Just as we need water, food and shelter, we need social connections and friendships to survive as well. Human beings have a basic drive for
contact and intimacy with others. We are “social animals” even if we feel somewhat introverted, shy or fearful of new situations. Life’s challenges are better faced with social support.
Loneliness is the feeling of being alone even if one has social contact. Episodic periods of feeling alone are very normal. Most people experience the loneliness following the loss of a loved one, a move to a new city, or the breakup of a relationship. This isolation tends to be short lived and a time for grieving losses, building new relationships, and renewing established contacts.
Chronic loneliness is different. Social isolation, the lack of an adequate support system, poor or nonexistent family ties, an addiction to smartphones and the internet, and few (or no) friendships are all signs of loneliness. The “deficiency of relationships” can make a person feel sad and isolated.
Julianne Hold-Lunstad, professor of psychology at Brigham Young University, presented research findings on loneliness at the 2018 annual American Psychology Association convention.
She showed that loneliness is more dangerous to health than obesity and actually rivals the risks of smoking.
She stated, “Indeed, many nations around the world now suggest we are facing a loneliness epidemic. The challenge we face now is what can be done about it.”
Two meta-analyses were explored. The first included 148 studies with data on 300,000 participants; it found a 50% reduction in the risk of early death among people with more social contacts. The second showed data from 70 studies including 3.4 million people; it looked at social isolation, loneliness and living alone and found that all three increased health risks as much or more than obesity.
On May 1 of this year, U.S. Surgeon General Dr. Vivek Murthy issued a report calling loneliness the latest public health epidemic.
“We now know that loneliness is a common feeling that many people experience. It’s like hunger or thirst. It’s a feeling the body sends us when something we need for survival is missing,”
Murthy told the Associated Press in an interview. “Millions of people in America are struggling in the shadows, and that’s not right. That’s why I issued this advisory to pull back the curtain on a struggle that too many people are experiencing.”
We have become less connected to our houses of worship, community organizations, and even family members over the past several years. This got a lot worse during the COVID-19 isolation mandates with even less time spent with friends, family, work colleagues and schoolmates. The report noted that we spent about 20 minutes a day in person with friends in 2020 compared with 60 minutes daily in 2000. Those ages 15 to 24 really suffered with a 70% drop during that same time period.
The American Association of Retired Persons (AARP) did a loneliness study in 2018. The findings were similar to the APA convention report: 42.6 million adults over the age of 45 suffer from chronic loneliness. The top factors in loneliness were the size and diversity of one’s social connections, physical isolation, age, depression, living in an urban environment, anxiety, overall physical health, and LBGTQ status. The incidence of loneliness was the same across race and ethnicity. Of note in this study, it was found that 33% of older adults who have ever spoken to their neighbors reported being lonely. A whopping 61% of those who have never spoken to neighbors experience loneliness.
Loneliness is a health hazard because it can lead to many problems such as higher levels of stress hormones, increased inflammation, a disruption in sleep patterns, appetite changes, decreased physical activity, and a less robust immune system. Any of these factors increases risk of disease and injury. The effects of loneliness and social isolation can be seen in both the brain and body; the negative effects of stress hormones can be felt at the cellular level and cause problems from higher blood pressure to memory losses. Loneliness can be a precursor to alcoholism and depression. Loneliness is not related to any known brain pathology but is a social and emotional state. The mind-body health connection is both fascinating and a little bit daunting. As we delve into those links, we find more reason to explore our communality and the positive connections between people.
Social media and technology may be driving the upward curve of the nation’s loneliness. One study noted in the surgeon general’s report found that people who used social media for two or more hours a day were more than twice more likely to report feelings of social isolation than people who used these platforms for 30 minutes or less. Are we using technology instead of in person communication and interaction? Protections for children and young teens need to be put in place to curb hours online.
“Social Isolation and Loneliness in Older Adults,” a 2020 book by the National Academies of Sciences, Engineering and Medicine, articulated that loneliness increases the risk of premature death by almost 30%. Poor social connectedness also increases the risk of heart disease (29%) and stroke (32%). Loneliness in patients with heart failure was associated with a four times increased risk of death, 68% increased risk of hospitalization, and 57% increased risk of visits to an emergency room. Social isolation was associated with a 50% increased risk of dementia. Loneliness was also associated with higher rates of depression, anxiety and suicide. This is a good book for health care providers as it highlights assessment tools, and resources to combat causes of loneliness.
The surgeon general’s report calls on workplaces, schools, community organizations, tech companies, parents, and people in general to make changes that will boost the country’s connectedness. His advice is for people to “put down their phones when they’re catching up with friends; employers to think carefully about their remote work policies; and health systems to provide training for doctors to recognize the health risks of loneliness.”
There are ways to avoid being lonely. Social isolation can be deadly and we need to be aware not only of our own community connections but also those of the people we care for. Home health agencies offer in home support and assistance for those who may be homebound. For older adults, senior centers are a haven for many to socialize, eat a hearty meal, embark on new projects, and meet like minded adults with varied interests. There are many church organizations that have social programs for people of all ages from children to older adults. Community agencies (such as Interfaith Community Services here in Pima County) offer services to meet the social needs of almost every demographic.
Volunteer agencies actively seek assistance in many projects. Many schools have foster grandparent programs that foster intergenerational friendships and understanding. Some libraries have reading groups and frequently offer lifelong learning courses. The key is to look outward from oneself. We need to look out for each other, too, and bring those who may be isolated into our social circles.
Mia Smitt is a longtime nurse practitioner. She writes a regular column for Tucson Local Media.
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