Loneliness is being treated as a serious health risk

A few years ago, the U.S. Surgeon General issued a formal advisory describing loneliness and social isolation as an epidemic — the same kind of warning used in the past for public health matters like smoking. He compared the physical health impact of chronic isolation to smoking 15 cigarettes a day.

Loneliness doesn’t always mean being alone, April Health reports. It can be felt in a crowd or surrounded by strangers, and is closer to a feeling of lack of connection. According to research from Wysa, nearly one in three American adults often or always feels lonely. The study, which surveyed 2,044 American adults last year, uncovered a correlation between persistent loneliness and a wide range of health symptoms including depression, chronic pain, fatigue, and insomnia.

Other research has linked loneliness and social isolation to a higher risk of serious physical illness, such as heart disease and stroke, and among older adults, a significantly increased risk of dementia and cognitive decline. This is because chronic loneliness keeps the body’s stress response permanently switched on, and over time this can cause elevated stress hormones and inflammation, which in turn puts pressure on the heart and the immune system.

The impact of loneliness on mental health is more complex, as loneliness is both a risk factor for depression and a symptom of it. When a person experiences loneliness, they are more likely to be withdrawn which, in turn, can increase the symptoms of depression, and when a person is depressed, they may withdraw from socializing. Both loneliness and depression become a cause and a consequence of each other, creating a loop that makes it difficult to deal with. This also places loneliness at the center of physical and mental health, which is why it has drawn the attention of the health system.

As people age, their social circles begin to shrink, mobility often declines, and partners and close friends are lost, all of which can leave someone increasingly isolated and less able to attend the gatherings that once kept them connected. But the other group affected is young adults, with research repeatedly finding that people aged 18 to 25 report among the highest loneliness rates of any age group, despite being the most connected generation in history, with texts, video calls, and group chats always at their fingertips. Part of the explanation may be that being online is not the same as feeling close to someone. With social media presenting a polished version of everyone else’s life, when a young person’s own experience doesn’t match that picture, it can actually leave them feeling more alone.

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Whilst recognizing loneliness as a health risk is a great step forward, doing something about it isn’t quite as simple. Unlike a physical illness, which usually has a clear treatment plan and improvements, loneliness has no obvious cure, and its causes, such as living alone, working remotely and fewer community and social events, are not easily solved. This is also why advice that amounts to telling people to “put themselves out there” tends to fail, as it adds pressure to the person and loops back to the same cycle.

The U.S. Surgeon General recognizes that tackling loneliness requires big changes across communities, healthcare, and technology, as it isn't a problem individuals can fix entirely on their own. In response, some healthcare systems have started screening patients for loneliness during routine visits. However, screening is only helpful if there is something positive that can be given to alleviate it.

Behavioral health support, available directly through primary care doctors, is starting to make a difference. With this pathway, a conversation about loneliness can turn into an actual plan, whether that's ongoing mental health support, or an introduction to community programs, senior centers, faith groups, or peer support networks in their area.

This doesn’t make loneliness simple to solve, but primary care doesn't need to solve loneliness on its own to make a huge difference to those suffering. It just needs to be the place where someone struggling is noticed, taken seriously, and connected to the kind of ongoing support that can actually change their trajectory. That shift, from noticing loneliness to acting on it, is what integrated care models are built to address.

This story was produced by April Health and reviewed and distributed by Stacker.