Loneliness and Social Isolation

August 3, 2018 – Volume 28, Issue 28
Do they pose a growing health epidemic? By Christina L. Lyons

Introduction

Emily Wilson, a freshman at the University of Tennessee at Chattanooga (Cover: AP Photo/Chattanooga Times Free Press/Erin O. Smith)  
Emily Wilson, a freshman at the University of Tennessee at Chattanooga, walks among backpacks that exhibit stories of suicide victims on March 22, 2018. The traveling display, part of the Send Silence Packing tour, is designed to raise awareness about suicide. Studies associate loneliness and isolation with increased risk of serious health problems and suicide. (Cover: AP Photo/Chattanooga Times Free Press/Erin O. Smith)

Loneliness afflicts millions of Americans of all ages, and some experts think the problem is getting worse, driven by an aging population, changes in family structure, reliance on technology in place of face-to-face discourse and other forces. Medical studies have associated loneliness with costly physical and psychological ills, and social scientists say it can erode community cohesion and even undermine the nation's commitment to shared values and democratic ideals. Countries such as Japan, China and South Korea report similar problems, and in January British Prime Minister Theresa May appointed the world's first “minister of loneliness” to address the issue there. Some researchers contend that Americans are no lonelier than in past generations, and they say technology can bring people closer together as well as drive them apart. But others argue that psychologists, social workers, medical practitioners and policymakers should treat loneliness and isolation with the same urgency as drug abuse or other major social ills.

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Overview

Paula Dutton experienced a series of life changes that reduced the number of close friends and relatives she could turn to: a cross-country move from her hometown of Philadelphia to Los Angeles, a divorce, the death of both parents. Then she retired.

Suddenly she was alone. Anxiety and depression set in.

“I worked myself into a fever pitch in my loneliness,” Dutton said. After a panic attack that resulted in a call to paramedics, she realized her loneliness might be affecting her health. Once she joined a church and began connecting with a community, she felt calmer.1

Dutton's story is far from unusual. Nearly half of Americans say they “always” or “sometimes” feel alone or left out, and nearly one-fifth feel they have no one to turn to, according to a study released in May by global health insurer Cigna. Young adults ages 18 to 22 were slightly more likely to report feeling lonely than those in other age groups. In addition, about half of those who reported feeling lonely said they were in “fair” or “poor” health.2

The Cigna study is part of a growing body of evidence that loneliness and social isolation afflict millions of Americans and that the problem is associated with costly illnesses, erodes social cohesion and — according to some theories — even exacerbates the nation's partisan political divide, with potential implications for democracy.

Experts have differing theories about what is driving loneliness and isolation, and not all agree that the problem is growing. But there is widespread agreement that psychologists, social workers, medical practitioners and public officials should pay more attention to it.

Young men in New York City (Getty Images/Robert Alexander)  
Young men in New York City use their smartphones while waiting for a clothing store to open in 2017. As social media and the internet dominate American life, some researchers say technology can encourage social interaction while others caution that it can do the opposite. (Getty Images/Robert Alexander)

“Loneliness is a growing health epidemic” in the United States, affecting “people of all ages and socioeconomic backgrounds,” former U.S. Surgeon General Vivek Murthy declared last year.3

And the problem is not confined to the United States. In January, British Prime Minister Theresa May appointed the world's first “minister of loneliness” to address the issue there. “I want to confront this challenge for our society and for all of us to take action to address the loneliness endured by the elderly, by carers, by those who have lost loved ones — people who have no one to talk to or share their thoughts and experiences with,” she said.4

Humans need social interaction and can suffer health consequences without it, says Louise Hawkley, a senior research scientist at the NORC (originally named the National Opinion Research Center), a social research institution at the University of Chicago. “We are deeply social as a species” and “not designed to be solitary survivors,” she says.

Studies have found that loneliness and social isolation are associated with high blood pressure and cardiovascular disease and are risk factors for poor cognitive functioning, personality disorders, Alzheimer's disease and suicide. Some researchers say chronic loneliness poses the same health risk as smoking 15 cigarettes a day and a greater mortality risk than obesity.5

Some psychologists, social workers and others blame the persistence of loneliness on the stresses of modern society and cultural and demographic changes: More Americans today are older, single, living alone, have smaller families and are living far from relatives. Such changes in family and household structure could create diminishing support networks as individuals age, say psychologists and sociologists.6

“We've never been a more isolated society than we are now,” Lenard Kaye, director of the University of Maine Center on Aging, told the Senate Special Committee on Aging last year. “It used to be we had extended families living under the same roof or at least in the same neighborhood or community.”7

Kaye's remark echoed the position of Harvard political scientist Robert Putnam, who said in his landmark 2000 book, Bowling Alone, that American society began to fragment in the 1950s because of cultural changes such as the rise of television, the growing number of women working outside the home and dwindling family sizes. Americans also spend less time today socializing, interacting with neighbors and engaging in civic and religious groups, and more time online, potentially increasing feelings of isolation, experts say.

“Social Isolation epidemic rages on, undermining our democracy,” Putnam tweeted last August, citing an article by Washington Post columnist E. J. Dionne, arguing that Americans’ increased isolation is associated with political partisanship. Living alone, feeling isolated or distrusting others is associated with decreased empathy and could be contributing to the increased political partisanship in the United States, some analysts contend.8

Some researchers say part of the problem stems from modern technology, with Americans spending increasing amounts of time staring at cellphone and computer screens and less time in face-to-face interactions.

Researchers disagree on whether loneliness is on the rise, in part due to the difficulty in identifying who is lonely and who is socially isolated — and whether that isolation in fact leads to loneliness. For example, some experts cite the increase in the number of people living alone — which nearly doubled between 1967 and 2017 — as evidence that loneliness is growing.9

But living alone and being lonely are not the same thing, says Eric Klinenberg, a professor of sociology at New York University and author of the 2012 book Going Solo. Many people who live alone interact with large social networks, he says.

The late John Cacioppo, founder of the University of Chicago's Center for Cognitive and Social Neuroscience and a lead researcher on loneliness for more than 20 years, defined loneliness as the feeling or perception of being isolated and the belief that others cannot be trusted. In the Cigna study, about 54 percent of respondents said they felt no one knew them well, and 56 percent reported feeling like the people around them “are not necessarily with them.”10

Cacioppo saw a connection between societal changes and a lack of support networks. “We no longer live in the same village for generations, which means we don't have the same generational connections,” he said.11

About 55 percent of Americans today are members of a church or synagogue, down from nearly 70 percent in 1970. And the percentage of adults who spend a social evening with a neighbor at least several times a week dropped from 30 percent to 19 percent between 1974 and 2016. Instead, Americans increasingly are engaged online: A quarter of adults say they are “almost constantly” online, up from 21 percent in 2015, according to a January Pew Research Center survey.12

Some experts worry that as the Baby Boom generation ages and the elderly population increases, a growing number of seniors could experience loneliness or isolation, raising health care costs.

A recent study commissioned by the AARP Public Policy Institute found that health care for socially isolated seniors costs Medicare, the federal health insurance program for people over 65, about $6.7 billion a year more than care for individuals who are more connected. Isolated seniors generally are sicker and more likely to be admitted to a nursing home after hospitalization than connected individuals who may have family members to help care for them, the study said.13

Chronic loneliness also leads to more frequent doctors’ visits by older Americans, some medical researchers say.14

The bar graph shows additional monthly Medicare cost, per enrollee, for select conditions.  

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Medicare, the federal health care program for Americans age 65 or older, spends $6.7 billion more a year for enrollees who are socially isolated than for those who are more connected to their communities. The added spending averages $134 a month per socially isolated enrollee. Such enrollees generally are sicker and more likely to be admitted to a nursing home after hospitalization than more-connected Medicare recipients.

Source: “Medicare Spends More on Socially Isolated Older Adults,” AARP Public Policy Institute, November 2017, https://tinyurl.com/y8o6rdjm

Data for the graphic are as follows:

Condition Monthly Cost per Enrollee (in millions)
Diabetes $270
Heart disease $241
High blood pressure $163
Social Isolation $134
Arthritis $117

Steven W. Cole, a professor of medicine and psychiatry and behavioral sciences at the UCLA School of Medicine, and his colleagues have found that when people suffer loneliness, certain genes linked to inflammation become more active and genes related to antiviral responses become less active. And researchers at the University of California San Diego School of Medicine have found evidence that a persistent perception that one's social network should be larger than it is — a so-called loneliness trait — can be inherited.15

Social and health experts say the loneliness problem warrants greater attention in the United States. Meanwhile, as scientists, health experts and policy analysts debate loneliness, these are some questions they are asking:

Is the United States facing an epidemic of loneliness?

In declaring loneliness “a growing health epidemic,” Murthy, the former surgeon general, cast a wide net. The problem afflicts middle and high school students in urban and rural areas who turn to “violence, drugs and gangs to ease the pain of their loneliness,” he said. It also torments parents who isolate themselves due to the shame of having lost children to drug overdoses, he continued. And, he said, it affects many people who feel alone at work, including half of the nation's CEOs.16

“In times of stress, you hope that people will come together and support each other,” Murthy said. But while traveling the country as surgeon general, “I found that there were a growing number of people who were saying that they felt profoundly alone.”17

But scholars continue to debate whether the problem of deep-seated, chronic loneliness that can cause health problems is even growing, let alone whether it has reached crisis or epidemic proportions.

Murthy said loneliness has “doubled since the 1980s” but did not cite specific data. The University of Chicago's Cacioppo said his research showed that in 2016, about 26 percent of survey respondents said they “regularly” or “frequently” felt lonely, up from between 11 and 20 percent in the 1970s and '80s.18

But other researchers say loneliness studies are difficult to analyze because loneliness is a subjective feeling that is hard to measure or even define.

UCLA researchers devised a Loneliness Scale in 1978 to provide some uniformity in surveys. It allowed participants to rate on a four-point scale how they felt about each of 20 statements, such as “There is no one I can turn to” and “No one really knows me well.”19 However, researchers often do not use the same sets of questions or answers from the scale, Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University in Utah, says, so results are difficult to compare.

In addition, identifying the subjective feeling of loneliness can be challenging because some individuals — especially men — may not respond accurately to surveys for fear of being stigmatized, NORC's Hawkley says. And adolescents may be more inclined to rate their feelings based on a recent social episode or based on the number of friends they have, many researchers say.

Thus, some researchers prefer to examine hard data that they can measure, such as the number of Americans living alone, the size of families or how often someone has friends or family over for dinner.

But New York University's Klinenberg says just because someone lives alone does not mean they are lonely or socially isolated. In fact, he says, many people who live alone have larger social networks than married people, he says.

Claude S. Fischer, a professor of sociology at the University of California, Berkeley, and author of the 2011 book Still Connected, says people are as socially connected as ever and “are just as lonely as they ever were.” People may have fewer relatives today than in the past, he says, but they may be more involved with nonrelatives.

And while fewer people may be hosting dinner parties, he says, they may be meeting for meals outside of the home instead. His research shows that the percentage of Americans who entertained at least monthly fell from about 40 percent in 1980 to less than 20 percent by the 2000s, but the percentage of people who said they spent a lot of time visiting friends changed little.20

He says claims of a loneliness crisis or epidemic have surfaced before, often during periods of rapid social and technological change. Such claims have been recurring since 1950, Fischer says, typically following publication of a major book or study that raises public awareness.

Klinenberg is similarly skeptical. He says studies that show a spike in loneliness “are almost never peer reviewed,” and the wording of many surveys is too imprecise to detect whether an individual is chronically lonely or just experiencing a fleeting feeling of loneliness. “Some surveys measure loneliness based on whether a respondent said they had felt they had no one to talk to at any time in the previous six months,” he says. “But that's tapping into an experience that is extremely common.”

