Loneliness: A Global Epidemic

Just over a year ago, I listened to an interview with US Surgeon General Dr. Vivek Murthy about loneliness being as harmful to our health as smoking a dozen cigarettes daily. This analogy shook me to the core and got me reading more about social health and how increasingly disconnected we are as a society. In addition to Dr Murthy’s warning, more policy-level attention has been geared towards tackling loneliness, even in years before the COVID-19 pandemic, which we know exacerbated the situation even further. In the UK, for example, The Minister for Loneliness was appointed in 2018, followed by Japan in 2021. The World Health Organisation launched a commission on social connection in 2023, co-chaired by Dr Murthy.

Introduction and Research

According to a Meta–Gallup survey, one in four people worldwide report feeling very or fairly lonely. However, the true figures could be significantly higher, as the survey excluded China, the second most populous country in the world. While many initiatives aimed at addressing loneliness focus on older adults, data shows that loneliness is less prevalent among this group, with the majority of those aged 45 and more reporting they do not feel lonely at all. In fact, the lowest rates of loneliness were reported among those aged 65 and over, with only 17% feeling very or fairly lonely. In contrast, the highest rates were observed among young adults aged 19–27, with 27% reporting feeling very or fairly lonely. This percentage decreases slightly in other age groups, with 25% of those aged 30–44 and 22% of those aged 45–64 feeling very or fairly lonely.

On a more positive note, 72% of the global population feels very or fairly connected to others, with 6% not feeling connected at all, the latter still representing an equivalent of one in every 20 people or 287 million people. Compared to loneliness rates (how emotionally isolated people feel from others, such as family, friends, and coworkers), social connectedness (how emotionally connected and supported they feel by others) seems to be more consistent across age groups. It is important to point out that some people still reported feeling lonely despite having social connections. Interestingly, the survey found very few, if any, gender differences in both loneliness and social connectedness worldwide. Globally, 24% of both men and women reported feeling very or fairly lonely, while an additional 27% said they felt a little lonely. Overall, 73% of men and 72% of women reported feeling very or fairly connected, with 6% and 7% not feeling connected at all. There were, however, more significant differences between the two genders in several individual countries, the highest being 25% difference in social connectedness between men and women.

Moving Beyond Loneliness: A Proactive Approach

While governments are increasingly more aware of the implications of loneliness, Kasley Killiam, MPH, a social scientist who devoted her career to social health research, believes that we should stop reactively responding to loneliness and start proactively promoting social health and wellbeing.

What is Social Health?

Before we get into the above in more detail, let’s define social health. Robert D Russel, a professor of health education at Southern Illinois University, was the first to define social health as a dimension of wellbeing. Social health can also be defined as ”adequate quantity and quality of relationships in a particular context to meet an individual’s need for meaningful human connection” (Doyle and Link, 2024). Further expanding on this definition, Killam describes social health as “not the driver of social health and our environment but as an essential pillar of health, alongside physical and mental”. While physical health is about the body and mental health is about the mind, our social health is about relationships and depends on the quality of our connections.

Killam also argues that while loneliness is a component of social health, it is by far not the only component of it. While loneliness is one piece of the puzzle, it is just one sign of poorer social health. It should also not be understood as the opposite of optimal social health.

Social health is relational, and typically, we talk about relationships in the context of mental health, but it goes beyond that. People who feel isolated and lack meaningful connections have a higher risk of mortality (Barnes et al., 2022). Feeling connected not only improves our mood, but it affects the functioning of our bodies, lowers the risk of disease and improves the course of health outcomes (Holt-Lunstad 2024).

The Link Between Connection and Physical Health

A study that looked at a random sample of around 7000 adults living in Alameda County in California showed that those who lacked social connections and community ties were more likely to die in the follow-up period than those who had more extensive contacts. Regardless of their baseline health and adjusted for age-related factors, men were twice as likely to die and women three times as likely (Wingard et al, 1982).

But what specifically links the connections in our lives to the risk of physical illness? According to Killam, one reason is stress buffering. When we encounter stress, cortisol is triggered in our body, which causes inflammation that can weaken our immune system. Being chronically lonely causes a lot of stress that in turn, continues to weaken our immune system, increasing our risk of cardiovascular disease, stroke, depression and dementia. Killam also adds that practical implications, such as having someone to remind you to take medications, where to get treatment and support for a condition or symptoms, having someone to support you through an illness, reminding you to eat well and exercise, and thus engage in health-seeking behaviours, are an important element of nurturing our health. Our environment plays a big role in whether our behaviours are proactively health-seeking or not.

