Findings published this week in the journal Heart demonstrate that loneliness and isolation are as serious a risk factor for stroke and heart disease as anxiety and a stressful job. The findings open a debate about how society and the medical community should respond.
Physical inactivity and obesity are well-known risk factors for a reduction in lifespan.
Researchers have uncovered a wealth of information on how those, and other common factors, directly impact health and longevity.
Loneliness and isolation, however, appear to be just as destructive to an individual's health, but little research has been launched to investigate the scope of their influence.
Early research has provided a basic framework to explain how a person's social relationships (or lack thereof) can impact their health.
The factors are essentially split into three headings:
- Behavioral: health-risk behaviors related to loneliness and isolation, including increased sedentary behavior and smoking
- Psychological: loneliness is linked to lower self-esteem, depression and sleep problems
- Physiological: isolation and loneliness has been linked to a reduced immune response and higher blood pressure.
Existing research shows that isolation can lead to premature death, and as such, addressing loneliness could be of huge benefit to public health and well-being at large.
The current study, conducted by Dr. Nicole Valtorta at the Department of Health Sciences, University of York, UK, set out to understand loneliness and its consequences for health in more detail.
Dr. Valtorta and her team specifically investigated the links between deficiencies in social relationships and the incidence of coronary heart disease and stroke, two conditions that are the greatest cause of disease burden in the Western world.
Loneliness, isolation and premature death
The researchers trawled through previous studies and collated relevant data, which they combined into one large sample. In total, the team unearthed data for 181,000 individuals. This included 4,628 coronary heart disease events and 3,002 strokes.
Although loneliness is known to play a significant role in premature mortality, the results highlighted a surprisingly pronounced effect.
Loneliness and social isolation was associated with a 29% increase in coronary heart disease and a 32% increased risk of stroke.
These effect sizes are comparable to other recognized risk factors such as anxiety and a stressful job. The impact was equivalent to that of light smoking and greater than that of obesity and hypertension. The authors say:
"Our work suggests that addressing loneliness and social isolation may have an important role in the prevention of two of the leading causes of morbidity in high income countries."
The authors are quick to note that the study is observational and cannot, therefore, prove cause and effect: did the loneliness produce the disease, or did the disease bring on the loneliness?
Future interventions in isolation?
More research is, of course, necessary, but against this rather stark backdrop, loneliness is certainly a facet of the human experience that deserves further investigation.
The Heart article is published alongside an editorial, written by Dr. Julianne Holt-Lunstad and Dr. Timothy Smith of Brigham Young University, UT. They argue that loneliness should become part of medical training and enter policy with official guidelines and the introduction of risk assessments for individuals who might be in the most isolated situations.
The editorial pays particular attention to the role of technology in the modern world, they say:
"With such rapid changes in the way people are interacting socially, empirical research is needed to address several important questions. Does interacting socially via technology reduce or replace face-to-face social interaction and/or alter social skills?
Given projected increases in levels of social isolation and loneliness in Europe and North America, medical science needs to squarely address the ramifications for physical health."
Medical professionals have already taken a justifiably strong stance on other health factors such as healthy eating, smoking and alcohol consumption, perhaps it is time for the health care industry to directly address the prevention of loneliness.
The study's findings prompted a response from the Local Government Association's Community Wellbeing spokeswoman, Izzi Seccombe, who said:
"With more than 1 million people aged over 65 believed to be suffering from loneliness, councils with their responsibility for public health see this as a major concern. [...] Loneliness is an issue that needs our urgent attention, and something that will become an increasingly important public health concern as people live longer lives."
On the surface, the take-home message is a bleak one, but it is better that we uncover the influence of reduced social interaction now so that going forward, we can strive to rectify the shortfalls.
Adding fuel to the fire, Medical News Today recently covered research showing that loneliness can alter the immune system and cause illness.