“Basically, Americans are just as socially isolated … and just as lonely as they have been for decades,” Klinenberg says. “That doesn't mean there isn't a problem. I just don't know why we need to say it is increasing.”

The bar graph shows the percentage of Americans experiencing feelings associated with loneliness.  

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A third or more of U.S. adults experience feelings of loneliness or isolation at least some of the time, according to a survey by Cigna, a health services organization. More than half said they sometimes or always feel as though no one knows them well, and 46 percent reported sometimes or always feeling alone.

Source: “Cigna U.S. Loneliness Index,” Cigna, May 2018, p. 4, https://tinyurl.com/y6ue3pv6

Data for the graphic are as follows:

Feeling of Respondents Percentage Who Always Experience Feelings of Loneliness Percentage Who Sometimes Experience Feelings of Loneliness Percentage Who Rarely Experience Feelings of Loneliness Percentage Who Never Experience Feelings of Loneliness
Interests and ideas are not shared by those around you 9% 50% 34% 7%
People are around you but not with you 10% 46% 33% 11%
Feel shy 11% 45% 31% 13%
No one really knows you well 13% 41% 33% 13%
Left out 8% 38% 39% 15%
Alone 10% 36% 37% 17%
Lack companionship 10% 34% 34% 23%
Relationships are not meaningful 7% 36% 39% 18%
Isolated from others 8% 35% 37% 20%
No longer close to anyone 8% 31% 35% 26%
There is no one you can turn to 7% 29% 36% 28%

Fischer argues that statistics show Americans are less transient today than in the past, helping them to maintain long-term friendships and relationships. Migration rates have been declining steadily since 1948, according to a U.S. Census Bureau survey, reaching an historic low in 2016, when 11.2 percent of the U.S. population had moved in the previous year — half the 20.2 percent rate in 1948.21

UCLA's Cole says surveys have not been conducted over a long enough period to determine whether the number of lonely people has increased significantly. Nevertheless, he says, he believes “there's a bit of an epidemic” of loneliness because of cultural changes that are “changing the rate at which [people] interact with each other.”

Holt-Lunstad says statistics and surveys show shrinking social networks — the number of friends and family people can rely on — so social disconnection is rising and posing a health risk, regardless of whether more Americans say they are lonely.

Such statistics, combined with those indicating the number of people living alone and marital status, are very “crude indicators” of a lack of social connection or loneliness, she says, but they are “robust indicators of risk,” because they indicate a lack of a social safety net.

Does technology increase loneliness?

Cornell University freshman Emery Bergmann struggled with loneliness last fall, and whenever she got on social media it made her think everyone except her was having a great time at college.22

Her feelings correlated with several studies, including a March 2017 study by researchers at the University of Pittsburgh Schools of the Health Sciences, that found that the more time young adults use social media, the more likely they are to feel socially isolated.

While technology — including the internet, smartphones, computers and video games — dominates Americans’ social and work lives today, sociologists disagree over whether its use worsens or improves loneliness or social isolation.

Elizabeth Miller, a professor of pediatrics at the University of Pittsburgh, said of the 2017 study, “We do not yet know which came first — the social media use or the perceived social isolation.” Young adults who felt isolated may have turned to social media, she said, or high social media use may have made them feel isolated. “It also could be a combination of both.”23

Jean Twenge, a San Diego State University psychology professor and author of iGen, has been studying technology's impact on the generation born between 1995 and 2012 (which she calls iGen), who have come of age since smartphones became ubiquitous. The internet and, especially, the smartphone have led this generation of young people to spend far less time than previous generations interacting in person with friends — with dire consequences, she said.

“Rates of teen depression and suicide have skyrocketed since 2011,” she wrote in The Atlantic last September. “It's not an exaggeration to describe iGen as being on the brink of the worst mental health crisis in decades. Much of this deterioration can be traced to their phones.”24

However, loneliness has been declining among young adults, according to Sara Konrath, an associate professor of philanthropic studies at Indiana University in Indianapolis and director of the university's Interdisciplinary Program on Empathy and Altruism Research, a research lab studying motivations and behaviors relevant to philanthropic giving and volunteering. “Young people may be more socially isolated, but they are becoming less lonely,” she says, citing a 2014 study of high school and college students.25

Employees play pool on Jan. 3, 2018, at the Assemblyon2 common space (Getty Images/Bloomberg/Adam Glanzman)  
Employees play pool on Jan. 3, 2018, at the Assemblyon2 common space in a Boston office building. Some companies are providing more space for workers to relax and interact. Researchers say such amenities not only help attract talent but also can reduce isolation and foster greater social connectedness. (Getty Images/Bloomberg/Adam Glanzman)

Because of their instant access via smartphones or social media, she says, young people may feel surrounded by people, and they may communicate more with their parents than in the past. She instead attributes mental health problems among young adults to high stress levels and a greater emphasis on success.

A 2012 study by a University of Arizona psychology professor and a doctoral candidate at the University of Berlin in Germany concluded that posting frequent status updates on Facebook tends to reduce loneliness because it helps individuals feel more connected to their friends, regardless of whether the friends respond.26

Some researchers say social media can have a beneficial effect on community participation and social networks by helping people maintain long-distance friendships. Keith Hampton, a professor of media and information at Michigan State University, said technology allows people to maintain relationships that in the past might have fallen by the wayside as people went to college, moved or changed jobs. “Now … ties stick with us,” he said, and people are “gaining a more diverse social network.”27

A new study by the Pew Research Center found that about half of Americans have engaged in some form of political or civic-minded activity through social media in the previous year.28

Many psychologists and health care providers worry that excessive use of entertainment technology, such as video games, can isolate users and lead to loneliness or even a form of addiction. Yet, studies about gaming produce conflicting results.

The Hazelden Betty Ford Foundation, which operates addiction treatment centers, said teens addicted to gaming can have “feelings of isolation, extreme anxiety and depression” when not gaming. However, a recent survey on the use of electronic gaming found that more than half of gamers ages 14 to 21 considered friendship an essential part of playing.29

Technology also appears to help those who have difficulty socializing. A study published in February by Martin Sundberg, a psychology professor in Budapest, Hungary, found that adolescents and adults with autism spectrum disorder who participated in low to moderate online gaming were less lonely and had more friends than nongamers.30

Robert Pietrzak, an associate professor of psychiatry at the Yale University School of Medicine, says technology also can help address loneliness among military veterans, especially those suffering from post-traumatic stress disorder (PTSD). Health care providers are encouraging veterans and their families to use electronic applications, such as PTSD Coach Online and PTSD Family Coach, to create social connections and help families understand what their loved one may be going through.

The effects of technology on loneliness and social isolation are a mixed bag, says Konrath. “It could be good or bad or both,” she says. “And it's hard to lump all technology together. It's changed the way people interact socially, but we don't know the long-term effects of that, so it's an area ripe for research.”

Can federal policies help decrease loneliness?

Some researchers say policymakers and government leaders should help address the problem of loneliness, particularly because of its effects on health care costs and economic productivity.

In an article in the American Psychologist journal last September, Brigham Young's Holt-Lunstad, Theodore F. Robles of UCLA and David A. Sbarra of the University of Arizona urged the Centers for Disease Control and Prevention (CDC) to focus more resources on researching the scope of loneliness in the United States, educating the public about the health consequences and developing effective interventions and public health policies.31

Holt-Lunstad says medical providers should be required to include information about patients’ social networks or levels of isolation in their electronic health records, which the National Institutes of Medicine recommended in 2014. “Then they can identify those who are at risk and make some referrals or recommendations,” she says, enabling loneliness problems to “be caught early and preventative efforts taken.”

NORC's Hawkley also says public health care policies should address loneliness — particularly given the rising concern about the problem among young people and the relationship between social media use and bullying, which can cause a young person to feel socially isolated.

The line graph shows the percentage of U.S. adults living alone from 1970 through 2017.  

Long Description

The share of American adults living alone nearly doubled over the past 50 years, to about one in seven. About 20 percent more women live alone than men, and adults ages 35–65 are most likely to live alone.

Source: “Table AD-3. Living Arrangements of Adults 18 and Over, 1967 to Present,” Historical Living Arrangements of Adults, U.S. Census Bureau, Current Population Survey, Annual Social and Economic Supplement, November 2017, https://tinyurl.com/y735t6lc

Data for the graphic are as follows:

Year Percentage of U.S. Adults Living Alone
1970 8.6%
1971 8.8%
1972 9.2%
1973 9.3%
1974 9.7%
1975 9.9%
1976 10.4%
1977 10.7%
1978 11.2%
1979 11.4%
1980 11.6%
1981 11.8%
1982 11.9%
1983 11.7%
1984 11.9%
1985 12.2%
1986 12.3%
1987 12.2%
1988 12.5%
1989 12.7%
1990 12.8%
1991 13.0%
1992 13.1%
1993 12.6%
1994 12.5%
1995 12.9%
1996 12.9%
1997 13.0%
1998 13.3%
1999 13.3%
2000 13.3%
2001 13.6%
2002 13.7%
2003 13.9%
2004 13.8%
2005 13.9%
2006 13.9%
2007 14.0%
2008 14.3%
2009 13.9%
2010 13.7%
2011 14.2%
2012 14.1%
2013 14.2%
2014 14.3%
2015 14.4%
2016 14.5%
2017 14.3%

Federal lawmakers also could help, some contend. For example, Congress last year passed a law, sponsored by Sen. Elizabeth Warren, D-Mass., and incorporated into the Food and Drug Administration Reauthorization Act, to make some hearing aids — which are not covered by insurers or Medicare — available over-the-counter. Passage came after several witnesses testified before the Senate Committee on Aging that untreated hearing loss may contribute to loneliness, potentially increasing the risk of serious illnesses.32

Former Surgeon General Murthy said government and the health care system should help increase understanding of the impact of loneliness, identify who is affected and determine which interventions work. However, he added, local resources — families, schools, social groups and workplaces — are more crucial to helping solve the problem than the federal government.33

New York University's Klinenberg says local government could play a role by considering the impact of zoning decisions on loneliness. “If we're concerned about our capacity to build relationships and deal with polarization and segregation, we need to invest in social infrastructure, or places that facilitate social ties,” he says.

In a forthcoming book, Palaces for the People (2018), Klinenberg argues that shared spaces such as libraries, childcare centers, bookstores, churches, synagogues and parks can encourage people to socialize and make friends — expanding their social networks and breaking down barriers that lead to social isolation and political partisanship.

Konrath agrees. Schools, for instance, can have a “friendly drop off area” where parents can sit on benches and feel welcome to linger and talk. And museums and libraries could offer places for socializing. The Pew Research Center found that people who use libraries tend to be more sociable and active in community events and activities.34

George S. Sigel, program director at the South Boston Behavioral Health Clinic and a clinical professor of psychiatry at Tufts University, meets with a group of other psychiatrists who discuss how to help people who are lonely. But they are moving incrementally, beginning with pushing for a state bill to enable people to keep their existing medical providers if their insurance changes — which could ensure that they can continue to see a mental health provider who is helping them overcome loneliness-related issues, for instance.

But neither public policies nor community institutions can force people to socialize, say Sigel, NORC's Hawkley and others. “People can choose to be alone,” Hawkley says. “You cannot choose their social life. Losing that sense of autonomy can play a role in how [individuals] feel.”

Sigel says the challenge is to help lonely people change their unrealistic beliefs that others cannot be trusted or do not want to socialize with them. Likewise, Cacioppo found that helping lonely people change how they think about other people can be effective.35

Fischer agrees that public policy could help address loneliness and social isolation. But he worries “that attention to this kind of subjective psychological stuff is a distraction,” he says.