What I found incredibly fascinating, especially as a nutrition practitioner, is the comparison of brain scans of people who were isolated to those who were hungry (Tomova et al, 2020). They found that the same regions in the brain are activated in both instances, meaning that just as your brain recognises the need for food, so too can it detect the lack of meaningful connection. The problem is that we are not as well versed or open to acting on it as compared to not eating because loneliness doesn’t kill in the short term.

What Does It Mean to Be Socially Healthy?

For starters, our connection with ourselves is the basis of social health. For example, if you are more of an introvert, allowing adequate time to recharge on your own will be crucial to being more connected to others. Another important factor is quality over quantity, focusing on building meaningful connections rather than simply having more people around you. Also, knowing what type of connections are fulfilling to us—as we are all different—is important, so being curious and honouring these differences matters. Lastly, ensuring we have diverse ties means we should not look for one person to be all and end all for us but have friends, romantic partners, family, coworkers, and interest groups. It is also crucial that we try to be part of a community or a group, get outside of our comfort zone, and befriend people from different cultures who have different sets of values and beliefs.

Even if you are not feeling lonely, it does not mean you can’t benefit from optimising your social health. Just as physical health is multidimensional, so too is social health. And just like exercising regularly does not mean you couldn’t optimise your physical health more by eating better, so too being connected to your friends and family does not mean you can’t optimise your social health by getting more involved in your community or connecting with your neighbours.

How Individuals Can Improve Social Health

Being socially healthy means prioritising it in our daily lives, just as we do with exercise and healthy meals. It is as much of a commitment as it is a choice that needs to be intentional and thoughtful. And while I understand we lead busy lives and it’s hard sometimes to find the time and energy even for things that matter to us, these do not have to be grand gestures.

It can be as simple as putting your phone down so that you are more present with the people around you. It might also be asking questions and truly listening to the other person to hear them, not simply to respond to them. It can also be a quick call to check in on someone, giving someone a wave on the street, or a smile. Other things to consider are doing random acts of kindness, such as writing a thank you card, helping at a shelter, or leaving sticky notes for your family or friends (my personal favourite). Once we become more intentional about our social health, we will open our eyes to all the social-health-enhancing opportunities out there, and there truly is an abundance of them! Another amazing aspect of this dimension of our health is that compared to exercise and diet, it’s mutually beneficial – both the person performing the act of kindness and the person receiving it gain something positive.

I also like Killam’s 5-3-1 guideline, which stands for connecting with five different people each week, maintaining three close relationships overall, and spending one hour out of your day connecting.

Taking stock of your current social health status to see where your baseline is can also be beneficial. Think about the people that matter to you most and are in your life. How often and how well do you connect with them? Think about the quality and the strength of these connections and whether you need to invest in them more intentionally. Is there at least one person in your life that you can share anything and everything with and truly be yourself?

While hanging out and having shared experiences is an important aspect of building connection and trust, honouring the innate need to feel seen, heard and accepted for both ourselves and the connections in our lives is crucial to building strong social health. If the thought of having a deeper conversation is uncomfortable, don’t worry; you are not alone in thinking and feeling this way. Many of us fear that if we move beyond the surface level, we might get rejected or shut down. However, our self-disclosure can show the other person that it is ok to be imperfect and, in turn, allow them a safe space to share their experiences and thoughts.

The Cost of Loneliness for Businesses

Loneliness is also costly for businesses. According to Cigna’s Loneliness Index Data, loneliness strongly affects an organisation and its bottom line. Lonelier employees have higher rates of stress-related absenteeism and miss more than five additional workdays per year in the US. Cigna’s report estimates that loneliness costs employers more than $154 billion (£126 billion) annually in lost productivity due to absenteeism. In the UK, a report by Telus Health estimated that a third of UK workers have a high mental risk driven by loneliness. In addition, a report issued in 2017 by Co-op and the New Economics Foundation in conjunction with the Jo Cox National Commission on Loneliness estimated the cost of loneliness to employers at £2.5 billion a year.

How Companies Can Improve Social Health

What are some things companies can do to improve social health among their employees? While many of the usual initiatives, such as gym memberships and bringing in health experts for talks, are well-intentioned, they often don’t get to the heart of the issue. Unless they are part of a deeper, organisation-wide approach, they can feel short-sighted, surface-level fixes.

So how do we go deeper into the core of the challenge?

One key aspect is role modelling from the top. Leaders must set the tone by prioritising connection, work-life balance, and genuine engagement. Scheduling emails during working hours is a good start, but how are leaders showing up authentically, creating space for vulnerability and demonstrating that connection is a shared responsibility at all levels?

Redefining flexible working is another area that is worth tackling. This isn’t just about allowing remote work but truly rethinking how flexibility supports autonomy and trust within teams. When people feel trusted and have the freedom to work in ways that align with their personal needs, they are far more likely to feel connected and valued. They then have time to connect with others and their meaningful relationships.

