Elvis was onto something when he sang Heartbreak Hotel, which includes the lyrics “I get so lonely I could die”. It turns out that loneliness is detrimental to your health. Loneliness and social isolation are two sides of the same coin, the former more subjective as it relates to how you feel at any given time, the latter quantifiable by looking at how large or small your social circle is. This topic has caused so much concern that earlier this year, the United Kingdom appointed a Minister of Loneliness whose charge will be to develop policies to combat loneliness and isolation. Does modern life disconnect our social connections to the point that it harms us? The question is complex, and the answer has some known and emerging inputs; let’s examine some.
Spending money on social services
One aspect of combatting social isolation and loneliness lies in developing services that weave a social fabric supporting all members of society, and that pays particular attention to those most vulnerable. The Organization for Economic Co-operation and Development (OECD) index for spending on social services reports that of the 34 countries which comprise OECD, the USA is just under 20% of GDP expenditure for the most vulnerable citizens. By comparison, France has the highest at 31.5% (based on 2016 numbers). The OECD was set up as part of the Marshall Plan and is one of the most robust data sets that track spending in key areas including health, education, and pensions. The lowest GDP % (10.4) was reported for Korea. Spending in this area is one piece of the puzzle that points to a decrease in social cohesion; this may feed the sense of loneliness and isolation people experience.
Does our social circle reduce our risk of dying early?
Prior to World War II, communities in the USA were built around schools, places of worship, and places where people could socialize. This changed with the housing growth that occurred after the War, with the many troops returning home needing new places to live and settle with their families. Urban planning saw a shift at this time, resulting in the proliferation of “lollipop” shaped housing developments to meet demand. In this model, driving to get to local amenities became the norm. In fact, in the decade after World War II, vehicle ownership doubled. Looking back, many argue that this new way of living has also sowed the seeds of some of the ill-health Americans experience today.
In 2010, Julianne Holt-Lunstad, Professor of Psychology at BYU, and colleagues examined the connection between social relationships and mortality risk in a meta-analysis, a study of studies that pools participants and the variables measured to see what trends emerge. Holt-Lunstad pooled 148 studies and included over 308,849 people; findings reliably point to the importance of social connection and strong relationships. Participants who had strong social relationships had a 50% increased likelihood of survival. This finding was consistent across gender, age, cause of death and initial health status. The lack of strong social relationships is a risk factor on par with smoking and alcohol consumption.
Loneliness in Older Adults
In 2012, Perissinotto, Associate Chief for Geriatrics Clinical Programs at UCSF, and colleagues examined loneliness as a predictor of functional decline and health. Their study included 1604 participants over age 60 who were members of the Health and Retirement Study. From 2002 through 2008, every two years participants were asked about their feelings of being left out, isolated or lacking companionship. Over the study period, death, changes in functional status, difficulty with activities of daily living (e.g. dressing, bathing, stair climbing) were then categorized as “not lonely” or “lonely” based on survey responses. Even when adjusting to demographic variables, living situation and depression, participants who were categorized as “lonely” had significant declines in activities of daily living, mobility, and difficulty in stair climbing. They also experienced an increased risk of death: 22.8% vs 14.2% when compared to the “not lonely” participants.
Both studies clearly show that loneliness and social isolation are of the same magnitude of concern as smoking. While we await a clearer picture to emerge regarding best ways to reduce the impacts of loneliness, the solution will need to be multi-dimensional: health, business, urban planning, housing, social services, non-profit agencies, and citizens will need to come together to build solutions that work for how we live our lives. Global populations are already skewed toward older adults, and that will only increase over the next decade!
Thanks for reading- Trina
(Opinions are my own)
OECD (2016), Society at a Glance 2016: OECD Social Indicators, OECD Publishing, Paris. http://dx.doi.org/10.1787/9789264261488-en
Care Sales in USA in 1940s
Social Relationships and Mortality Risk
Loneliness in Older Persons