“That doesn't mean I think it's unimportant,” he adds. “But compared to the important structural issues of employment and health care, economic inequality and so forth — worrying about happiness, loneliness, angst of various kinds, alienation … raises questions of what we are not doing while funding a minister of loneliness,” referring to the new British minister.

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Background

Weakening Ties

Americans in the early 1800s liked to create and join civic, social, business and religious groups that contributed to community life and political debate, French diplomat Alexis de Tocqueville said in his classic book, Democracy in America (1835). But he also said the nation's celebrated individualism could confine a citizen “entirely within the solitude of his own heart.”36 Since then, stories and theories about Americans’ social life have fluctuated between the two themes.

Throughout much of the 19th century, most Americans lived in rural towns like those de Tocqueville observed, where organizations such as the Grange, a fraternal group focused on agriculture, offered a business and social network for farmers and their families. Families typically were large and served as vital support networks for multiple generations. Married couples tended to have an average of seven children, at least one of whom typically remained at home to care for the aging parents.37

By the start of the 20th century, many Americans had begun to migrate to the cities. Fearing the demise of the traditional farm community, President Theodore Roosevelt created the Commission on Country Life, which reported to the Senate in 1909 about hardships, such as isolation, faced by farmers and especially their wives. The commission said social isolation and other problems of rural life were “beyond the reach of legislation.” But Roosevelt pushed, unsuccessfully, for the Department of Agriculture to be renamed the Department of Country Life and its focus expanded to help farmers improve social life in rural areas.38

As the 20th century progressed, rural residents increasingly moved to cities, particularly during World War I and World War II, when factory jobs were plentiful. The largest shift to urban life took place within “the span of a single generation,” said sociologist Louis Wirth in 1938, and was “accompanied by profound changes in virtually every phase of social life.”39

City residents often experienced tenuous and changing social relationships, Wirth said. Even those who joined small social groups found that membership frequently turned over.

Multigenerational households became less common and family sizes shrunk. By 1950 women had an average of just under three children. Meanwhile, improvements in sanitation, nutrition and medical care meant life expectancy rose, from under age 50 in 1900 to more than 65 by 1950.40

Runners of all ages hit the pavement on May 5, 2018 (AP Photo/The Porterville Recorder/Chieko Hara)  
Runners of all ages hit the pavement on May 5, 2018, at the 17th annual Rotary Cancer Run/Walk hosted by the Porterville Breakfast Rotary Club in East Porterville, Calif. The event raises funds to benefit cancer treatment in the community. As membership in such civic clubs declines, experts say Americans are losing a way to interact with people who might have different social or political views, potentially increasing their own isolation. (AP Photo/The Porterville Recorder/Chieko Hara)

By 1950 Americans had become less focused on family and more on how others like them behaved and the attitudes of their peers and the mass media, sociologist David Riesman wrote in his 1950 book The Lonely Crowd, a landmark study of middle-class America.

About 4 million Americans were living alone in 1950, a little less than 10 percent of households, up from 1 percent in 1850. Fischer and Michael Hout, a sociologist at the University of California, Berkeley, attributed the increase in part to greater economic security and help from Social Security and private pensions.

By 1960, Americans were moving to the suburbs, and the sense of solidarity that “everyone in town” belonged to a community began to fall away, sociologist Maurice Robert Stein wrote.41

Meanwhile, more than 500,000 Americans with mental illness were secluded in mental institutions, or “asylums,” which had been established in the 1800s, says Boston psychiatrist Sigel. But in the 1950s and '60s, psychoanalyst Frieda Fromm-Reichmann, author of a 1959 essay titled “On Loneliness,” argued that loneliness was at the core of nearly all mental illness and that trust and intimacy could cure many patients. Amid increasing concerns about poor medical practices in the asylums, many mental health advocates cited Fromm-Reichmann's theory in pushing for reform.42

In 1963, President John F. Kennedy pushed through Congress the Community Mental Health Centers Construction Act, which aimed to replace mental institutions with a system of subsidized, community-based outpatient mental health centers. The law did not succeed in emptying out all mental hospitals, however, said Gerald Grob, Rutgers University professor of the history of medicine. In 1960, 75 percent of the patients were unmarried, widowed or divorced — making it unlikely they could live in the community with families while undergoing outpatient treatment, he said.43

And those patients who did return to the community had mixed results. “I think it's from there that the issue of loneliness really started to emerge,” Sigel says. “We discharged people into the community where they were not welcome,” he adds, noting that many newly released patients were uncomfortable using public transportation or feared social contact.

What's more, some patients were elderly and suffering from dementia. Many were able to move into nursing homes with support from Medicare or Medicaid, health insurance programs for elderly Americans created by Congress in 1965. Between 1960 and 1976, the number of nursing homes grew by 140 percent.44

Meanwhile, Arizona real estate developer Del Webb developed the first “retirement community” for the elderly, in Sun City, a concept that would be copied throughout the United States. Many Baby Boomers moved to such communities when they reached retirement age in hopes of finding continued social and medical support as they aged.

The 1960s also marked a period of high levels of participation in political groups, churches, synagogues and civic associations in America. By 1965 Americans reported an increased confidence in their neighbors. The proportion that agreed that “most people can be trusted,” rose from 66 percent during and after World War II to 77 percent in 1964.45

In 1969, sociologists Daniel Bell and Virginia Held said “there is more participation than ever before in American society.” Even so, in a survey that same year, 26 percent of Americans reported they had felt “very lonely or remote from other people” during the previous few weeks.46

Raising Alarms

Despite such high community engagement in the 1960s, Brandeis University sociologist Philip Slater warned in his 1970 book, Pursuit of Loneliness: American Culture at the Breaking Point, that Americans were seeking more privacy but feeling “more and more alienated and lonely” when they achieved it.47

Journalist Vance Packard in 1972 said in many regions more than 35 percent of the population was moving each year, and a typical junior executive moved 15 times in 20 years. Such mobility, Packard said, was destroying the sense that one had a community to “share experience, to find assurance of emotional and other support, and to develop some enduring friendships.”48

A year later, University of Massachusetts sociologist Robert S. Weiss wrote in his book Loneliness that “severe loneliness appears to be almost as prevalent as colds during the winter.”49

Journalist Suzanne Gordon in Lonely in America blamed increasing loneliness on a rising divorce rate, the launch of a “singles” industry focused on dating and group activities for singles and a growing technological culture that kept residents watching televisions rather than socializing.50

In 1979, Lisa F. Berkman, a social epidemiologist at Harvard, and S. Leonard Syme, an epidemiology professor at University of California, Berkeley, published a study of 4,775 adults in Alameda County, Calif. They found that people who were not strongly connected with others — through marriage, friends or social groups, for instance — were three times as likely to die over a nine-year period as those with strong ties. The difference existed regardless of physical health, socioeconomic status, lifestyle or other factors.51

In the early 1980s, social psychologist Carin Rubenstein and psychologist Philip Shaver, a professor at the University of Colorado in Denver, analyzed different survey data and concluded that loneliness declines with age, a phenomenon they attributed to individuals’ changing self-esteem and self-awareness.52

At the time, many sociologists and psychologists blamed loneliness or isolation on the increasing “impersonality” of large urban settings, workers’ growing reliance on technology and increasing mobility and divorce. In April 1983, New York Times health editor Jane Brody declared loneliness a “national epidemic.”53

But not everyone agreed that urban life was weakening social networks. “Residents of large and small communities alike generally manage to sustain helpful and meaningful relations,” Berkeley's Fischer said in 1983. And city dwellers “are more likely to have friends that they pick and choose rather than friends they inherit by virtue of geography or kinship or even occupation,” he said.54

Still, several studies concluded that socially isolated or lonely people faced a higher risk of death. A 1984 study published in The New England Journal of Medicine found that among 2,320 male patients who had suffered heart attacks, those classified as socially isolated or suffering from life stress faced more than four times the risk of death than those with less stress and isolation.55

A UCLA study of men infected with HIV found that those who had not disclosed their sexual preference, fearing social rejection, developed AIDS and died an average of two to three years earlier than those who were not “in the closet.” UCLA's Cole theorized — and later proved with tests on HIV-infected blood — that an individual with a false identity and fear of social rejection had higher levels of stress hormones in the body, which caused tissues to swell, hiked blood pressure and weakened the immune system.56

In another study, University of Iowa psychologists Daniel W. Russell and Carolyn E. Cutrona found that college freshmen were lonelier than the elderly. And in a study with physician Robert Wallace, the two psychologists determined that loneliness among the elderly was a greater predictor than blood pressure of mortality and admission to a nursing home.57

By 1994, Steven Ruggles, then a University of Minnesota associate professor of history, concluded, based on U.S. Census data from 1850 to 1990, that the 19th-century tendency of extended families to live together and the nation's history of maintaining strong family ties had disappeared.58

Klinenberg, author of the 2002 book Heat Wave, found that during a heat wave in Chicago in July 1995, a lack of family and social support contributed to the deaths of hundreds of residents who, he said, “died alone, behind locked doors and sealed windows, out of contact with friends, family and neighbors, unassisted by public agencies or community groups.” The city began a public campaign to find living relatives for 170 unclaimed bodies — a third of which remained unclaimed when Klinenberg published his book.59

Meanwhile, as the number of home computers grew in the late 1980s and the internet rose to prominence in the '90s, sociologists saw the growing use of technology as a potential cause of social isolation or feelings of loneliness. By 1998, about 40 percent of all U.S. households had personal computers, about a third of which had internet access.

But while some researchers said the internet was causing people to become socially isolated, others said it enabled people to create more social relationships without the constraints of geography.60

New Research

Putnam's Bowling Alone returned the nation's focus in 2000 to dwindling civic engagement, which he called the erosion of “social capital.” Although the number of national nonprofit organizations had doubled between 1968 and 1997, few had mass memberships, he said. And the number of Americans who said they had “attended a public meeting on town or school affairs” in the previous year had fallen by more than a third — from 22 percent in 1973 to 13 percent in 1993.61

By 2000, about a quarter of American households consisted of one person, and only 14 percent of citizens lived in extended-family households. Birth rates had dropped to an average of 2.4 children per woman of childbearing age. Putnam said such statistics indicated the erosion of social capital, which he attributed to more women working outside of the home, greater mobility, a lower marriage rate and technological changes, such as the rise in the popularity of video games.62

In a 2000 book on the medical consequences of loneliness, psychologist James J. Lynch, of Towson, Md., wrote: “New Age cultural forces that disturb, disrupt and destroy human dialogue must be viewed with the same concern and alarm as has been brought to bear on other plagues, infectious diseases, viruses, bacteria and cancers.” Loneliness, particularly if it begins in childhood, is linked to premature death in all technologically advanced nations, he said.63

However, not all surveys during this period found negative results. By 2000, some reported that a majority of U.S. adults said they felt good about their communities and had a sense of belonging with their neighbors. Almost half of adults said they had at least a few friends in the neighborhood.64

Soon, more scientific studies explained the link between loneliness and physical illness. In a study published in Science in 2003, researchers using neuroimaging determined that the brain responds to the pain of social exclusion similarly to how it responds to physical pain. And in another study, Cole, Hawkley and Cacioppo found a connection between chronic loneliness and an elevated risk of inflammatory disease.65

Cacioppo compiled much of the research in his 2008 book Loneliness: Human Nature and the Need for Social Connection. At the time, he noted, about 20 percent of citizens said feeling isolated was “a major source of unhappiness in their lives.”66

But researchers increasingly debated how best to measure loneliness. In 2006, sociologists from the University of Arizona and Duke University found that the percentage of respondents to the General Social Survey, conducted periodically by NORC to track trends in American society, who said they had discussed “important matters” with no one in the previous six months had risen from 10 percent in 1985 to nearly 25 percent in 2004. But their conclusion drew heavy criticism. Fischer, for example, said the results likely were due to changes in survey procedures or technical errors.67