At HumanOS, we want to challenge and encourage companies to go beyond token initiatives and focus on creating systems and environments that build genuine human connections.

If you are in a leadership role, ask yourself: Does your organisation ensure your teams have time to build meaningful relationships at work? Are you intentionally creating spaces, whether virtual or in-person, where people feel seen and heard? Are you proactively encouraging diversity of thought and inclusivity in ways that break down barriers to connection?

Tackling loneliness is a multifaceted challenge, but one that presents an opportunity for forward-thinking companies and leaders.

Why Intentionality Matters

There are currently many reasons why we are globally more disconnected than ever. Technology and social media are two of them, but also more people are living alone and working remotely. We also don’t have access to third-place spaces as much as we did in the past, we are busier, lack time and energy, tend to prioritise work over relationships, and move around more.

As with most health-related topics, the solutions are multifaceted and need addressing on both systemic, public, and individual levels. There are only so many things we can control within our environment, especially in the short term. For this reason, we must be that much more intentional and focus on what we can do and what is within our control.

Just as with food and food patterns that strengthen or weaken our health in the long run, or exercise that can strengthen our muscles, so too can we be more intentional about choices that benefit our social health and connections.

To quote Simon Hill, one of my favourite health podcast hosts and nutritionists, “if we truly want to live better for longer, we ought to consider investing in relationships with the same vigour and intentionality that we bring to our nutrition and exercise.”

Alja, Nutrition Lead at HumanOS

References:

Barnes, T. L., Ahuja, M., MacLeod, S., Tkatch, R., Albright, L., Schaeffer, J. A., & Yeh, C. S. (2022). Loneliness, Social Isolation, and All-Cause Mortality in a Large Sample of Older Adults. Journal of Aging and Health, 34(6-8), 883. https://doi.org/10.1177/08982643221074857

Co-Op, New Economics Foundation. (2017). The Cost of Loneliness to UK Employers. Report. https://assets.ctfassets.net/5ywmq66472jr/24Nr2598xKAwSiAciwYAmK/3b10bc1c3999df76882d0b0f4e85d532/NEF_COST-OF-LONELINESS_DIGITAL.pdf

Dax Shepard, 2023: ‘Vivek Murthy Returns (US Surgeon General)’, Armchair Expert with Dax Shepard. [Podcast] Available at: https://open.spotify.com/episode/0VIg6KtfuWWtx25sOPjXE2?si=7f31d183bb3f4832&nd=1&dlsi=79115def73f840dc.

Doyle, D. M., & Link, B. G. (2024). On social health: History, conceptualization, and population patterning. Health Psychology Review, 18(3), 619. https://doi.org/10.1080/17437199.2024.2314506

Gallup, Meta. (2023). The Global State of Social Connections. Survey.

Holt-Lunstad, J. (2024). Social connection as a critical factor for mental and physical health: Evidence, trends, challenges, and future implications. World Psychiatry, 23(3), 312. https://doi.org/10.1002/wps.21224

Killam, K. (2024). Shifting the focus from loneliness to social health. [Online] STAT. Available at:https://www.statnews.com/2024/06/03/loneliness-social-health/

Killam K. (2024). The Art and Science of Connection: Why Social Health is the Missing Key to Living Longer, Healthier and Happier. HarperOne.

Russel, R. D. “Social health: An attempt to clarify this dimension of wellbeing.” (1973): 74-82.

‘TELUS Mental Health Index: Alarming isolation and loneliness levels among young workers in the UK’. Telus Health, 2024. https://go.telushealth.com/hubfs/MHI 2024/UK_MHI_January_2024.pdf

Tomova L, Wang KL, Thompson T, Matthews GA, Takahashi A, Tye KM, Saxe R. Acute social isolation evokes midbrain craving responses similar to hunger. Nat Neurosci. 2020 Dec;23(12):1597-1605. doi: 10.1038/s41593-020-00742-z. Epub 2020 Nov 23. Erratum in: Nat Neurosci. 2022 Mar;25(3):399. doi: 10.1038/s41593-021-01004-2. PMID: 33230328; PMCID: PMC8580014.

‘The Business Case for Addressing Loneliness in the Workforce’. Cigna Healthcare, 2022, https://newsroom.cigna.com/business-case-addressing-loneliness-workforce

‘WHO launches commission to foster social connection’. WHO, 2023, https://www.who.int/news/item/15-11-2023-who-launches-commission-to-foster-social-connection.

Wingard DL, Berkman LF, Brand RJ. A multivariate analysis of health-related practices: a nine-year mortality follow-up of the Alameda County Study. Am J Epidemiol. 1982 Nov;116(5):765-75. doi: 10.1093/oxfordjournals.aje.a113466. PMID: 7148802.