Silent Epidemic? WHO Declares Loneliness Global Public Health Threat

Loneliness, once perceived as a challenge limited to developed nations, has now been elevated to the status of a pressing global health threat by the World Health Organization (WHO). The gravity of this issue has been likened to smoking 15 cigarettes a day by the US Surgeon General, Dr Vivek Murthy. This declaration comes in the wake of the COVID-19  pandemic, which not only disrupted economic and social activities but also heightened the levels of loneliness across the globe.

To combat this pervasive issue, WHO has initiated an International Commission led by Dr Vivek Murthy and Chido Mpemba, the African Union youth envoy. This commission, comprising 11 advocates and government ministers from diverse backgrounds, including Ralph Regenvanu from Vanuatu and Ayuko Kato from Japan, is poised to address loneliness on a global scale. The commission's mandate extends over three years, emphasizing its long-term commitment to tackling this profound challenge.

Dr Murthy dismantles the misconception that loneliness predominantly affects specific demographics, revealing that one in four older people globally experiences social isolation. This realization demands a reevaluation of the narrative surrounding loneliness, recognizing it as a universal challenge rather than a localized issue.

The Loneliness Curve

In a groundbreaking study featured in the esteemed journal Psychological Science, researchers have shed light on a fascinating phenomenon: the loneliness curve. Contrary to conventional wisdom, loneliness doesn't follow a straight path; instead, it takes the shape of a U, weaving through the lives of people from all walks of life. Beginning in the turbulent phase of young adulthood, when the search for identity clashes with societal standards, loneliness develops as an enormous challenge. However, when individuals find their way through the hurdles of midlife, they experience a moment of respite characterised by a decrease in reported loneliness. However, this respite is brief, giving rise to a recurrence of loneliness in later life, especially around the age of 80. So, why do we experience this rollercoaster of emotions?

Experts like Dr Eileen K. Graham from Northwestern University Feinberg School of Medicine, reported by The New York Times, say that social connections play a big role. When we're in our prime adult years, we're often surrounded by friends, family, and coworkers, which can help stave off feelings of loneliness. But as we get older, those connections can start to fade away, leaving us feeling isolated and alone.

In the study, which examined data waves spanning several decades, beginning in the 1980s and ending in 2018, participants at either end of the age spectrum were more likely to agree with statements such as "I miss having people around me" or "My social relationships are superficial."

Surgeon General Murthy compares social interaction to a muscle that needs regular exercise. When we don't use our social muscles enough, they start to weaken, making it even harder to connect with others. With so much of our communication happening through screens these days, it's easy to see how our social muscles might be getting a little flabby.

The International Commission Initiative

As Chido Mpemba aptly states, "Loneliness transcends borders and is becoming a global public health concern affecting every facet of health, wellbeing, and development." 

Dr Murthy's analogy is striking: loneliness poses mortality risks comparable to the act of smoking, "Loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day and even greater than that associated with obesity and physical inactivity. And the harmful consequences of a society that lacks social connection can be felt in our schools, workplaces, and civic organizations, where performance, productivity, and engagement are diminished."

Loneliness Across Age Groups

Impact on Older Adults

The Gallup survey reveals that older adults, aged 65 and above, report the lowest levels of loneliness, with only 17% feeling very or fairly lonely. This challenges the stereotype that associates loneliness predominantly with the elderly. Surprisingly, the majority of those aged 45 and older report not feeling lonely at all.

Yet loneliness can't be overlooked, and it's not just a psychological burden for the elderly; it is a tangible threat to their health. Studies indicate a 50% increased risk of dementia and a 30% increased risk of coronary artery disease or stroke among lonely older adults. The implications are clear: loneliness is not solely an emotional struggle but a critical factor in the deterioration of physical health, particularly in the elderly.

Plight of the Youth

Contrary to popular belief, loneliness is not exclusive to the elderly. Young adults, aged 19 to 29, emerge as the demographic facing the highest rates of loneliness, with 27% feeling very or fairly lonely. This sheds light on the often-overlooked challenges faced by the younger generation in establishing meaningful social connections.

Adolescents, between 5% and 15% of them, grapple with loneliness, with rates varying across continents. In Africa, where the majority of the population is comprised of young people, the challenges around peace, security, climate crises, and high unemployment rates contribute significantly to social isolation. Loneliness among young people is not only a precursor to mental health issues but also has repercussions on education and employment outcomes.

The impact of loneliness extends beyond the emotional realm into education and employment. Young individuals experiencing loneliness at school face a higher likelihood of dropping out of university. Moreover, the repercussions spill over into the professional sphere, where feelings of disconnection and a lack of support can lead to decreased job satisfaction and performance.

Gender Dynamics of Loneliness

Loneliness, a silent and pervasive epidemic, touches the lives of more than a billion people globally, constituting nearly a quarter of the world's population. This revelation stems from a recent Meta-Gallup survey encompassing over 140 countries, offering a profound insight into the intricate fabric of societal well-being. What's striking is that these staggering numbers may even underestimate the true scale of the issue, as the survey excludes China, the second-most populous country on the planet.

Globally, rates of reported loneliness show minimal gender differences, with 24% of both men and women indicating feelings of loneliness. However, a closer look at the data reveals substantial gender gaps in specific regions. In 79 countries, self-reported loneliness is higher for women than men, while the reverse is true in 63 countries.

Social Isolation vs Loneliness

The study defines "social isolation" as "an objective lack of (or limited) social contact with other people." This is characterized by a person having a limited social network, infrequent social contacts, or possibly living alone. On the other hand, "loneliness" is described as "a subjective feeling of distress arising when there is a discrepancy between desired and actual social relationships." It is possible to be socially isolated without feelings of loneliness, emphasizing the nuanced nature of these conditions.

Impact of Social Isolation and Loneliness on Mortality

A groundbreaking meta-study, comprising findings from 90 separate studies involving 2,205,199 individuals, sheds light on the intricate relationship between social isolation, loneliness, and mortality.

The study brings forth compelling evidence, indicating that being socially isolated is associated with a staggering 26% increase in the risk of all-cause death compared to individuals who are not socially isolated. While the effect of loneliness is slightly less pronounced, individuals experiencing prolonged loneliness face a 14% higher chance of mortality than their non-lonely counterparts.

The study reveals nuances in the impact of social isolation and loneliness on specific health conditions. For individuals with cancer, both social isolation and loneliness are linked to a higher risk of death. However, for those with heart disease, it is social isolation, not loneliness, that poses a higher mortality risk.

Loneliness is no longer an individual struggle but a global challenge that warrants urgent attention. As WHO's international commission takes on the task of digging into the complexities of loneliness, the world must acknowledge and act upon the underappreciated public health threat that it poses.