In 2009, a Pew Research Center survey indicated that the average size of Americans’ social networks had shrunk by a third since 1985, with 12 percent of Americans saying they had no one with whom they could discuss important matters. That year, U.S. Surgeon General Regina Benjamin issued a “call to action” to promote social networks in the community by creating sidewalks, parks and mass transit, and locating stores, schools and workplaces nearby.68

In 2014, Cacioppo and fellow researchers determined that the effect of loneliness — or perceived isolation — was an “evolutionary, heritable trait,” or that some individuals have a genetic predisposition to set certain standards for social connection and to feel lonely if those standards are not met. The researchers also found that loneliness both affects, and is affected by, depressive symptoms. But Cacioppo and other researchers concluded the only method that showed promise in reducing loneliness was talk therapy to help a patient end thoughts of low self-worth and to alter skewed ideas that others were untrustworthy.69

In 2016, as surgeon general, Murthy traveled the country and asked communities what issues were important to them. “What I heard time and time again was that people were in fact dealing with an epidemic of stress and loneliness,” he said. He urged health care providers and communities to address social factors — such as isolation — that affect public health.70

In 2017 Congress began taking some interest in tackling the issue of loneliness, especially among the elderly. At a Senate Special Committee on Aging hearing, Chair Susan Collins, R-Maine, said, “Just as we did when we made a national commitment to cut smoking rates in this country, we should explore approaches to reducing isolation and loneliness. Each has a real impact on the health and well-being of our seniors.”71

In addition, Sen. Mike Lee, R-Utah, began directing a multiyear research project, under the auspices of the Joint Economic Committee of Congress, to determine what societal changes might be causing a breakdown of community ties.

The so-called Social Capital Project's first report, released in May 2017, found that citizen participation had generally declined over time in community organizations — including family, churches, schools and civic associations.72

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Current Situation

Potential Solutions

Although the Trump administration has not proposed specific policies related to reducing loneliness or isolation, President Trump has signed into law two measures that aim to help caregivers for the elderly and grandparents caring for children of parents addicted to opioids. Experts say family caregivers for senior citizens often feel lonely and isolated, as do the children of opioid addicts.

“The loneliness felt by many family caregivers compounds their emotional suffering, making it harder for them to sustain themselves over time,” said Barry J. Jacobs, a clinical psychologist and family therapist and a member of the AARP Caregiving Advisory Panel.73

In January, Trump signed a measure calling on the secretary of Health and Human Services to develop a strategy to support families caring for aging relatives. The bipartisan measure, introduced by Sens. Collins of Maine and Tammy Baldwin, D-Wis., aimed to ease the costs for family caregivers.74

People share a bench in South Pointe Park in Miami (Getty Images/Universal Images Group/Jeff Greenberg)  
People share a bench in South Pointe Park in Miami. Some researchers are encouraging cities to provide more places, such as in parks or at libraries, where people can socialize, in part to help alleviate feelings of isolation or loneliness. (Getty Images/Universal Images Group/Jeff Greenberg)

In July, Trump also signed legislation to provide resources to help grandparents raising grandchildren whose parents are addicted to opioids. About 2.6 million children are being raised by grandparents, according to the Senate Special Committee on Aging.75

Meanwhile, the CDC remains focused on preventing suicide, in part by developing strategies to boost the social connections of individuals exhibiting nonfatal suicidal behavior and expanding research on how to monitor those social connections.76

Former Surgeon General Murthy continues to push companies to help reduce isolation in the workplace. While new models of working, such as telecommuting and a heavier reliance on independent contractors, give employees and companies greater flexibility, they also can reduce the opportunities for in-person interaction and relationships, said Murthy. “And even working at an office doesn't guarantee meaningful connections,” he said.77

Meanwhile, a Minneapolis-based company called Blue Zones is helping local communities and organizations devise ways to improve residents’ health, in part by improving social connectedness. The program is based on studies of so-called Blue Zone areas that have exceptional longevity, such as Sardinia's Nuoro province, which has the world's largest concentration of male centenarians, and three other areas: Japan's island of Okinawa, Costa Rica's Nicoya Peninsula and a Seventh-day Adventist community in Loma Linda, Calif.78

Blue Zones founder Dan Buettner, with support from the National Geographic Society, identified certain commonalities among the communities, including social structures that keep the elderly in the community and in extended-family homes and residents’ participation in regular group activities.

Buettner says he tries to help other communities adopt social habits similar to those found in the Blue Zones. His organization works with government leaders, schools, workplaces, grocery stores and others to create social groups and volunteer opportunities for residents and to help communities design walkable towns with accessible community areas like parks.

Overseas Efforts

The United Kingdom's new minister of loneliness, Tracey Crouch, is leading a group seeking ways to alleviate isolation and loneliness, focusing heavily on the elderly. An earlier government survey indicated about 200,000 British seniors had not talked with a friend or relative in more than a month. Meanwhile, Britain's Office for National Statistics is crafting a method to measure loneliness.79

The appointment of a minister of loneliness was recommended by the Jo Cox Commission on Loneliness, established in 2016, which concluded that isolation had become a social crisis and called for a way to measure how government policies affect families. The commission was named after Cox, a member of Parliament who formed the commission and had suffered from loneliness herself. She was murdered in 2016 by an unemployed man suffering from depression.80

Meanwhile, Scotland is pursuing a national strategy to tackle social isolation and loneliness after a report by a nonprofit mental health association found that 11 percent of Scottish adults often feel lonely. Last spring, the government circulated a draft strategy listing ways to build cohesive communities, encourage kindness, tackle poverty and address inequality, among other things. In Ireland, Sen. Keith Swanick, a general practitioner in Belmullet, set up a task force to analyze the loneliness problem after researchers estimated that 400,000 people were suffering from loneliness.81

In Japan, which has the world's fastest growing elderly population and where a quarter of its population is over 65, about 30,000 people die alone each year. Analysts blame persistent economic stagnation, which left many families and communities frayed. Meanwhile, the country's Baby Boom Generation has aged and Japan's birth rate declined, leaving many elderly with no one to care for them.82

The problem has led to the rise of an unorthodox industry, which allows people to pay for actors to pretend to be relatives — such as a wife for a bereaved widower or relatives to fill out seats at a wedding.83

China's growing elderly population also faces loneliness and isolation, largely due to the Communist government's one-child-per-couple population-control policy from 1979 to 2016. Because Chinese culture prefers sons over daughters, many couples ended their pregnancies during that period if they found their unborn child was female. China now has millions more men than women, leaving fewer daughters to care for aging parents, as custom dictates.

In addition, the gender imbalance means that by 2020 the nation will have some 30 million more men ages 24-40 than women, making it difficult for men to find a partner, according to sociologist Jin Tiankui.84

And in South Korea, middle-aged men increasingly are at risk of dying alone. In 2013, more than 3,300 cases of solitary deaths in Seoul were reported, 162 of which involved people in their 50s, and men comprised 84.6 percent of those deaths. “Middle-aged men are more easily exposed to socioeconomic changes due to situations like early retirement, divorce and bad health,” Dr. Lee Ho-sun, the director of a center for seniors in Seoul, said. They also tend to shut their doors to society when they are in despair, he said.85

The Seoul government is encouraging local communities to help reduce the number of such deaths by creating neighborhood groups to visit those who live alone.86

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Outlook

New Studies

In the next five to 10 years, researchers likely will continue to expand and refine studies on how loneliness affects human health and on solutions.

Brigham Young's Holt-Lunstad is studying the health care costs connected to social isolation, while other researchers are focusing on possibly developing drugs to treat the health effects of loneliness. “We are at an early stage with loneliness — we called it out as a pain and don't know what to do with it,” UCLA's Cole says. “We know inflammatory signal molecules go through the blood and into the brain, which makes you feel sick” so that you rest, he says.

Thus, “when people get lonely, biology kicks in and helps them stay lonely longer.” However, he adds, “It's not clear just treating with anti-inflammatory medications will do that much,” and other drugs can create other health problems. “But there is a lot of interest in what is going on in the brain and whether we can develop drugs that target that.”

Psychiatrists say that many people suffering from loneliness due to a breakdown in traditional community ties and family support might turn to antidepressants for treatment. But psychiatrists say such drugs are designed to treat depression related to low levels of a hormone called serotonin and do not substitute for social connections.

Caroline Abrahams of Age UK in Britain said rather than prescribe antidepressants, doctors should help people “connect with their communities and get back in touch with or make new friends.”87

NORC's Hawkley says extensive research needs to be done on how to effectively help people who feel lonely despite efforts to engage them. “Just because you engage people in an activity, they can still feel lonely,” she says. And increasing contact with family members could have a negative effect for some people, depending on family dynamics, she adds.

As for loneliness among young adults, some observers cite the recent uptick in student protests and rallies around the issue of gun control as an indication that more young people are becoming politically engaged. But experts say it is unclear whether such activity will reduce loneliness or social isolation.

“Participating in political movements and organizations can connect people, and that's one reason people choose to participate in politics,” Peter Levine, an associate dean for research and a professor of citizenship and public affairs at Tufts University, said in an e-mail. “Thus there is some potential for an energizing election to reduce social isolation, but only if organizations and networks emerge that really engage people — as opposed to [simply] driving them to the polls at the last minute.”

David Ellis, director of communications studies at York University in Toronto, worries about individuals’ growing reliance on technology, citing evidence that digital addiction is “promoting depression, loneliness …, even suicidal behavior, especially among teens and adults.” Konrath of Indiana University says much more study needs to be done on how technology use — for work, entertainment or social connections — affects loneliness. About half of Americans believe future digital technologies will have more beneficial than negative effects on society, according to a 2018 Pew Research Center report, but many also believe that it could further erode social life and increase loneliness.88

And as scientists learn more about the brain, researchers could potentially develop drugs to target the feelings or pain associated with loneliness. “I think there will be a lot of interest in understanding the biology a bit more,” Cole says. “We are at an early stage [of understanding] loneliness.”

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Pro/Con

Is today's society making Americans lonelier than in the past?

Pro

George Sigel M.D.
Program Director, South Boston Behavioral Health Clinic, and Clinical Professor, Tufts University School of Medicine. Written for CQ Researcher, August 2018

Changes in America are felt differently by kids, younger adults and older adults.

Compared to my youth, kids today must navigate a very bumpy road. In many communities they no longer have neighborhoods where they can go out and play. There are no other kids to play with, and there is a growing feeling that the streets are unsafe.

More kids today are being raised by single, working parents, so there is more turning inward to self and more screen time. But, for many, screen time may be a solution to the feeling of being alone.

School is a good antidote, but bullying seems to be more common in schools today. In addition, a stressed-out parent or marital conflict can rub off on kids, affecting their self-esteem. Lower self-esteem saps social energy, so being at home with a screen offers a path of less resistance. And for many the cure can be as bad as the disease: When all else fails, some kids turn to drugs.

Younger adults have their own worries, which can be worse today. The divorce rate remains high, perhaps because people are too quickly getting into relationships to avoid loneliness. Some may be saddled with student loans. Others have a child or two and a tense relationship with a significant other, leading to increased loneliness. Internet dating can be good, but many find it hard to trust strangers and are overwhelmed by too many choices. And contract jobs, which are plentiful these days, provide no job security or benefits.

Older adults often are considered the most lonely. The culture has changed in how older Americans fit in as they lose their ability to be independent. Problems such as fixed incomes, growing costs, health problems, stairs, transportation and distance from loved ones pose challenges in the last chapter of life. And relying on already-stressed families for support and care may be less of an option, making assisted living or some level of institutional care necessary.

