New epidemic affects nearly half of American adults

The newest epidemic in America now affects up to 47% of adults—double the number affected just a few decades ago. This condition is associated with a 26% increased risk for early mortality—a risk rate on par with that of obesity or smoking 15 cigarettes a day. It is also associated with higher systolic blood pressure, body mass index, and high-density lipoprotein cholesterol levels, not to mention an increased risk for depression, personality disorders psychoses, and suicide. And, according to experts, physicians don’t usually screen patients for this condition.

What is this epidemic? It’s loneliness.

Loneliness affects your patients’ health, and it’s more widespread than you probably think.

All the lonely people

According to a recent survey of more than 20,000 US adults conducted by Cigna and Ipsos:

• Nearly half of Americans sometimes or always feel alone (46%) or left out (47%).
• Approximately 1 in 4 Americans (27%) rarely or never feel as though there are people who really understand them.
• Roughly 2 in 5 Americans sometimes or always feel that their relationships are not meaningful (43%) and that they are isolated from others (43%).
• Only about half of Americans (53%) have meaningful in-person social interactions on a daily basis.
• Generation Z (adults aged 18 to 22 years) is the loneliest generation and reports being in worse health than older generations.

Loneliness as an epidemic

Former US Surgeon General Vivek H. Murthy, MD, MBA, identified loneliness as an epidemic in a 2017 article in Harvard Business Review.

“I think of loneliness as an epidemic because it affects a great number of people in our country but also because one person’s loneliness can have an impact on another person. This is not a condition that is developing in isolation,” Dr. Murthy told The Washington Post.

“I talk about this as an epidemic because it’s far more widespread than people believe, and like many illnesses that are related to our mental and psychological state, it gets swept under the rug and exists in the shadows,” he added.

Although loneliness has about the same risk for premature death as smoking and obesity, it gets nowhere near the amount of public health attention or resources that go into curbing smoking and obesity, Dr. Murthy pointed out.

“Loneliness is often stigmatized, trivialized, or ignored, but—with the rapidly growing number of older adults in industrialized countries, the increased likelihood of premature mortality, and the deleterious effects of loneliness that have been identified in animal models and human longitudinal investigations—loneliness is emerging as a public health problem,” according to neuroscientists in a 2018 article in The Lancet. “Physicians are encountering this condition, but most do not have the information needed to deal effectively with loneliness in their patients.”

But there are steps physicians can take.

What you can do about it

First, recognize that continued (ie, chronic) loneliness is significantly associated with an increased number of doctor visits—among older adults at least—according to findings of a survey by health policy researchers published in American Journal of Public Health.

Because these chronically lonely older adults are likely to turn to physicians for social contact, clinicians should take loneliness into consideration as a factor for other illnesses and complaints, the researchers advised.

When you encounter these patients, consider using one of the quick and valid measures used to screen patients for high levels of loneliness.

“Loneliness is something that is easily preventable and with little cost compared to other chronic illnesses,” said co-author of the survey study, Jayani Jayawardhana, PhD, associate professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens, GA. “With interventions as simple as a phone call, home visit or community program, you can avoid unnecessary health care utilization and additional expenditures that ultimately cost all of us as a society.”