I keep mentioning that loneliness is emerging as one of the greatest threats to physical and emotional health. I thought it might be good to quantify that a little because for many, loneliness seems like something we can just handwave away. An ephemeral threat. One that either effects us or it doesn't, and either way is as intractable as all the other existential problems we face. But it's not really any of these things. It has incredible influences on our behaviour in ways that impact entire communities. It also kills us, quite literally. And unlike many of our societal issues, it's not in the least intractable.
Not just mental health but physical health
I often link off to the Campaign to End Loneliness, a UK programme aimed at overcoming loneliness in particularly older populations.
They keep their "risk to health" page fairly up to date. At the time of writing, the last modification date was August 2020 and their references are broad and current. The kind of research overview we like to see. Or in this case, perhaps we'll have a little less enthusiasm.
I think it's fairly intuitive to say that loneliness predicts depression and anxiety. It also predicts suicide. There are other more complex psychological effects described in detail in their recent report on the subject, but these are the broad strokes. This is distressing enough, but of course I also mention the risks to physical health.
To demonstrate the physical peril, they highlight the similarity between loneliness or isolation, obesity, and smoking in terms of adverse health effects. This is particularly true of cardiovascular issues. Essentially, lonely people, like smokers and the obese, are far more likely to die of heart issues, heart attack and stroke.
Less intuitive outcomes on both physical and mental health are the impact on cognitive function. Isolation is a risk factor for cognitive decline, poorer cognitive function, and dementia. Loneliness quite literally impacts how you think.
Of course, many of these outcomes might be explained by the behaviours lonely people engage in, or their context. Unusual coping strategies, inactivity, lack of support. In any context, these things could result in poorer health. But loneliness and isolation have direct impact on health related physiology like blood pressure and reduced immune function. It's also linked to sleep disturbances.
Outside of the Campaign to end Loneliness, we have Harvard's Grant and Glueck study. For almost a century, across multiple generations of researchers, a cohort of almost 1000 individuals from both less-advantaged and more-advantaged backgrounds underwent extensive physical, psychological, and neurological testing to determine, among other things, the key drivers of well-being. According to one director of the project:
The clearest message that we get from this 75-year study is this: Good relationships keep us happier and healthier. Period.
Lastly, and perhaps most shockingly, ongoing social isolation quite literally changes your DNA. Epigenetic changes resulting from rejection events will result in the creation of cells less resistant to viruses and more likely to increase inflammation in the body as soon as 40 minutes later. With enough of these events, the cumulative impact would mean a person who is genetically more inclined to get sick.
In short, there's something especially destructive about isolation. This might help us to understand the extraordinary lengths we will go to connect with others.
We hear this loneliness problem called an 'epidemic' in the media. This is not just because loneliness is so detrimental for our health, but because it's spreading with increasing rapidity through our society.
This is happening to about one in five people
A recent YouGov survey has around one fifth of the respondents in any category reporting feeling 'always' or 'often' lonely. Indeed, about 22% of millenials claimed zero friends, and similar percentages of millenials and generation xers claimed zero close friends.
This particular poll places the loneliness burden on the younger generations, but older people have long struggled with isolation, at least since the advent of wide-scale aged care institutionalisation. The Campaign to End Loneliness places four of nine million lonely people in the UK, about 45%, in their 'older' category.
The point being, that while the generational burden of loneliness might change from place to place, and media campaign to media campaign, a substantial minority of people are lonely in this world. At the time of writing, this accounts for about one person in every five.
For one person in every five, this loneliness will not just impact their happiness, but their body. It will impair their thinking. It will increase their chance of death.
For one person in every five, this loneliness will increase their chance of killing themselves.
And anything that affects so many people surely shouldn't leave them feeling alone.
There are many reasons why, but none of them are good enough
There are many attempts to explain the loneliness epidemic. Two recent trends have been popular.
The first is the more longstanding. The influence of social media. Online relationships are no replacement for real life relationships, and a media model that capitalises on the "fear of missing out" heightens a sense of isolation.
The second is more recent. A lack of trust in institutions. This might seem counter-intuitive, but the thrust of the idea is that we first cease trusting political and corporate interest groups, then authorities more broadly, and finally all adults. A sort of emotional transfer of mistrust that encourages isolation.
A final contribution, and possibly the most convincing for me is the dissolution of family and community groups. This is a far older complaint, but I would suggest the typical conservative emphasis on this problem is misplaced. As are the typical liberal counter-arguments.
Indeed, I have misgivings about each of these explanations. Certainly our media model is problematic, and our institutions are corrupt, but these aren't new problems. Humans are also fairly robust to environmental perturbations, it's what makes us unique. The answer to this, as many things, is probably some complex mix of many factors.
But unlike many of our most intractable problems, we don't need to understand the causes of loneliness to fight it. This requires no complex institutional response, or change in community attitudes. No. For this, we merely have to invest the time in reaching out.
We are all so curiously alone, that's why it's important to make signals through the glass.
Marina, So Much To Tell You