Loneliness has become a pressing health issue, with significant negative impacts to people's mental and physical health. As loneliness increases among both young people and older adults, health experts say that "rebuilding social connection … has to be a national priority." But how? Advisory Board's Sydney Moondra shares three things stakeholders should consider as they take on loneliness, and shares case studies of how some providers are working toward this goal.

How loneliness can impact your health

According to Kelsey McNamara, senior director of research at Papa, an organization that provides paid companionship to people who need social support, loneliness among both young people and older adults is a health problem, and it needs more attention.

"Loneliness increases the risk of premature death, independent of other kinds of physical and mental health conditions," McNamara said. "You probably have heard the statistic that loneliness is just as dangerous as smoking a pack of cigarettes a day. And the relationship between loneliness and chronic conditions is bi-directional: inflammation and the biological conditions of loneliness can lead to illness, but also, having a chronic condition and the isolated experience and disabilities that might come up also leads to loneliness."

Between January and June 2023, Papa surveyed 28,000 Medicare Advantage members. Among the participants, the average age was 72, 31% were male, and 13% were dual eligible for both Medicare and Medicare.

Overall, 62% of the participants said they were lonely, with the highest level of loneliness reported by those with disabilities (75%). In addition, 40% of participants said it would be difficult to find someone to support them in a time of need.

Loneliness was associated with more unmet social needs, as well as more transportation barriers. It was also associated with more ED utilization. Twelve percent of respondents who were "severely lonely" qualified as frequent ED users compared to 7.4% who were "lonely" and 4.1% who were "not lonely."

"Being hospitalized makes us more vulnerable to isolation, especially when you're recovering and mobility is limited for a while, but the inverse is also true," McNamara said. "People who are isolated are more likely to go to the hospital when it's not medically necessary."

According to McNamara, the people who are at the greatest risk of loneliness and social isolation are women, those at a lower socioeconomic status, the LGBTQ+ community, and older adults. Younger adults and people who recently experienced losses are also at an increased risk of loneliness.

"We need to treat loneliness and social connection needs like other types of social determinants of health -- housing, transportation, and food insecurity," McNamara said. "We need to ensure it's a standard part of screening, and then we actually need to act on data and do something about it. And what we see again and again is that 'social prescribing' is only the first step and we need to work collaboratively with patients to help them over time."

Rebuilding social connection is a 'national priority'

Earlier this year, U.S. Surgeon General Vivek Murthy declared loneliness and isolation an epidemic "that has harmed individual and societal health" in the United States.

"We have become professionals at putting masks on and walking around society ... like everything is going fine," said Murthy at a recent gathering of all living former and current U.S. surgeons general. "But what it betrays is the reality ... that a lot of people are walking around suffering."

"Our connection to one another is a foundation on which we build a healthy society," he added. "As that foundation has crumbled and weakened, we've seen that we're suffering across the board. And that's why I really believe that rebuilding social connection in America, the social fabric of our country has to be a national priority."

In a report released in May, Murthy outlined a national framework "to rebuild social connection and community in America" based on six pillars:

1.       Strengthening social infrastructure in local communities

2.       Implementing public policies that promote connection

3.       Enhancing public health surveillance and interventions through healthcare providers

4.       Modifying digital environments to improve data transparency and safety

5.       Investing in a national research agenda on loneliness

6.       Creating a culture of connection

"This work will take all of us: schools, workplaces, community organizations, government, health workers, public health professionals, individuals, families and more working together," Murthy said. "And it will be worth it because our need for human connection is like our need for food and water: essential for our survival." (Frieden, MedPage Today, 9/21; King, Axios, 10/10)