A Loneliness Epidemic among Older Americans
Master’s Student in Epidemiology
According to the American Psychological Association, more than 42 million American adults say they feel lonely. When loneliness becomes a lifestyle, it can have a profound effect on health and can lead to increased levels of stress hormones as well as a heightened risk for heart attack and stroke, dementia, and death.1
When loneliness becomes a lifestyle, it can have a profound effect on health and can lead to increased levels of stress hormones as well as a heightened risk for heart attack and stroke, dementia, and death.
Chronic loneliness can lead to psychological illnesses that manifest as physical symptoms and more visits to the doctor's office. In fact, the AARP Public Policy Institute estimates that social isolation is associated with $6.7 billion in additional Medicare spending.2
Health care professionals see loneliness as not only an emerging public health hazard, but an epidemic. Despite this, the US does not have policies to address this burgeoning epidemic at a national level.
Social relationships are key to healthy aging and maintaining good health. Social connections benefit health by providing the psychological resources important for coping with difficult situations.
What Are Other Developed Countries Doing to Combat the Loneliness Epidemic?
The United Kingdom, like the US, has a growing elderly population. In 2016, 20 percent of its residents were over the age of 65.3
In 2001, the UK adopted the National Service Framework for Older People that offered cultural and institutional programs funded by tax revenue to meet the needs of older adults. The elderly reported satisfaction with the social care and support services they received and appreciated feeling like they were equal partners in the process of their care.
The framework encouraged aging in place—or providing adequate resources to the elderly so that they could continue residing in their homes. Some of the resources included home care services like providing a visiting nurse or a home helper and day care facilities.
In 2018, the UK appointed a Minister for Loneliness who has since been working to expand Shared Lives, a British home-sharing program matching older adults struggling with loneliness with young people needing somewhere to live, and Men's Shed, an organization that has opened more than 400 communal sheds to connect retired or unemployed men through activities like woodworking and repairing electronics.4
Japan's aging demographic also presents unique challenges. A quarter of the Japanese population is 65 or older and the population is declining due to plunging birth rates.5 In 2016, the aging population, combined with the decline in working-age adults, were identified by the prime minister as "the root of the obstacles in economic growth."
At the national level, the Ministry of Health, Labor and Welfare and the Ministry of Finance support programs targeted at tackling social isolation and loneliness at local levels.6
A notable effort in Japan is the subscription-based Watchover Service, run by the government-owned company Japan Post, which leverages the network of post offices and their staff to provide support services for the elderly by monitoring their wellbeing and reporting back to the older adults' families. People can subscribe to receive hour-long visits or daily check-ins from the postal employees. In 2015, IBM and Apple joined Japan Post to connect older adults to services through iPads and wireless technology.7
The US needs a shift in policy that makes scalable solutions a priority with consolidated efforts to define assessment criteria for social isolation and loneliness in medical practice at a national level.
What Can the US Do?
There are similar programs here in the US, but widespread change cannot occur in isolated pockets through smaller programs at the county or state level. The US needs a shift in policy that makes scalable solutions a priority with consolidated efforts to define assessment criteria for social isolation and loneliness in medical practice at a national level.
The federal government should ensure that social isolation becomes a part of the lexicon of social determinants of health by including it as a social determinant in official documents. Additionally, a change in the mindset of primary care doctors, who would have an obligation to address loneliness as a social determinant of health, would help connect lonely older adults with resources in their communities. At the state level, legislation to ensure funding of programs that support successful integration of older adults in their communities is essential.
Ultimately, recognizing that aging in place is beneficial not only to the elderly and their families but also to society is key to maintaining the richness of our social fabric.
- Valtorta, Nicole K., Mona Kanaan, Simon Gilbody, Sara Ronzi and Barbara Hanratty. "Loneliness and Social Isolation as Risk Factors for Coronary Heart Disease and Stroke: Systematic Review and Meta-Analysis of Longitudinal Observational Studies." PMC - U.S. National Library of Medicine. National Institutes of Health. Heart. Vol. 102, No. 13, pp. 1009–1016. April
- Lynda Flowers, Ari Houser, Claire Noel-Miller, Jonathan Shaw, Jay Bhattacharya, Lena Schoemaker and Monica Farid. "Medicare spends more on Socially Isolated Older Adults." AARP Insight on the Issues. November 2017
- United Nations, Department of Economic and Social Affairs, Population Division. "World Population Aging 2015." 2015.
- Jo Cox Commission on Loneliness "Combating Loneliness one Conversation at a time - A call to action" 2017.
- "Loneliness increases risk of seniors' premature death by 14%, physiological study finds." The Japan Times. November 24, 2015.
About the Author
A master's student studying Epidemiology, Vidhi Verma is a licensed family medicine physician from Dubai. She is currently researching the factors that influence traditional waterpipe use among US born and non-US born Arab Americans in the Detroit metropolitan area. She is interested in the effects of race and ethnicity on mental health disparities, specifically timely access to medical care.