Loneliness is a public health issue: Let's tackle it together
Lindsay Kobayashi
Associate Professor, Epidemiology and Global Public Health
If you’re feeling lonely, you’re not alone. Recent surveys have found that approximately half of U.S. adults report experiencing loneliness, with some of the highest rates among young adults. In 2023, US Surgeon General Vivek Murthy issued an advisory that highlighted an epidemic of loneliness in the US.
What exactly is loneliness?
Loneliness is the psychological experience of a lack of social connections. It's the way you feel when your social relationships don't match what you would ideally want them to be. This is different from social isolation—a crucial distinction many people miss. You can be surrounded by people and still feel lonely, or be alone and feel completely content.
Anyone can be vulnerable to loneliness—it's a common aspect of the human experience that changes over time. During the COVID-19 pandemic, we saw something particularly interesting: Younger groups, including teenagers and young adults, were most likely to experience loneliness. However, when it comes to the health effects of loneliness, older adults face the most significant consequences.
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The health consequences of loneliness
Loneliness has profound health implications. Over the last couple decades, a robust body of evidence has linked loneliness to a range of health conditions, from physical and cognitive decline during aging to cardiovascular health issues, and even an increased risk of death.
In two studies led by my doctoral mentee and University of Michigan School of Public Health graduate Dr. Xuexin Yu, PhD ‘24, we found a dose-response relationship between loneliness and poor health outcomes among middle-aged and older adults. People who experienced loneliness over a longer duration experienced faster memory decline as they aged. In addition, we observed an excess of 288 deaths per 10,000 person-years among those who were consistently lonely over an eight-year period. In other words, if you followed 10,000 people who consistently felt lonely, there would be 288 more deaths within a year compared to the number of deaths that would be expected if those people had not felt lonely.
Factors contributing to loneliness
The factors contributing to the loneliness epidemic are complex and have evolved over time. During the COVID-19 pandemic, we saw how external circumstances can dramatically change our social experiences. Suddenly, many of us weren't able to go out and take part in our usual social activities. Many people are still feeling the aftereffects of social isolation and loneliness during the pandemic.
The internet, digital technologies, and social media play a complicated role in shaping social relationships and how we feel about them. They aren't inherently bad or good, but using social media and the internet as a substitute for building meaningful in-person relationships can lead to more isolation and loneliness.
One factor I find particularly important is our built environment. What do our cities, towns, and communities look like when we go out into the world? In the United States, we generally don't have walkable cities, and there is not a lot of funding support for public spaces where people can spend time together. The more public resources available for spaces to spend time in, the more we can be social and interact with other people in meaningful ways.
A structural approach to healing
The Surgeon General's advisory on loneliness was groundbreaking because it recognized loneliness as a structural issue. The recommendations span from individual interventions to national government strategies. This multi-level approach is crucial because loneliness is often produced by the external circumstances we live in.
I believe the more we feel like a cohesive community—from our immediate local neighborhoods to the national level—the better we can address social isolation. This means investing in:
- Public spaces that encourage interaction
- Community organizations with low financial barriers
- Urban planning that prioritizes human connection
- Support for different social groups and activities
Looking forward
Implementing these recommendations won't be easy. The language in the advisory is intentionally broad because interventions will look different across various contexts and population groups. We currently have evidence for individual-based interventions like support groups and cognitive behavioral therapy, but we lack evidence for structural or community-based interventions to address loneliness.
If you're reading this and you're experiencing loneliness,—or you think you might be experiencing loneliness but you're not sure—I want you to know something important: Although loneliness is common, it can be hard to admit to yourself, let alone to others around you. As humans, we're social creatures, and when you're feeling like you're not being social, it can make you feel bad. If you’re feeling lonely, I encourage you to recognize that feeling, probe why it's there, and think about what you can do to help change it in your life.
Loneliness is not inevitable. It's a modifiable condition, and it's something we can change through intervention. If you're feeling lonely, recognize it, talk about it, and take steps to address it—because if you let it go unchecked for a long period of time, there can be long-term negative effects on your health.
The more that we feel like we are a community, both within our immediate local communities and at broader levels, the better we can address this critical public health challenge.
About the author
Lindsay Kobayashi is an associate professor of Epidemiology and Global Public Health at the University of Michigan School of Public Health. Her research focuses on the social epidemiology of cognitive aging from a global perspective, with an emphasis on health disparities. She investigates social and economic life course influences on cognitive aging, primarily using data from longitudinal studies of aging, including older populations across the globe. an associate professor of epidemiology at the University of Michigan School of Public Health. Her research primarily focuses on the effects of air pollution and noise on healthy aging, with additional interests in global health, extreme weather events, and intervention strategies to improve health.