Background

Loneliness is a subjective, distressing experience that results from perceived isolation, where there is a discrepancy or unmet need between an individual’s preferred and actual experience. A study based on data from 113 countries spanning 2000-2019 found that loneliness at a problematic level is a common experience worldwide.

Link between loneliness and public health

Loneliness is a public health issue because it is evident from research that social isolation and loneliness have a serious impact on people’s physical and mental health, quality of life, and longevity. The effect of social isolation and loneliness on mortality is comparable to that of other well-established risk factors such as smoking, obesity, and physical inactivity. Loneliness is a potent risk factor for developing several health conditions, such as coronary heart disease and stroke, and is associated with a 26%-50% increased risk in mortality. In terms of mental health, loneliness and social isolation are not only correlated with depression but can increase vulnerability to developing future depressive episodes. It is also linked to sleep problems, inflammation, and immune changes in younger adults. 

Loneliness affects all age groups and demographics. In fact, the rate of loneliness among young adults increased every year from 1976 to 2019, as stated by the US Surgeon General in the latest 2023 report.

COVID-19 and loneliness: disruptive but provides opportunities

While social connection had been declining for decades prior to the COVID-19 pandemic, the onset of the pandemic and its associated lockdowns brought the issue of connection to the forefront of public consciousness, raising awareness about this critical and ongoing public health concern. With policymakers’ sights set on “building back better” after the pandemic, there is a window of opportunity to tackle the root causes of loneliness among people of all ages.

Challenges

It is difficult to identify and address loneliness because there is no standard diagnostic test to assess this.

Many people still do not talk about loneliness.

It is only when loneliness leads to depression, anxiety, obesity, or substance abuse that it is identified and addressed to some extent.

Even if people want to address loneliness, there are no comprehensive approaches developed and implemented that can address the complex web of psychosocial, socioeconomic, cultural, and geographic issues around it.

Loneliness is a result of many complex issues, including how our societies function, how our towns and cities are built and dis/connected, how our health and social care systems de/prioritize human connection and social integration, cultural and familial attitudes towards social media over/usage, and cultural and social perception of older people. Therefore, addressing loneliness requires a multisectoral approach, where every government ministry is accountable for ensuring human connection and social wellbeing are woven into policies spanning from health to education, urban planning, communication, transport, and aged care.

There is very limited data available on loneliness globally. It is especially lacking for young and middle-aged adults, compared with adolescents and older adults.

Desired state of Policy

Some countries are already tackling the issue of loneliness, with the UK being the first country to develop a strategy, the US Surgeon General recognizing it as a public health problem, and Japan enacting a national law in 2023 to promote measures for supporting people in social isolation and loneliness. The WHO has also called on all governments to allocate priority and resources to addressing social isolation and loneliness, to ensure that all people benefit from a shared spirit of friendship and solidarity and to improve research and evidence for effective interventions.

With loneliness now defined as a public health problem, tackling it requires a multi-pronged approach and the involvement of multiple stakeholders, including:

Define the magnitude and distribution of the problem through surveillance.

Reduce stigma and encourage people to talk about loneliness and seek help.

Drive a lasting shift so that human relationships and loneliness are considered in policymaking and delivery.

Build evidence around the full burden of loneliness and create a compelling case for action.

Address loneliness across the life course and seek to facilitate genuine human connection through a multi-sectoral, multi-ministerial, “connection in all policies” response.

Tools to support in the diagnosis of “risk of loneliness and its implications,” e.g., three simple questions to identify people at risk of loneliness.

Develop guidelines for holistic interventions to address loneliness and isolation.

Recently, the US Surgeon General released the Advisory on Loneliness and Isolation that presents six pillars, including strengthening of social infrastructure, enacting pro-connection public policies, mobilizing the health sector, reforming digital environments, deepening knowledge, and cultivating a culture of connection. These pillars can be a great start to the problem of isolation and loneliness. Once implemented, these pillars can help improve social connections, and different stakeholders, including governments, civil society, schools, workplaces, and individuals, can play a significant role in advancing these social connections. It is crucial to invest in communities and social infrastructure, recognize or adopt policies that reduce disparities and benefit connection, and build knowledge for relevant stakeholders to address gaps and drive a culture of connection.

