A recent press release by the American Psychological Association says, “Loneliness and social isolation may represent a greater public health hazard than obesity, and their impact has been growing and will continue to grow”. Having just finished reading the book Social by Matthew Lieberman, and learning about our fundamental need to connect with other people, I was primed to absorb social psychology research and curious to learn more about this public health issue.
The press release talked about a report which estimated that 35% of adults over the age of 45 in the United States are suffering from chronic loneliness (AARP Research 2010). Going further, the authors found that loneliness was a significant predictor of poor health. They explained, “Those who rated their health as ‘excellent’ were over half as likely to be lonely than those who rated their health as ‘poor’ (25% vs. 55%)”… What? I had to read this sentence over a few times because it wasn’t clear what it really meant.
I was even more confused when I checked the report because the total responses to the question exceeded 100%. I think the study is saying that lonely people were more likely to rate their health as ‘poor’ than ‘excellent’. Although loneliness and poor health being linked makes sense to me, poorly presented statistics do not.
Let’s take a closer look at this study. It was conducted using an online panel of a nationally representative sample of over 3,000 US adults. I was curious about this methodology, having never heard of it before. In the report I noticed that there were no discussions on limitations. After some investigation, it appears that the methodology has both advantages and disadvantages, as with every survey methodology. While an impressive sample size, and a cost-effective method, online panels have limitations including conditioned bias (repeated participation of panel members in similar surveys) and attrition bias (loss of panel members over time) (Warren & Halpern-Manners, 2012; Bosnjak et al. 2016). For this survey, I would also like to add potential for careless responses… imagine yourself doing the online survey, would you respond to 91 questions about loneliness, carefully?
Better evidence presented in the press release were two meta-analyses that explored the impact of social isolation and loneliness on health. A meta-analysis is a statistical approach that combines results from multiple studies and estimates the effect size (the size of a difference between two groups). Here, the effect size would be the difference in the likelihood of death between groups that differ in terms of their social relationships. The first study involved 148 studies, representing more than 300,000 participants, and found that greater social connection is associated with a 50% lower risk of dying (Holt-Lunstad et al. 2010). The second study involved 70 studies, representing more than 3.4 million individuals, found that social isolation, loneliness, and living alone had a significant effect on risk of early death, similar that of obesity (Holt-Lundstad et al. 2015).
According to the author of these meta-analyses, Julianne Holt-Lunstad, there is robust evidence that social isolation and loneliness significantly increases the risk of early death. She says, “With an increasing aging population, the effect on public health is only anticipated to increase… indeed, many nations around the world now suggest we are facing a loneliness epidemic.” These recommendations apply to us in Canada as well, as recent estimates suggest that nearly one in five older Canadian adults are lonely (Statistics Canada 2015).
What is the bottom line? It appears that loneliness is becoming increasingly recognized as a threat to public health, perhaps on par with other well-accepted risk factors of mortality like obesity, and, greater priority should be placed research and resources to tackle this public health issue. I would be interested in seeing more research on younger adults though, given that most of the studies conducted thus far were on older adults.
What are your thoughts, do you think we should be concerned about loneliness? To what extent do you think young adults are lonely?
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