So as America changes, many are very lonely.

For my patients and their families, these problems are getting worse, while access to social services and health care is increasingly difficult.

In addition, the feeling that government serves the interests of the wealthy more than ever before leaves many lonely, anxious and worried about their future.

Con

Claude S. Fischer
Professor of Sociology, University of California, Berkeley, and Author, Still Connected. Written for CQ Researcher, August 2018

Today's society is making some Americans lonely, but no more so than American society did in previous eras.

There is little systematic evidence that average levels of feeling or being isolated have increased in the last generation or so.

Periodically, scary studies grab headlines, but they are anomalies. One such study, published in 2006, seemed to find that Americans’ access to confidants had shrunk over the prior 20 years. This study is still cited — as recently as June 19 in The New York Times — but researchers have known for several years that the finding was in error.

The bulk of the evidence, as I often report in my blog, “Made in America,” shows relative stability in levels of loneliness in America. For example, the General Social Survey, which has gathered data on American society since 1972, has asked for decades how often people see family, friends and neighbors. The long-term trend: a slight decrease in neighbor meetings and slight increases in friend and family meetings. No big news; so, no big headlines.

Indeed, today's society is not unique in presenting concern about isolation and loneliness. This has been a repeated meme.

The most persuasive descriptions of a real loneliness crisis appeared in early 20th-century studies of “the country problem,” which described isolated and lonely wives in rural places (although by then their isolation was already declining).

When commentators point with alarm to loneliness today, they commonly cite the internet. (In the past, it was the Sony Walkman, television, suburbanization, urbanization, etc.) Serious studies on the internet's impact have shown that it is a mixed bag. Some people use the internet to hide from personal contact, but more people use it to amplify personal contact.

To be sure, isolation and feelings of loneliness (which are not the same things) should be matters of concern.

Health professionals ought to look for signs of both and try to deal with them, especially as they affect adolescents and as the population ages. The elderly, notably elderly men, are particularly vulnerable to isolation, although they do not necessarily report loneliness.

The problem with sounding a false alarm that something new is happening today — and blaming the internet — is that it distracts attention from historically deeper, surer sources of social unraveling and psychological distress, such as economic and health insecurity.

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Chronology

 
1830s–1940sStrong community, family ties begin to weaken.
1835French diplomat Alexis de Tocqueville documents prevalence of community, social and political groups in the United States.
1880sPopulations migrate from rural areas to industrializing cities.
1909President Theodore Roosevelt unsuccessfully pushes to rename the Department of Agriculture the Department of Country Life and expand its focus to include improvements to farmers’ social lives.
1938Sociologist Louis Wirth describes changes in every phase of social life, as people continue to migrate to cities.
1946After World War II, city dwellers begin to migrate to the suburbs; observers lament a breakdown of community ties.
1950s–1970sResearchers find a rise in loneliness and say it threatens health.
1950Sociologist David Riesman's The Lonely Crowd describes a decline in Americans’ focus on the family and warns of increasing loneliness among children.
1950sPsychoanalyst Frieda Fromm-Reichmann says loneliness is at the core of most mental illnesses.
1963Congress passes the Community Mental Health Centers Construction Act to replace mental institutions with out-patient mental health centers.
1965National Opinion Research Center survey finds that 26 percent of Americans feel lonely or isolated.
1970Sociologist Phil Slater's Pursuit of Loneliness says more Americans than ever are “alienated and lonely.”
1973Sociologist Robert Weiss in Loneliness says “severe loneliness” is as common as wintertime colds.
1978President Jimmy Carter's Commission on Mental Health says greater coordination of health services and support systems for the mentally ill could strengthen communities.
1980s–1990sNumber of Americans living alone continues to increase.
1983 New York Times health editor Jane Brody declares loneliness a “national epidemic.”
1984 New England Journal of Medicine publishes study saying male heart attack victims have a more than fourfold higher risk of death if they are socially isolated.
1991Harvard economist Juliet Schor says Americans are overworked, spending less time with family and friends.
1995Hundreds of isolated residents die alone during a July heat wave in Chicago.
1998About 40 percent of U.S. households have computers, one-third with internet access, spurring sociologists to question the effect of technology on loneliness.
2000-PresentResearchers link loneliness to physical and mental illnesses.
2000Sociologist Robert Putnam's Bowling Alone cites changes in family structure, civic and community life for the erosion of “social capital.”
2003Neuroimaging reveals how the brain responds to pain of social exclusion.
2008In his book Loneliness, neuroscientist John Cacioppo describes his landmark studies on the effects of chronic loneliness.
2009Survey finds average American's network of family and friends has decreased one-third since 1985.
2013Nearly half of adults in England report feelings of loneliness.
2018Health insurer Cigna concludes that nearly half of Americans suffer from loneliness…. New law requires Health and Human Services Department to devise strategy to help families care for aging relatives at home.
  

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Short Features

It's “every bit as important as food and water and shelter.”

Jim O'Brien, age 80 and a lifelong bachelor, lives in Minneapolis far from his eight siblings. As he aged, his social life dwindled.

Then a few years ago, O'Brien met Caitlin Heaney, now 27, through a nonprofit program called Little Brothers-Friends of the Elderly that aims to relieve loneliness among seniors. The two quickly became friends, and they now share a meal at a restaurant once a month and hold piano concerts at the senior housing facility where O'Brien lives.1

“Social engagement is every bit as important as food and water and shelter,” said James Falvey, the program's executive director.2

Amid an explosion of scientific studies associating loneliness or social isolation with illnesses such as dementia and cardiovascular disease, more and more communities, nonprofits and volunteer groups are testing new ways to care for seniors and help alleviate loneliness.

In about 350 communities across the United States, for instance, groups of seniors are forming their own “villages” to help each other stay in their homes. Under the concept, which originated in Boston in 2002, residents pay membership dues averaging a few hundred dollars a year to a neighborhood-based membership organization that employs a small support staff. Volunteers help connect the residents to discounted services and organized social activities.

“When you're a widow and it's a Friday night, this lets you meet people you can go to a play with,” said Ann Schummers, an organizer of a Massachusetts village called “Concord After 60.”3

In a 2016 study of seven villages in California by University of California, Berkeley, researchers, 74 percent of respondents said they know more people and 54 percent said they feel more connected with others because of their village membership. Still, the researchers said the seniors already were in good health and well-connected socially when they joined their village.4

Experts say that while innovative approaches can help many seniors stay connected, the challenges of social isolation and loneliness could grow significantly as the population ages. The number of Americans age 65 or older is expected to reach an estimated 98 million by 2060, roughly double today's count.5

Team members cheer for Ginny Williams (Getty Images/Portland Press Herald/Jill Brady)  
Team members cheer for Ginny Williams, 98, far left, in April 2018 at the Big 20 Bowling Center in Scarborough, Maine. Shared social activities can keep the elderly engaged and help alleviate feelings of loneliness, psychologists say. (Getty Images/Portland Press Herald/Jill Brady)

Moreover, many experts say societal changes such as dwindling family sizes, rising divorce rates among older Americans, increased numbers of people living alone and higher rates of distrust of other people could exacerbate loneliness by reducing the number of social connections.

“The importance of having available a social network cannot be overstated in guarding against social isolation,” Lenard W. Kaye, director of the University of Maine's Center on Aging, told the Senate Special Committee on Aging last year. “Family, friends, neighbors and professional caregivers provide social support, social influence, create a buffer against stress, increase your access to resources and can even stimulate your immune system.”6

While estimates vary on the extent of loneliness among older Americans, an oft-cited 2010 AARP study found that about 25 percent of those older than 70 reported feelingly lonely, compared with 43 percent among those ages 45 to 49.7

Yet Berkeley sociologist Claude Fischer suspects many elderly Americans may be lonelier than they indicate on surveys. Many may compare themselves to other elderly people they know and think, “‘At my age, if I can get out of bed or get to church every week I'm doing pretty good,’” Fischer says.

Research into the effectiveness of programs to alleviate loneliness are limited, says Louise Hawkley, senior research scientist at University of Chicago's NORC, a social research center. But for elderly people who are painfully lonely or dangerously isolated, it is important to help them make meaningful connections that will improve or at least protect their health, she says.

“We can't expect putting mom in [an assisted living] facility will make her less isolated,” Hawkley says. “She might actually be lonelier.”

While some older people living in retirement communities engage in the group social activities available, a few studies have said loneliness was a potential cause for depression among some residents. A study conducted in 2011, for instance, found that about 29 percent of residents in retirement communities in northern Ohio reported feelings of loneliness.8

Meanwhile, some evidence suggests positive health effects of programs enabling social connections for the elderly, particularly across generations. A 2015 study on community involvement and volunteerism among people ages 65 to 84 found a decrease in reported feelings of loneliness, from 63 percent of respondents to 43 percent.9

That echoes evidence from a program in Baltimore called Experience Corps, which helps seniors mentor students in public schools, Hawkley says. A 2004 study found that the program resulted in improved physical, cognitive and social activity among the older volunteers, and another study found that test scores improved among children in grades K-3 whom the volunteers mentored.10

“Both sides really came to see the value of the other,” Hawkley says, “and they ended up forming really good relationships.”

— Christina L. Lyons

[1] Tom Weber, “How loneliness may be killing us,” MPRNews, May 31, 2018, https://tinyurl.com/yctc3n4w.

[2] “Watch Our Mission in Action,” Little Brothers-Friends of the Elderly, Minneapolis/St. Paul Chapter, https://tinyurl.com/y8aupntm.

[3] Robert Weisman, “For some seniors, a cultural shift and a vital volunteerism,” The Boston Globe, July 7, 2018, https://tinyurl.com/yckbexce; Ina Jaffe, “‘Village Movement’ Allows Elderly To Age In Their Homes,” NPR, Dec. 12, 2017, https://tinyurl.com/yckbexce.

[4] Carrie Graham, Andrew E. Scharlach, and Elaine Kurtovich, “Do Villages Promote Aging in Place? Results of a Longitudinal Study,” Journal of Applied Gerontology, 2016, https://tinyurl.com/yb3wxowd.

[5] “Fact Sheet: Aging in the United States,” Population Reference Bureau, Jan. 13, 2016, https://tinyurl.com/y9sqeqhb; “Facts for Features: Older Americans Month: May 2017,” U.S. Census Bureau, April 10, 2017, https://tinyurl.com/y83uyxoh.

[6] Lenard W. Kaye, “Hearing on ‘Aging Without Community: The Consequences of Isolation and Loneliness,’” Senate Special Committee on Aging, April 27, 2017, https://tinyurl.com/yaf29te4.

[7] G. Oscar Anderson, “Loneliness Among Older Adults: A Survey of Adults 45+,” AARP, September 2010, https://tinyurl.com/yccxl8pl.

[8] Abir K. Bekhet and Jaclene A. Zauszniewski, “Mental Health of elders in retirement communities: Is loneliness a key factor?” Archives of Psychiatric Nursing, June 10, 2011, https://tinyurl.com/y8hjote4.

[9] Manuela Dias et al., “Intervention in the Loneliness of the Elderly — What Strategies, Challenges and Rewards?” Journal of Health Science, 2015, https://tinyurl.com/ycc3ysn4.

[10] Linda P. Fried et al., “A social model for health promotion for an aging population: Initial evidence on the experience Corps model,” Journal of Urban Health, March 2004, https://tinyurl.com/ycbk4lsj; George W. Rebok et al., “Short-term impact of experience Corps participation on children and schools: Results from a pilot randomized trial,” Journal of Urban Health, March 2004, https://tinyurl.com/y8lw7trn.

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“That's not ideal for American democracy.”

