The Epidemic of Loneliness

In 2018, Cigna Healthcare conducted an online survey of 20,000 U.S. adults using the UCLA Loneliness Scale. They found that most Americans were lonely. Nearly half reported “sometimes or always feeling alone” and only half reported having meaningful in-person social interactions on a daily basis. In 2019, Cigna conducted a follow-up report surveying 10,000 U.S. adults to explore the impact of loneliness. They found that 61 percent of those surveyed reported feeling lonely, a jump from the 54 percent in 2018. Moreover, nearly a quarter of them characterized their mental health as fair or poor. Cigna data suggest a large portion of U.S. adults lack meaningful social connection. In fact, the level of loneliness reported in the 2018 Cigna study was characterized as “epidemic.”

Loneliness and social isolation

Loneliness and social isolation do not always go hand-in-hand. People who do not engage in social interactions with others are not necessarily lonely. They may simply prefer to have little social contact. There are also people who have many social interactions and still feel lonely. Recognizing how each person is affected by these behaviors is important in addressing any interventions for those who are feeling negatively impacted.

More younger people are lonely than older people.

Social isolation and loneliness are not confined to the elderly who are often the focus of research on this topic. The Cigna study in 2018 described Gen Z, those 18- to 22-year-olds, as having the highest loneliness scores, while those ages 72 years and older were the least lonely. As before in the 2019 survey, it was younger people who were lonelier than older folks: 79 percent of Gen Z and 71 percent of millennials versus 50 percent of boomers.

One explanation may be that youth are particularly vulnerable because they are in a state of development—physically, emotionally, and cognitively. They are being challenged to deal with issues regarding self-esteem that can affect how they relate to others. If they lack self-confidence or are particularly sensitive, they may withdraw from social interactions. This “protective maneuver” can foster a poor view of themselves, little confidence in their ability to interact with peers, and fear of failure leading to further issues regarding self-worth.

The impact of loneliness can have additional detrimental effects—particularly, for middle-aged individuals. Holt-Lunstad (2017) found, “Middle-aged adults were at greater risk of mortality when lonely or living alone than when older adults experienced those same circumstances.” The authors suggest some possible explanations for this finding. For example, people who live to “old age” may be more resilient; retirement and the loss of familiar social interactions may affect mental health.

Social isolation and loneliness have physical and psychological consequences.

A large body of scientific data has consistently demonstrated that having meaningful close relationships and feeling connected socially to others is associated with good physical and mental health, and even reduces the risk of early death (Holt-Lunstad, 2017). There is much evidence that social isolation and loneliness are risk factors for mortality, including “obesity, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to health care" (Holt-Lunstad et al., 2015).

Why are Americans so lonely?

Almost 20 years ago, researchers McPherson and colleagues surveying Americans found that fewer people in 2004 than those in 1985 could identify a person with whom they could discuss important matters. These researchers named shrinking social networks as contributing to social isolation. By 2004, there were fewer connections that people had with their neighbors or with community groups than they did in 1985.

Interventions

The psychological and physical effects of those experiencing loneliness and social isolation are responsible for a life that is hindered from satisfaction and purpose. This is not to say that all people who have few social interactions are negatively impacted. Some people prefer to be alone. However, recognizing and intervening for those who are experiencing problems or dissatisfaction should call for evaluation and intervention as a part of their medical care. Unfortunately, Perissinotto et al. (2019) noted that “To date, there has been no uniform way of evaluating and documenting loneliness and social isolation as a part of a review of a patient’s social determinants of health."

The Surgeon General’s recognition and call for means to address these issues highlights the medical seriousness and complexity of loneliness and social isolation. They do not arise out of simple problems and may require individualized solutions.

As with all problematic issues, understanding the nature and scope of the problem (i.e., identifying what is contributing to the person’s loneliness or social isolation) is crucial. Some suggestions include health care providers discussing the importance of healthy relationships and the need for social activity (Perissinotto, et al., 2019). With this information in mind, a treatment plan can be developed.

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The Surgeon General’s Advisory (2023) also offers suggestions for becoming more socially connected:

• "Invest time in nurturing your relationships through consistent, frequent, and high-quality engagement with others."

• "Seek out opportunities to serve and support others, either by helping your family, co-workers, friends, or strangers in your community or by participating in community service."

• "Reduce practices that lead to feelings of disconnection from others. These include harmful and excessive social media use, time spent in unhealthy relationships, and disproportionate time in front of screens instead of people."

Other interventions that can be helpful include the following:

• Looking for ways to give your life meaning.

• Focusing on the positive and seeking sources that offer assistance in this endeavor, whether they be psychological or spiritual.

• The behaviors we engage in influence our psychological well-being and ultimately our physical health. Thus, helping others with similar difficulties can be a catalyst for helping ourselves.

Care and concern for those who are in need of comforting is not restricted. Anyone who can sympathize with the pain of loneliness and social isolation can be a source of support for others. In fact, people who have or are experiencing those same issues can be even more effective.