The role private sector can play:

This is an opportunity for the private sector to “walk the talk” and to truly address a root cause of many of society’s ills. If private sector actors truly want to be a partner in public health, there are multiple ways to support policy development and programs to address loneliness. For example:

  • Fund research into the best ways to build connection among different risk groups.
  • Support research to drive development of guidelines to diagnose risk of loneliness and support lifestyle prescriptions for social interaction.
  • Help develop tools to diagnose loneliness.
  • Generate evidence to support the development of guidelines to address loneliness and isolation as part of a comprehensive treatment plan for diseases for which there are medicines.
  • Develop social media campaigns that offer localised omni-channel advertising of “in real life” opportunities for connection, supported by online follow-ups and engagement.
  • Implement CSR programs that seek to facilitate connection and outreach for population groups that align with a company’s area of expertise, e.g., advocating for a “connection in all policies” approach to town and urban planning.
  • Funding programs that provide team sports for pre-teens and teens (especially in rural and underprivileged areas), adopt parks and areas for social interaction, support your employees in becoming connectors of people in their communities, etc.

Conclusion

With broad and deep experience in multisectoral and interministerial policy responses, PW can help our clients understand this important landscape and where your company could appropriately contribute to addressing social isolation and loneliness, identify potential partnerships, navigate key stakeholders and ministries, and ultimately demonstrate true partnership in public health.

References:

  1. New advocacy brief highlights serious consequences of social isolation and loneliness on the health of older people, calls for greater political priority to the issue. 29 July 2021.Departmental news. WHO. Retrieved from: https://www.who.int/news/item/29-07-2021-new-advocacy-brief-highlights-serious-consequences-of-social-isolation-and-loneliness-on-the-health-of-older-people-calls-for-greater-political-priority-to-the-issue
  2. Social Isolation and Loneliness. Advocacy Brief. WHO. Retrieved from: https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/social-isolation-and-loneliness
  3. Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. 2023. Office of the US Surgeon General, US Public Health Service. Retrieved from: https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf
  4. Government’s work on tackling loneliness. Guidance Published on 27 May 2022. Department for Culture, Media and Sport and Department for Digital, Culture, Media & Sport, UK Government. Retrieved from: https://www.gov.uk/guidance/governments-work-on-tackling-loneliness
  5. Loneliness in Young People. Young People’s Experiences of Loneliness and Ideas for Policy Solutions. February 2021. Mental Health Foundation. Retrieved from: https://www.mentalhealth.org.uk/sites/default/files/2022-06/mhf-Loneliness-policy-recommendations-young-people.pdf
  6. Surkalim D L, Luo M, Eres R, Gebel K, van Buskirk J, Bauman A et al. The prevalence of loneliness across 113 countries: systematic review and meta-analysis BMJ 2022. Retrieved from: https://doi.org/10.1136/bmj-2021-067068
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  9. Taking on the Public Health Threat of Loneliness and Social Isolation. February 15, 2023. American Psychiatric Association. Retrieved from: https://www.psychiatry.org/news-room/apa-blogs/loneliness-and-social-isolation
  10. Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a metaanalytic review. Perspect Psychol Sci. 2015;10(2):227-237. Retrieved from: https://doi.org/10.1177/1745691614568352
  11. Prohaska T, Burholt V, Burns A, et al. Consensus statement: loneliness in older adults, the 21st century social determinant of health? BMJ Open. 2020;10(8):e034967. Retrieved from: https://doi.org/10.1136/bmjopen-2019-034967
  12. WHO’s work on the UN Decade of Healthy Ageing (2021–2030). WHO. Retrieved from: https://www.who.int/initiatives/decade-of-healthy-ageing
  13. Japan’s parliament enacts bill to tackle social isolation. Japan Times, May 31, 2023. Retrieved from: https://www.japantimes.co.jp/news/2023/05/31/national/social-isolation-bill/