Much has been written about the link between loneliness on health. It’s an issue that has attracted increasing attention, including from the World Health Organisation which recently launched an international commission on the problem.
But one question has always proved difficult to untangle. Is it really loneliness that causes poor health (and an earlier death) – or does poor health cause loneliness?
One theory is that maybe loneliness doesn’t impact our life expectancy at all. It could just be that the same poor health that leads to an early death also happens to cause loneliness.
Well, a major study has gone some way to unravelling this particular ‘chicken and egg’ problem and has shown that loneliness can indeed significantly increase the risk of dying earlier in life.
The study aimed to determine whether loneliness has a causal effect on all-cause mortality. Unlike many previous studies, which often relied on loneliness or health data collected at one point in time, this research took several measurements at different times over 18 years. They then used advanced statistical methods that allowed them to unravel cause and effect.
The data from over 11,000 women aged 45+ showed that the more often someone felt lonely, the higher their risk of death during the study period. Women who reported feeling lonely in two different years were nearly 50% more likely to subsequently die during the study period. Those who felt lonely in six different years had more than triple the risk.
Of course, it still undoubtedly true that poor health does raise the risk of loneliness. This will be particularly true if our health problems seriously limit our ability to engage in social activity, work or generally interacting with other people.
But these findings confirm that loneliness is not just a fleeting emotional consequence of poor health. Rather, it’s a serious cause of poor health and mortality in its own right.
So how does this happen? Through what process does loneliness, which is by nature a psychological state, have such a significant impact on physical health?
The first answer is that loneliness directly damages physiological systems. For example, a recent study found that loneliness is associated with changes in proteins that are linked to cardiovascular disease, type 2 diabetes, stroke, and early death.
Second, loneliness can have an indirect effect on our health, through its effect on our behaviour. For example, several studies have shown a link between loneliness and unhealthy diets while others have suggested loneliness increases the likelihood of starting smoking and difficulty quitting.
Whatever the process, the evidence is clear. Loneliness is a significant public health issue that we really need to prioritise as a society.
In an earlier blog I’ve suggested that health professionals should be routinely asking patients about loneliness and signposting to sources of support. I honestly believe that if we can pluck up the courage to ask patients if they feel lonely, it may be the most impactful and beneficial conversation we ever have with them.
But it’s not just about health professionals. In a recent article for The MJ, I made the case for local government investing in community-based programmes that can tackle loneliness, as well as the social isolation that so often goes with it.
Finally, maybe we can all challenge ourselves to make a difference. In an increasingly divided and isolated society, surely everyone has a role in tackling loneliness? If someone we know is feeling lonely, reaching out could be more than kind – it could be lifesaving.
