Michael Abrahams | The loneliness epidemic

According to the World Health Organization (WHO), loneliness is a subjective experience arising from a mismatch between expected and actual quality/quantity of connections. Interestingly, someone can be alone and not be lonely, or be surrounded by people and suffer from loneliness. The connectivity between people is what is important.

Many experts agree that we are now facing a loneliness epidemic. A global social isolation and loneliness trend has been increasing since the 2010s. The COVID-19 pandemic and the accompanying social distancing, stay-at-home orders and deaths worsened this. Today, loneliness is such a significant global public health concern that in 2023, the WHO launched an international commission on the problem, led by the US surgeon general, Dr Vivek Murthy, and the African Union youth envoy, Chido Mpemba.

The issue is global, as one in four older people experience social isolation in all regions. A recent Gallup poll found that approximately 20 per cent of American adults experience “daily loneliness”, the highest level in two years. The poll also found that Generation Z (those born from the mid-1990s to the early 2010s) might be the loneliest generation. In Britain, according to a study published in the British Medical Journal in 2022, between five per cent to 15 per cent of adolescents are lonely. There also appears to be a global variation, with African adolescents being more affected than those in Europe. Every year, thousands of South Koreans, mostly middle-age men, die alone. It sometimes takes days or even weeks before their bodies are found. There is even a name for the phenomenon: ‘lonely deaths’, or godoska in Korean.

MEN AFFECTED MORE

Men appear to be affected more than women. A YouGov survey carried out in 2019 found that 20 per cent of British men had no close friends, which was twice the rate for women. In the US, in 2021, a study by the Survey Center on American Life found that since 1995, the number of men reporting a lack of close friends increased fivefold, from three per cent to 15 per cent, and the number of men having at least six close friends halved from 55 per cent to 27 per cent. More recently, in 2023, the State of American Men report by non-profit Equimundo found that two-thirds of men age 18-23 felt ‘no one really knows them’. One of the reasons why men are hit harder may have been revealed in a 2017 study by the University of Oxford researchers, where it was found that while women were better able to keep connections alive on phones, men needed one-on-one, in-person interactions to maintain satisfactory relationships.

Understandably, loneliness often leads to depression. But there are other health risks involved. For example, meta-analyses have found that social isolation or loneliness in older adults is associated with a 50 per cent increased risk of developing dementia, a 30 per cent increased risk of coronary artery disease or stroke, and a 26 per cent increased risk of all-cause mortality (a measurement of the number of people who die from any cause within a specific group of people over a given period).

According to Dr Murthy, the health risks associated with loneliness are as bad as smoking up to 15 cigarettes a day and even greater than those associated with obesity and physical inactivity and, according to Mpemba, loneliness “transcends borders and is becoming a global public health concern affecting every facet of health, well-being and development”, adding “social isolation knows no age or boundaries”.

MULTIFACTORIAL

The causes of loneliness are multifactorial. Loneliness can result from living alone, moving to an area where you feel isolated, the end of a relationship, lack of meaningful relationships, the death of a loved one, empty nest syndrome (the grief some parents feel when their children move out of their home), and cultural and even genetic factors. As modernisation continues and technology advances, life has become more fast-paced for many, negatively impacting social connections. More individualistic lifestyles and the use of the Internet as a substitute for in-person social interaction have also contributed to the uptick in loneliness worldwide.

According to Dr Murthy, “Loneliness and isolation represent profound threats to our health and well-being – as individuals and societies. Rebuilding social connection must now be a public health priority… it will require reorienting ourselves, our communities and our institutions to prioritise human connection and healthy relationships.”

Counselling, psychotherapy and other interventions, such as mindfulness meditation and yoga, are of value in managing the afflicted and fighting the pandemic. Helping people strengthen their existing relationships and build new ones and identifying and visiting shut-ins will also help. In some countries, such as the US, professional cuddlers use platonic touch therapy to assist adults battling loneliness, intimacy issues and anxiety. In Seoul, city authorities recently announced they would spend 451.3 billion won (nearly US$327 million) over the next five years to “create a city where no one is lonely”, utilising hotlines, online platforms, and in-person consultations.

We must take loneliness seriously. It is not benign.

Michael Abrahams is an obstetrician and gynaecologist, social commentator, and human-rights advocate. Send feedback to columns@gleanerjm.com and michabe_1999@hotmail.com, or follow him on X , formerly Twitter, @mikeyabrahams.