the most relevant cause of suicide attempts, both loneliness and social isolation have also been identified as major contributing factors [9]. Additionally, higher levels of loneliness are linked with the risk of memory loss and cognitive decline with aging, with a study finding that loneliness, limited social network, and limited social support were all risk factors for dementia [10]. According to the CDC, social isolation increases the risk of dementia by 50% [11].
Social isolation and loneliness have also been identified as a major risk factor for cardiovascular disease by various studies, with an increased risk of developing coronary heart disease and stroke [12]. Social isolation increases the risk of heart disease by 29% and stroke risk by 32%. A study involving heart patients found a 68% increased risk of hospitalization, a 57% increased risk of emergency department visits, and a 26% increased risk of outpatient visits for patients who self-reported high “perceived social isolation” compared with patients reporting low perceived social isolation [13]. Social isolation has also been linked with type 2 diabetes mellitus as well [14].
Social isolation and loneliness are important, yet often neglected, social determinants of health across all age groups. Loneliness costs the US economy an estimated $406 billion a year[14], in addition to the estimated $6.7 billion in annual Medicare costs for socially isolated older adults. Combating social isolation is a difficult process but taking small steps towards reaching out and reconnecting can go a long way, along with seeking professional help, joining support groups, and self-care. As UNC Health psychiatrist Nadia Charguia, says, “Each of us can start now, in our own lives, by strengthening our connections and relationships” [15]. As a community we should keep an eye out for those who might need assistance and stay connected. If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741).
Works Cited
[1] Our Epidemic of Loneliness and Isolation. (2023, May 3). US Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf
[2] Witters, D. (2023, April 4). Loneliness in U.S. Subsides From Pandemic High. Gallup.com. https://news.gallup.com/poll/473057/loneliness-subsides-pandemic-high.aspx
[3] Health Risks of Social Isolation and Loneliness. (2023, April 3). Centers for Disease Control and Prevention. https://www.cdc.gov/emotional-wellbeing/social-connectedness/loneliness.htm
[4] Loneliness and Social Isolation — Tips for Staying Connected. (n.d.). National Institute on Aging. https://www.nia.nih.gov/health/loneliness-and-social-isolation-tips-staying-connected#difference
[5] Walsh, C. (2021, February 17). Young adults hardest hit by loneliness during pandemic, study finds. Harvard Gazette; Harvard University. https://news.harvard.edu/gazette/story/2021/02/young-adults-teens-loneliness-mental-health-coronavirus-covid-pandemic/
[6] Towner, E., Tomova, L., Ladensack, D., Chu, K., & Callaghan, B. (2022). Virtual social interaction and loneliness among emerging adults amid the COVID-19 pandemic. Current research in ecological and social psychology, 3, 100058. https://doi.org/10.1016/j.cresp.2022.100058
[7] Brown, V., Morgan, T., & Fralick, A. (2021). Isolation and mental health: thinking outside the box. General psychiatry, 34(3), e100461. https://doi.org/10.1136/gpsych-2020-100461
[8] National Academies of Sciences, Engineering, and Medicine, Division of Behavioral and Social Sciences and Education, Health and Medicine Division, Board on Behavioral, Cognitive, and Sensory Sciences, Board on Health Sciences Policy, & Committee on the Health and Medical Dimensions of Social Isolation and Loneliness in Older Adults. (2020). Health Impacts of Social Isolation and Loneliness on Morbidity and Quality of Life. In www.ncbi.nlm.nih.gov. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK557983/
[9] Minayo, M. C., & Cavalcante, F. G. (2015). Suicide attempts among the elderly: a review of the literature (2002/2013). Ciencia & saude coletiva, 20(6), 1751–1762. https://doi.org/10.1590/1413-81232015206.10962014
[10] Penninkilampi, R., Casey, A. N., Singh, M. F., & Brodaty, H. (2018). The Association
between Social Engagement, Loneliness, and Risk of Dementia: A Systematic Review
and Meta-Analysis. Journal of Alzheimer's disease : JAD, 66(4), 1619–1633. https://doi.org/10.3233/JAD-180439
[11] Loneliness and Social Isolation Linked to Serious Health Conditions. (2021, April 29).
Www.cdc.gov; CDC.
[12] Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and
social isolation as risk factors for coronary heart disease and stroke: systematic review
and meta-analysis of longitudinal observational studies. Heart (British Cardiac Society),
102(13), 1009–1016. https://doi.org/10.1136/heartjnl-2015-308790
[13] Manemann, S. M., Chamberlain, A. M., Roger, V. L., Griffin, J. M., Boyd, C. M., Cudjoe, T.
K. M., Jensen, D., Weston, S. A., Fabbri, M., Jiang, R., & Finney Rutten, L. J. (2018).
Perceived Social Isolation and Outcomes in Patients With Heart Failure. Journal of the
American Heart Association, 7(11). https://doi.org/10.1161/jaha.117.008069
[14] Lukaschek, K., Baumert, J., Kruse, J., Meisinger, C., & Ladwig, K. H. (2017). Sex
differences in the association of social network satisfaction and the risk for type 2
diabetes. BMC public health, 17(1), 379. https://doi.org/10.1186/s12889-017-4323-7
[15] 5 Ways to Combat Loneliness and Isolation | UNC Health Talk. (2023, August 18).
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