Social isolation and loneliness are associated not only with poor physical or mental health but also with the health of the nation's democracy, sociologists, behavioral scientists and political experts say.

Today's divisive political discourse makes people want to isolate themselves even more than in the past, suggests Steve Cole, a professor of medicine, biology, psychiatry and bio-behavioral sciences at the University of California, Los Angeles (UCLA). The current political climate “creates this view that other people” — particularly those with different political views — “cannot be trusted,” he says.

Sociologists say distrust of people with opposing views fuels a cycle in which social isolation or loneliness and political polarization feed each other.

Throughout the 19th century and into the 20th century, families who lived on farms depended on their neighbors for help, sociologist Robert Putnam noted in Bowling Alone, a landmark 2000 book that explores the erosion of community ties in American society. Through organizations such as the Grange, which supported the agricultural and social needs of American farmers, rural families socialized with people who did not necessarily share the similar political views but had the same drive to keep their farms running and raise their children.

“You might not like or agree with your neighbor, but you could understand why someone might hold an opposing viewpoint,” said Marc J. Dunkelman, research fellow at Brown University's A. Alfred Taubman Center for Public Policy.11

But after the 1960s, Americans increasingly narrowed their networks of friends and family and rearranged themselves into politically compatible communities and neighborhoods, according to journalist Bill Bishop, author of the 2008 book, The Big Sort: Why the Clustering of Like-Minded America is Tearing Us Apart. From 1976 to 2016, the percentage of voters who lived in solidly Democratic or Republican counties rose from about 27 percent to 60 percent.12

Today, only about one in five Americans believes that most or all of their neighbors share their political views, although the proportion is higher — close to one-third — for both urban Democrats and rural Republicans, according to the Pew Research Center.13 Moreover, in 2016, only half of Americans said they trusted most or all of their neighbors, and young adults were significantly less trusting of others than older generations, according to Pew.14

People today are likely to interact only with neighbors who share their political views or have the same ethnic identity and social class, Pew survey results show. About 58 percent of Americans who believe their neighbors share their political views speak to those neighbors in person on a weekly basis, but only 42 percent of those who said only “some” or “none” of their neighbors shared their political views speak to those neighbors weekly.15

Sociologists and mental health experts say face-to-face interaction is important because if individuals become socially isolated, they feel less socially competent and then are more likely to withdraw, perpetuating their isolation and loneliness. Furthermore, people who are socially isolated are less empathetic and more hostile and aggressive, according to San Diego State University psychologist Jean M. Twenge and Florida State University social psychologist Roy F. Baumeister.16

Political researchers have found that face-to-face interaction — even for just a few minutes — can reduce prejudices and change voters’ opinions on certain issues. Stanford University's David Broockman, an assistant professor of political economy, and Joshua Kalla, a doctoral candidate in political science at the University of California, Berkeley, reported in a study published in Science that even a 10-minute, face-to-face-conversation can change views.17

But Americans no longer feel they need one another like they did in the 1800s, Cole says. Technology has created new marketplaces for labor, food, shelter and social communication, he says, changing neighborhood dynamics in the process.

And even within their own geographic neighborhoods, people are disengaging more than in the past. They are participating in few civic, religious or social groups, says Sara Konrath, an associate professor of philanthropic studies at Indiana University in Indianapolis. And more broadly, she says, “there has been a decline of socializing with people who aren't like us.”

That is worrisome for political discourse, Konrath says. “If everyone had just our best friends and our family, what would our world look like? We wouldn't care what was happening in the world …, in our community …, in our country, in our state. That's not ideal for American democracy.”

— Christina L. Lyons

[11] Marc J. Dunkelman, “Next-Door Strangers: The Crisis of Urban Anonymity,” The Hedgehog Review, Summer 2017, https://tinyurl.com/y8adq8yh.

[12] Matthew Shaw, “Political Isolation Among Young Americans,” Harvard Political Review, April 25, 2017, https://tinyurl.com/y87hbc5n.

[13] Kim Parker et al., “What Unites and Divides Urban, Suburban and Rural Communities,” Pew Researcher Center, May 2018, pp. 70–73, https://tinyurl.com/ybhapxv5.

[14] “George Gao, “Americans divided on how much they trust their neighbors,” Pew Research Center, April 13, 2016, https://tinyurl.com/ybtotrgb.

[15] Parker et. al., op. cit.

[16] Jean M. Twenge and Roy F. Baumeister, “Social Exclusion Increases Aggression and Self-Defeating Behavior While Reducing Intelligent Thought and Prosocial Behavior,” in Dominic Abrams, Michael A. Hogg and Jose M. Marques (eds.), The Social Psychology of Inclusion and Exclusion (2013), pp. 27–46.

[17] Benoit Denizet-Lewis, “How Do You Change Voters’ Minds? Have a Conversation,” The New York Times Magazine, April 7, 2016, https://tinyurl.com/hww6xdb; David Broockman and Joshua Kalla, “Durably reducing transphobia: A field experiment on door-to-door canvassing,” Science, April 8, 2016, https://tinyurl.com/yb59a7av.

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Bibliography

Books

Cacioppo, John T., and William Patrick , Loneliness: Human Nature and the Need for Social Connection , W.W. Norton & Co., 2008. A University of Chicago neuroscientist (Cacioppo) and writer (Patrick) present Cacioppo's pioneering research on the effects of loneliness.

Klinenberg, Eric , Palaces for the People: How Social Infrastructure Can Help Fight Inequality, Polarization, and the Decline of Civic Life , Crown Publishing, 2018. A New York University sociology professor argues that the development of shared community spaces, such as parks and museums, can reduce social isolation and political polarization.

Laing, Olivia , The Lonely City: Adventures in the Art of Being Alone , Picador, 2016. An author's memoir depicts the painful isolation she endured while living in New York City.

Putnam, Robert D. , Bowling Alone: The Collapse and Revival of American Community , Simon & Schuster, 2000. A Harvard University public policy professor presents data showing how changes in work, family structure and suburban life, alongside a rise in technology, have disconnected Americans from family and friends and harmed the health of individuals and communities.

Articles

Brody, Jane E. , “The Surprising Effects of Loneliness on Health,” The New York Times, Dec. 11, 2017, https://tinyurl.com/y7yevwzw. Scientists are gaining a better understanding of the effects of loneliness and social isolation on health and studying ways to combat the problem.

Resnick, Brian , “Loneliness actually hurts us on a cellular level: A scientist explains how the pain of loneliness makes us sick,” Vox, Jan. 30, 2017, https://tinyurl.com/y8wbrtsc. Steve Cole, a neuroscientist at the University of California, Los Angeles, details how loneliness leads to inflammation and a diminished ability to fight viruses.

Snell, Keith , “The rise of living alone and loneliness in history,” Social History, Jan. 6, 2017, https://tinyurl.com/y9ye7aax. A professor of rural and cultural history at the University of Leicester in the United Kingdom explores the history of family and household structure in Western culture since the 1800s and examines the issue of loneliness.

Twenge, Jean , “Have Smartphones Destroyed a Generation?” The Atlantic, September 2017, https://tinyurl.com/yd9pj5qu. A psychologist at San Diego State University argues that social-networking websites have contributed to teenagers’ increased feelings of loneliness.

Reports and Studies

“Cigna U.S. Loneliness Index: Survey of 20,000 Americans Examining Behaviors Driving Loneliness in the United States,” Cigna, May 2018, https://tinyurl.com/y6ue3pv6. A health insurer presents results of a survey that found more than half of Americans are lonely.

Holt-Lunstad, Julianne , “The Potential Public Health Relevance of Social Isolation and Loneliness: Prevalence, Epidemiology, and Risk Factors,” Public Policy & Aging Report, Jan. 2, 2018, https://tinyurl.com/ybosldyh. A Brigham Young University psychology professor summarizes evidence that social isolation and loneliness present greater risks for premature mortality than obesity.

Magnan, Sanne , “Social Determinants of Health 101 for Health Care: Five Plus Five,” National Academy of Medicine, Oct. 9, 2017, https://tinyurl.com/y7vbz8dr. A senior fellow at the HealthPartners Institute for Medical Education in Bloomington, Minn., explains why medical providers should evaluate a patient's social life.

Parker, Kim , et al., “What Unites and Divides Urban, Suburban and Rural Communities,” Pew Research Center, May 2018, https://tinyurl.com/ybhapxv5. Analysts find little difference in attitudes among residents of rural, urban and suburban localities about their connection to neighbors and communities.

Audio

“Dr. Jon Hallberg on the health implication of loneliness,” May 11, 2018, https://tinyurl.com/y94mn6pq. An associate professor in the Department of Family Medicine and Community Health at the University of Minnesota discusses the link between loneliness and poor health.

“The Universal Solitude of Americans: Loneliness on the Rise,” NPR, May 2, 2018, https://tinyurl.com/ydfqec2y. Former Surgeon General Vivek Murthy, psychology professor Jean Twenge of San Diego State University and Cigna chief medical officer Doug Nemecek discuss a survey of Americans and the health effects of isolation.

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The Next Step

Elderly Population

Bahrampour, Tara , “These college students moonlight as ‘grandkids’ for hire. Seniors love it,” The Washington Post, June 20, 2018, https://tinyurl.com/ycvsarbs. Using a new app pairing college students with the elderly, students in Florida are doing light housekeeping, driving seniors to appointments and, in the process, helping to alleviate loneliness.

Drury, Colin , “This Nightclub for the Elderly Is Fighting Loneliness with Tea Party Raves,” Vice, April 30, 2018, https://tinyurl.com/y8q8mytl. Two elderly siblings founded a weekly cabaret-style club near London to provide a lighthearted solution to seniors suffering from social isolation.

Rapaport, Lisa , “Depression may be more severe in elderly people,” Reuters, June 27, 2018, https://tinyurl.com/yajay9ld. The elderly are more susceptible to depression due to a prevalence of risk factors, such as chronic illness or loneliness, according to a recent Dutch study.

Health Effects

Coughlan, Doug , “Loneliness: The cost of the ‘last taboo,’” BBC News, Sept. 22, 2017, https://tinyurl.com/ycpb8dmo. The estimated health cost of loneliness for an elderly person in the United Kingdom is £6,000 (about $7,900) over a decade, according to a 2017 London School of Economics study.

Dodgson, Lindsay , “Lonely millennials are at a greater risk of developing anxiety and depression — but the reasons for their isolation are unclear,” Business Insider, July 3, 2018, https://tinyurl.com/y7huvzwc. Lonely Millennials are more likely to develop mental health problems, such as anxiety and depression, and are more likely to engage in risky behavior, such as smoking, according to a recent study in the journal, Psychological Medicine.

Ducharme, Jamie , “Loneliness Can Actually Hurt Your Heart. Here's Why,” Time, March 26, 2018, https://tinyurl.com/yda2a2hd. New research shows that socially isolated or lonely individuals are not necessarily at higher risk of cardiovascular disease but may have greater difficulty in recovering from cardiovascular events.

Policy Solutions

Kasley, Killam , “To Combat Loneliness, Promote Social Health,” Scientific American, Jan. 23, 2018, https://tinyurl.com/y7xw6vsf. A multipronged approach, using social awareness and medical resources, would be most effective in combating loneliness, says a health care manager at a life sciences organization.

O'Sullivan, Feargus , “The World's First Minister of Loneliness,” CityLab, June 18, 2018, https://tinyurl.com/y7jh7kfu. Britain's newly appointed minister of loneliness could provide strong political advocacy for socially isolated individuals and advise businesses on how to reduce customer alienation, says a journalist.

