Social Isolation and Loneliness ~ Major Health Risks

 

Although loneliness and social isolation are health and social issues that can be addressed, assessed, and mitigated, they rarely are. If you smoke fifteen cigarettes daily, does that put your health at risk? Absolutely! That is the equivalent health risk of loneliness and social isolation. Other risk factors include dementia, cancer, cardiovascular disease, high mortality, and suicide. While social isolation and loneliness are often discussed in tandem, they are two separate concepts.

Loneliness has been described as a sad or unpleasant feeling. Being disconnected. “Loneliness is the feeling of being alone, disconnected, or not close to others,” according to the CDC (2024).  Although they may be surrounded by people, they feel alone. The quality of connections matter. Some people have lots of contacts and friends, but they remain lonely. Conversely, social isolation is most often caused by diminished opportunities for socializing. According to the CDC (2024), “Social isolation is not having relationships, contact with, or support from others.” Think of a homebound older adult or a person with dementia without social supports or family.

Older adults are at higher risk, especially those with mobility constraints. Unfortunately, loneliness is minimized or ignored by the medical and mental health community. They avoid discussing it with clients and the majority do not screen for it. The Canadian National Institute on Aging Survey showed that 40% to 50% of older adults are “lonely” and 18% are “very lonely.” In the United States, 33% of adults reported being lonely, while 25% reported being socially isolated (CDC, 2024).

The world is hugely connected but since the 1980s, but loneliness has doubled. The solution? It is not a “one size fits all.” We need to understand the cause and scope of the problem and then figure out a solution. Former Surgeon General Dr. Vivek H. Murthy (2015-2017, 2021-2025) stated that loneliness is a health emergency. The CDC has created a website (shown below) with strategies for combating social isolation and loneliness. Canadians are addressing this crisis by creating the Canadian Institute for Social Prescribing, where workers are trained to be links to help families and individuals connect with the community. Screening for it in mental health and medical settings is encouraged and the most widely assessment tool, developed by psychologist Daniel Russell, is widely used and highly reliable (see link below).

Introverts report needing less interaction than extroverts. Some people like solitude for relaxation, decompressing, and tapping into their creativity. American social psychologist and neuroscientist Dr. John Cacioppo developed the EASE program, which has been adopted by the National Alliance on Mental Illness to combat loneliness. The acronym stands for Extend, Action Plan, Selection, and Expect results. The program includes extending yourself, creating an action plan, identifying opportunities for interaction, and expecting success even if it feels awkward. Adopting a dog and walking it allows for more interactions but that is not for everyone. Other strategies are getting at least 150 minutes of physical exercise weekly, volunteering, and intergenerational programs.

Demographics and geography impact loneliness. The young-old (ages 65-74) report more loneliness. Women report more loneliness, attributed to there being more widows than widowers. The LGBTQ community has high rates of loneliness. Urban dwellers are lonely, while rural residents have lower rates, as smaller communities are more connected.

The key is to gradually start building new connections and cultivate good people around you. Laugh. Talk to friends on the phone instead of texting. Join a gym, attend cultural events, or volunteer. Do it for maintaining optimum mental and physical health. More later, readers! AgeDoc

References:

Canadian Institute for Social Prescribing [CISP] (2025). https://www.socialprescribing.ca/

 

CDC. (May 15, 2024). Health Effects of Social Isolation and Loneliness. https://www.cdc.gov/social-connectedness/risk-factors/index.html

 

Morris, K. (June 13, 2018). Combating Loneliness with EASE. https://www.nami.org/bipolar-depression/combating-loneliness-with-ease/

 

Office of the Surgeon General (OSG). (2023). Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. US Department of Health and Human Services.  Download here: Our Epidemic of Loneliness and Isolation

 

Samtani, S., Mahalingam, G., Lam, B. C. P., Lipnicki, D. M., Lima-Costa, M. F., Blay, S. L., Castro-Costa, E., Shifu, X., Guerchet, M., Preux, P. M., Gbessemehlan, A., Skoog, I., Najar, J., Rydberg Sterner, T., Scarmeas, N., Kim, K. W., Riedel-Heller, S., Röhr, S., Pabst, A., Shahar, S., … (2022). Associations between social connections and cognition: a global collaborative individual participant data meta-analysis. The lancet. Healthy longevity, 3(11), e740–e753. https://doi.org/10.1016/S2666-7568(22)00199-4

 

UCLA Loneliness Scales:

Three-Item UCLA Loneliness Scale and Revised UCLA Loneliness Scale
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A Short Scale for Measuring Loneliness in Large Surveys: Results From Two Population-Based Studies. Research on aging, 26(6), 655–672. https://doi.org/10.1177/0164027504268574
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2394670/
(See Table 1, Page 11)