Waugh, Paul , “All Government Policy Changes Could Be Subject To ‘Loneliness’ Test, Minister Suggests,” The Huffington Post, May 7, 2018, https://tinyurl.com/yahy6rd9. Britain's new loneliness minister proposes assessing future government policy changes for their potential impact on people's level of loneliness

Social Media

Alexander, Reed , “Don't blame social media for being lonely all the time,” The New York Post, Feb. 19, 2018, https://tinyurl.com/y8yb4ljj. A recent study concluded that social media does not cause loneliness, but that people who are lonely might turn to social media for comfort.

Trinko, Katrina , “Gen Z is the loneliest generation, and it's not just because of social media,” USA Today, May 3, 2018, https://tinyurl.com/ya2oqloo. Individuals ages 18–22 are the loneliest of any age group due to a decline in face-to-face interaction, says a USA Today columnist.

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Contacts

AARP Public Policy Institute
601 E St., N.W., Washington, DC 20049
202-434-3840
www.aarp.org/ppi/
Research arm of advocacy group that analyzes policies related to health care for older Americans.

Institute for Public Knowledge
New York University, 20 Cooper Square, 5th Floor, New York, NY 10003
212-998-8466
ipk.nyu.edu
Education group that organizes discussions among researchers about cultural and social trends — including social isolation — that affect society.

NORC
University of Chicago, 1155 E. 60th St., 2nd Floor, Chicago, IL 60637
773-246-6000
www.norc.org
Research group, originally named the National Opinion Research Center, that conducts surveys and scientific research on society, health and well-being.

Pew Research Center
1615 L St., N.W., Suite 800, Washington, DC 20036
202-419-4300
www.pewresearch.org
Nonpartisan think tank that provides surveys, demographic research and other analysis of social trends in U.S. society.

Semel Institute for Neuroscience and Human Behavior
University of California, 760 Westwood Plaza, Los Angeles, CA 90095
310-825-9989
www.semel.ucla.edu
Research institute that studies the genetic, biological, behavioral and sociocultural components of human behavior, including the effects of loneliness.

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Footnotes

[1] Veronique de Turenne, “The pain of chronic loneliness can be detrimental to your health,” UCLA Newsroom, Dec. 21, 2016, https://tinyurl.com/yb5474mu.

[2] “Cigna U.S. Loneliness Index: Survey of 20,000 Americans Examining Behaviors Driving Loneliness in the United States,” 2018, p. 1, https://tinyurl.com/y6ue3pv6.

[3] Vivek Murthy, “Work and the Loneliness Epidemic,” Harvard Business Review, September 2017, https://tinyurl.com/yaydwpxu. Also see Erin Schumaker, “What A Surgeon General Learned From the Opioid Crisis Could Help Fight Loneliness,” The Huffington Post, Oct. 9, 2017, https://tinyurl.com/ybsyxr5b.

[4] “PM commits to government-wide drive to tackle loneliness,” press release, Prime Minister's Office, gov.uk, Jan. 17, 2018, https://tinyurl.com/ya8uqse3.

[5] Louise C. Hawkley et al., “Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults,” Psychology and Aging, March 2010, https://tinyurl.com/y8o6vj9z; Julianne Holt-Lunstad and Timothy B. Smith, “Loneliness and social isolation as risk factors for CVD: implications for evidence-based patient care and scientific inquiry,” Heart, July 2016, https://tinyurl.com/y7xbngz8; Carla M. Perissinotto, Irena Stijacic Cenzer and Kenneth E. Covinsky, “Loneliness in Older Persons: A Predictor of Functional Decline and Death,” Archives of Internal Medicine, June 18, 2012, https://tinyurl.com/yd9oazfq. Also see J.T. Cacioppo and L.C. Hawkley, “Perceived social isolation and cognition,” Trends in Cognitive Science, October 2009, https://tinyurl.com/ybgsp3p7; Raheel Mushtaq et al., “Relationship Between Loneliness, Psychiatric Disorders and Physical Health? A Review on the Psychological Aspects of Loneliness,” Journal of Clinical & Diagnostic Research, September 2014, https://tinyurl.com/yc873god; Julianne Holt-Lunstad et al., “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review,” Perspectives on Psychological Science, March 11, 2015, https://tinyurl.com/y8lvol55; Louise C. Hawkley and John T. Cacioppo, “Loneliness Matters: A theoretical and Empirical Review of Consequences and Mechanisms,” Annals of Behavioral Medicine, October 2010, https://tinyurl.com/yd9pf3zw.

[6] Kim Parker and Renee Stepler, “As U.S. marriage rate hovers at 50%, education gap in marital status widens,” Pew Research Center, Sept. 14, 2017, https://tinyurl.com/yargyuc7. Renee Stepler, “Led by Baby Boomers, divorce rates climb for America's 50+ population,” Pew Research, March 9, 2017, https://tinyurl.com/zvogsl5. “Average Number of Own Children Under 18 Per Family, By Type of Family: 1955 to Present,” “Historical Families Tables: Table FM-3,” U.S. Census Bureau, https://tinyurl.com/ycsodvv8; “Historical Living Arrangements of Adults,” U.S. Census Bureau, November 2017, https://tinyurl.com/y735t6lc.

[7] Nick McCrea, “Mainer to tell Senate about crippling effects loneliness can have on elderly,” Bangor Daily News, April 26, 2017, https://tinyurl.com/yb9mbh3a.

[8] E. J. Dionne, “Is American getting lonelier?” The Washington Post, Aug. 6, 2017, https://tinyurl.com/y9fjyr75.

[9] Sara Konrath, “Americans are becoming more socially isolated, but they're not feeling lonelier,” The Conversation, May 7, 2018, https://tinyurl.com/yaucjxhr.

[10] John Cacioppo, Loneliness: Human Nature and the Need for Social Connection (2008); Rhitu Chatterjee, “Americans Are a Lonely Lot, And Young People Bear the Heaviest Burden,” NPR, May 1, 2018, https://tinyurl.com/y8rbn7e9.

[11] Laura Entis, “Chronic Loneliness Is a Modern-Day Epidemic,” Fortune, June 22, 2016, https://tinyurl.com/zejfn37.

[12] “What We Do Together: The State of Associational Life in America,” Joint Economic Committee, U.S. Congress, pp. 3, 37, https://tinyurl.com/ycbynqtd; Andrew Perrin and JingJing Jiang, “About a quarter of U.S. adults say they are ‘almost constantly’ online,” Pew Research Center, March 14, 2018, https://tinyurl.com/y7ccewbv.

[13] Lynda Flowers et al., “Medicare Spends More on Socially Isolated Older Adults,” AARP, November 2017, https://tinyurl.com/y8o6rdjm.

[14] Kerstin Gerst-Emerson and Jayani Jayawardhana, “Loneliness as a Public Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults,” American Journal of Public Health, May 2015, https://tinyurl.com/ycgwcbr5.

[15] “Do these genes make me lonely? Study finds loneliness is a heritable trait,” Science, Sept. 20, 2016, https://tinyurl.com/gtcpobm.

[16] Murthy, op. cit.

[17] Ibid.

[18] See Stephanie Cacioppo et al., “Loneliness: Clinical Import and Interventions,” Perspectives on Psychological Science, March 2015, https://tinyurl.com/ybuc2y2p.

[19] Dan Russell, Letitia A. Peplau and Mary L. Ferguson, “Developing a measure of loneliness,” Journal of Personality Assessment, 1978, pp. 290–294; Dan Russell, Letitia A. Peplau and Carolyn E. Cutrona, “The Revised UCLA Loneliness Scale: Concurrent and Discriminant Validity Evidence,” Journal of Personality and Social Psychology, 1980, https://tinyurl.com/yb2c5rvr.

[20] Claude S. Fischer, “No Dinner Invitations?” Made in America, Sept. 22, 2010, https://tinyurl.com/y99fxtwl.

[21] David Ihrke, “United States Mover Rate at a New Record Low,” U.S. Census Bureau, Jan. 23, 2017, https://tinyurl.com/yau2ox3e.

[22] Allison Slater Tate, “This freshman's video nails what loneliness in college feels like,” Today, Oct. 18, 2017, https://tinyurl.com/yaq26lb7.

[23] “More social connection online tied to increasing feelings of isolation,” University of Pittsburgh Schools of the Health Sciences, March 6, 2017, https://tinyurl.com/huptmos.

[24] Jean M. Twenge, “Have Smartphones Destroyed a Generation?” The Atlantic, September 2017, https://tinyurl.com/yd9pj5qu.

[25] D. Matthew T. Clark et al., “Declining Loneliness Over Time: Evidence From American Colleges and High Schools,” Personality and Social Psychology Bulletin, Nov. 24, 2014, https://tinyurl.com/y7q5x463.

[26] Feene Grosse Deters and Matthias R. Mehl, “Does Posting Facebook Status Updates Increase or Decrease Loneliness? An Online Social Networking Experiment,” Social Psychological and Personality Science, Dec. 20, 2012, https://tinyurl.com/y7yt4bvw.

[27] Sarah DiGiulio, “Your Smartphone Is Changing the Human Race in Surprising Ways,” NBC News, April 12, 2017, https://tinyurl.com/y9yznlzp.

[28] Megan Gambino, “How Technology Makes Us Better Social Beings,” Smithsonian.com, July 10, 2011, https://tinyurl.com/y9m638gj; Monica Anderson et al., “Activism in the Social Media Age,” Pew Research Center, July 11, 2018, https://tinyurl.com/y9hfvdr3.

[29] “Technology Addiction,” Hazelden Betty Ford Foundation, undated, https://tinyurl.com/y8degrx9; Avi Selk and Emily Guskin, “The myth of the lonely video gamer playing in solitude is dead,” The Washington Post, March 9, 2018, https://tinyurl.com/ycq33aq3.

[30] Martin Sundberg, “Online gaming, loneliness and friendships among adolescents and adults with ASD,” Computers in Human Behavior, February 2018, pp. 105–10, https://tinyurl.com/yataq8p7.

[31] Julianne Holt-Lunstad, Theodore F. Robles and David A. Sbarra, “Advancing Social Connection as a Public Health Priority in the United States,” American Psychological Association, September 2017, p. 519, https://tinyurl.com/yczk4ajx.

[32] “S. 670: Over-the-Counter Hearing Aid Act of 2017,” govtrack, https://tinyurl.com/y82eru5t.

[33] Murthy, op. cit.

[34] Hector Tobar, “Library lovers are less lonely, Pew Research Center report finds,” Los Angeles Times, March 13, 2014, https://tinyurl.com/y7fps4fl.

[35] Tim Adams, “John Cacioppo: ‘Loneliness is like an iceberg — it goes deeper than we can see,’” The Guardian, Feb. 28, 2016, https://tinyurl.com/jql9chd.

[36] Alexis de Tocqueville, “Chapter V: Of the Use Which the Americans Make of Public Association in Civil Life,” Democracy in America (1970 edition), pp. 99, 106–10.

[37] William Berry Lapham, Centennial History of Norway, Oxford County, Maine, 1786–1886 (1886), p. 218, https://tinyurl.com/y8u3p9hn. Also see Atul Gawande, Being Mortal (2014), p. 21.

[38] “Report of the Country Life Commission,” U.S. Senate, 1909, pp. 47, 6, https://tinyurl.com/ycmflvgu.

[39] Louis Wirth, “Urbanism as a Way of Life,” The American Journal of Sociology, July 1938, pp. 1–24, https://tinyurl.com/yazwewgp.

[40] Steven Ruggles, “The Transformation of American Family Structure,” American Historical Review, February 1994, pp. 102–103; Gawande, op. cit., pp. 22, 198; “Life expectancy in the USA, 1900–98,” Berkeley Demography, https://tinyurl.com/4kjakmd.

[41] Joseph Stromberg, “Eric Klinenberg on Going Solo,” Smithsonian Magazine, February 2012, https://tinyurl.com/ycvbshmq; Claude S. Fischer and Michael Hout, Century of Difference: How America Changed in the Last One Hundred Years (2006), p. 74. Maurice Robert Stein, The Eclipse of Community: An Interpretation of American Studies (1960), pp. 92, 329.

[42] Judith Shulevitz, “The Lethality of Loneliness,” The New Republic, May 13, 2013, https://tinyurl.com/zfwfz2y.

[43] John F. Kennedy, “Remarks on Proposed Measures to Combat Mental Illness and Mental Retardation,” The White House, Feb. 5, 1963, https://tinyurl.com/ybtsymea. Gerald N. Grob, “Public Policy and Mental Illnesses: Jimmy Carter's Presidential Commission on Mental Health,” The Milbank Quarterly, 2005, pp. 426–427.

[44] “The History of Nursing Homes,” Foundation Aiding the Elderly, undated, https://tinyurl.com/y8e6e8an.

[45] George H. Gallup, The Gallup Poll: Public Opinion 1936–1971. Putnam said, however, that the version of the “trust” question used in the 1940s, '50s, and '60s is not directly comparable to the one that became standard in later years.

[46] Daniel Bell and Virginia Held, “The Community Revolution,” The Public Interest (1969), p. 14; Norman M. Bradburn, The Structure of Psychological Well-Being (1969), https://tinyurl.com/ycq7fot2.

[47] Philip Slater, The Pursuit of Loneliness: American Culture at the Breaking Point (1970), p. 12, https://tinyurl.com/yaqlsp7u.

[48] Granville Hicks, “Rootless Americans,” The New York Times, Sept. 10, 1972, https://tinyurl.com/yahz864k.

[49] Robert Weiss, Loneliness: The Experience of Emotional and Social Isolation (1973), p. 1.

[50] Suzanne Gordon, Lonely in America (1976), p. 22.

[51] Lisa F. Berkman and S. Leonard Syme, “Social Networks, Host Resistance, and Mortality: A Nine-Year Follow-Up Study of Alameda County Residents,” American Journal of Epidemiology, February 1979, https://tinyurl.com/ybldcuws.

[52] Carin Rubenstein and Philip Shaver, In Search of Intimacy: Surprising New Conclusions from a Nationwide Survey on Loneliness and What to Do About It (1982), https://tinyurl.com/yckx9jk3.

[53] Jane E. Brody, “Personal Health,” The New York Times, April 6, 1983, https://tinyurl.com/yde6oegs.

[54] Linda Wolfe, “Friendship in the City,” New York Magazine, July 18, 1983, p. 22, https://tinyurl.com/yad7kcky.

[55] William Ruberman, Eve Weinblatt, Judith Goldberg and Banvir Chaudhary, “Psychosocial Influences on Mortality after Myocardial Infarction,” The New England Journal of Medicine, Aug. 30, 1984, https://tinyurl.com/yaoz659b.

[56] Judith Shulevitz, “The Lethality of Loneliness,” The New Republic, May 13, 2013, https://tinyurl.com/zfwfz2y.

[57] Martha Lear, “Body and Mind; The Pain of Loneliness,” The New York Times, Dec. 20, 1987, https://tinyurl.com/ycd9u3jt.

[58] Ruggles, op. cit., p. 104.

[59] “Dying Alone: An interview with Eric Klinenberg,” University of Chicago Press, 2002, https://tinyurl.com/ybx572fb; Eric Klinenberg, Heat Wave: A Social Autopsy of Disaster in Chicago (2002), p. 15.

[60] C. Stoll, Silicon Snake Oil (1995); Robert Kraut et al., “Internet Paradox: A Social Technology That Reduces Social Involvement and Psychological Well-Being?” American Psychologist, September 1998, p. 1018, https://tinyurl.com/n2p8rv6; J. E. Katz and P. Aspden, “A Nation of Strangers?” Communications of the ACM, 1997; and H. Rheingold, The Virtual Community: Homesteading on the electronic frontier (1993).

[61] Robert D. Putnam, “Bowling Alone: America's Declining Social Capital,” Journal of Democracy, January 1995, pp. 65–78.

[62] Fischer and Hout, pp. 57, 63, 64. Putnam, ibid.

[63] James Lynch, A Cry Unheard: New Insights into the Medical Consequences of Loneliness (2000), p. 1.

[64] Fischer and Hout, op. cit., pp. 164–165, 244.

[65] Naomi I. Eisenberger, Matthew D. Lieberman and Kipling D. Williams, “Does Rejection Hurt? An fMRI Study of Social Exclusion,” Science, Oct. 10, 2003, https://tinyurl.com/gspmca6; Steve W. Cole et al., “Social regulation of gene expression in human leukocytes,” Genome Biology, Sept. 13, 2007, https://tinyurl.com/y9wuznpa.

[66] John Cacioppo, Loneliness: Human Nature and the Need for Social Connection (2008), p. 5.

[67] Miller McPherson, Lynn Smith-Lovin and Matthew E. Brashears, “Social Isolation in America: Changes in Core Discussion Networks Over Two Decades,” American Sociological Review, 2006, vol. 71, p. 358; Fischer, Still Connected (2011), op. cit., p. 1.

[68] Keith Hampton et al., “Social Isolation and New Technology,” Pew Researcher Center, Nov. 4, 2009, https://tinyurl.com/k7xefem; “The Surgeon General's Call to Action to Promote Healthy Homes,” Office of the Surgeon General, 2009, p. 1, https://tinyurl.com/y7yp9c7m.

[69] John Cacioppo and Stephanie Cacioppo, “Loneliness is a modern epidemic in need of treatment,” New Scientist, Dec. 30, 2014, https://tinyurl.com/jlxfxf5; John T. Cacioppo, Stephanie Cacioppo and Dorret I. Boomsma, “Evolutionary Mechanisms for Loneliness,” Cognitive Emotion, Sept. 25, 2013, https://tinyurl.com/ydddr97y; John Cacioppo and Stephanie Cacioppo, “Social Relationships and Health: The Toxic Effects of perceived Social Isolation,” Social and Personality Psychology Compass, Feb. 1, 2014, https://tinyurl.com/y8a2n3od; Christopher M. Masi et al., “A Meta-Analysis of Interventions to Reduce Loneliness,” Personality and Social Psychology Review, Aug. 17, 2010, https://tinyurl.com/y8kw3bpg.

[70] Murthy, op. cit.; Steven Ross Johnson, “Surgeon general: Entire community needs to tackle social factors of health,” Modern Healthcare, Dec. 6, 2016, https://tinyurl.com/y8yf7y6d.

[71] Sen. Susan M. Collins, opening statement in earing on “Aging Without Community: Consequences of Isolation and Loneliness,” U.S. Senate Special Committee on Aging, April 27, 2017, https://tinyurl.com/yacjjb75.

[72] “What We Do Together: The State of Associational Life in America,” op. cit.

[73] Barry J. Jacobs, “Overcoming the Loneliness of Dementia Caregiving,” AARP, https://tinyurl.com/yapj4col.

[74] “U.S. Senators Susan Collins and Tammy Baldwin Praise Signage of Bipartisan RAISE Family Caregivers Act,” Senate Special Committee on Aging, Jan. 23, 2018, https://tinyurl.com/y9xhclz6; Jo Ann Jenkins, “Caregiving Costly to Family Caregivers,” AARP, 2017, https://tinyurl.com/y8djz6jx.

[75] “Collins, Casey Bill to Support Grandparents Raising Grandchildren Heads to President's Desk to be Signed into Law,” press release, Senate Special Committee on Aging, June 21, 2018, https://tinyurl.com/ycdkr47w.

[76] “Connectedness as a Strategic Direction for the Prevention of Suicidal Behavior,” Centers for Disease Control and Prevention, https://tinyurl.com/y9p5lxup.

[77] Murthy, op. cit.

[78] Dan Buettner, “The Island Where People Forget to Die,” The New York Times Magazine, Oct. 24, 2012, https://tinyurl.com/yar2fmw7.

[79] Ceylan Yeginsu, “U.K. Appoints a Minister for Loneliness,” The New York Times, Jan. 17, 2018, https://tinyurl.com/yd4rczn6.

[80] “UK must tackle loneliness, says Jo Cox Commission report,” BBC News, Dec. 14, 2017, https://tinyurl.com/ybdlp724.

[81] “A Connected Scotland: Tackling social isolation and loneliness and building stronger social connections,” Government of Scotland, 2018, https://tinyurl.com/y9f5suuu; Joanna Teuton, “Social isolation and loneliness in Scotland: a review of prevalence and trends,” Edinburgh: NHS Health Scotland, 2018, https://tinyurl.com/y7txh2rl; Helen O'Callaghan, “All the lonely people: Epidemic of loneliness is leading to chronic health problems,” The Guardian, March 16, 2018, https://tinyurl.com/ya66t4ln.

[82] Norimitsu Onishi, “A Generation in Japan Faces a Lonely Death,” The New York Times, Nov. 30, 2017, https://tinyurl.com/yctnjohb; Anna Fifield, “Cleaning Up After the Dead,” The Washington Post, Jan. 24, 2018, https://tinyurl.com/y8usqxvo.

[83] Elif Batuman, “Japan's Rent-a-Family Industry,” The New Yorker, April 30, 2018, https://tinyurl.com/y83kvrdt.

[84] Mei Fong, One Child: The Story of China's Most Radical Experiment (2016); Wanning Sun, “’My parents say hurry up and find a girl,’” The Guardian, Sept. 28, 2017, https://tinyurl.com/ydgzjnpt.

[85] “‘Lonely Deaths’ Haunt Middle-Aged Men More Than Other Age Groups,” Korea Bizwire, Dec. 4, 2017, https://tinyurl.com/yamg92h7.

[86] Isabella Steger, “Middle-aged men in South Korea are particularly at risk of dying alone,” Quartz, March 22, 2018, https://tinyurl.com/ybazlalo.

[87] Chris Smyth and Louis Goddard, “Doctors using antidepressants to treat epidemic of loneliness,” The Times, July 21 2018, https://tinyurl.com/ybxu88ga.

[88] Jacqueline Olds and Richard S. Schwartz, The Lonely American: Drifting Apart in the Twenty-first Century (2009); Philipp Kuwert, Christine Knaevelsrud and Robert H. Pietrzak, “Loneliness Among Older Veterans in the United States: Results from the National Health and Resilience in Veterans Study,” American Association of Geriatric Psychiatry, 2014, https://tinyurl.com/y8jseeck; Aoife Hickey and Jason Crabtree, “Ageing and autism: loneliness and isolation,” Network Autism, Feb. 2, 2018, https://tinyurl.com/y8sfo49r; Janna Anderson and Lee R. Rainie, “The Future of Well Being in a Tech-Saturated World: Concerns about the future of people's well-being,” Pew Research Center, April 17, 2018, p. 2.

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About the Author

Christina L. Lyons, author of this week's edition of CQ Researcher  

Christina L. Lyons, a freelance journalist in the Washington, D.C., area, writes primarily about U.S. government and politics. She is a contributing author for CQ Press reference books, including CQ's Guide to Congress, and was a contributing editor for Bloomberg BNA's International Trade Daily. A former editor for Congressional Quarterly, she also was co-author of CQ's Politics in America 2010. She has a master's degree in political science from American University.

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Document APA Citation
Lyons, C. L. (2018, August 3). Loneliness and Social Isolation. CQ researcher, 28, 657-680. Retrieved from http://library.cqpress.com/
Document ID: cqresrre2018080300
Document URL: http://library.cqpress.com/cqresearcher/cqresrre2018080300
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Aug. 14, 1992  Work, Family and Stress
Aug. 13, 1982  Pressures on Youth
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