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The Other Health Crisis: Loneliness
We Need Each Other. Here’s Why, and How to Connect 07/01/2020 By Temma Ehrenfeld

As we often say in these pages, it’s vital to eat right, exercise and get plenty of good sleep. But emerging science makes it clear: sociability matters to your physical health far more than you might think.

In fact, meeting your social needs will help keep you alive.

As hunger and thirst prick you to seek food and water, loneliness is a signal that you need other people. But who wants to admit that they’re lonely? It seems a shameful secret, especially when we compare our lives to the happy scenes curated for Facebook and Instagram.

No one should feel ashamed of needing others. Human beings are profoundly social. As Vivek Murthy eloquently explains in his book Together: The Healing Power of Human Connection in a Sometimes Lonely World (Murthy, 2010), we are wired by evolution for far more connection than most modern American lives easily offer.

Murthy, a former U.S. Surgeon General, argues that loneliness is a root cause of division in our politics, difficulties for children in school, workplace stress and poor physical health.
As a doctor, he walks us through the hidden toll on our well-being.

The power of connecting

The statistics are dramatic: Strong relationships improve your odds of survival by 50 percent. Surviving what? It doesn’t matter. In a breakthrough meta-analysis, this finding was consistent across age, sex, initial health status, cause of death, and follow-up period.

Isolation is more harmful than not exercising and twice as harmful as obesity. It is as dangerous as alcoholism or smoking fifteen cigarettes a day.

These conclusions come from comparing death rates against the social habits of more than 300,000 people in 148 studies (Holt-Lunstad et al., 2010).

Among older people, social isolation has been linked to a 50 percent higher risk of dementia, a 29 percent higher risk of heart disease and a 32 percent higher risk of stroke (Centers for Disease Control and Prevention, 2020).

Murthy makes the case that one of the most powerful steps we can take as a society and as individuals is to reduce loneliness.

Loneliness is common

We need three kinds of connection, he explains: emotional intimacy, a social circle, and a community.

A strong core relationship - not necessarily a marriage - is correlated with lower blood pressure while you sleep, says Julianne Holt-Lunstad at Brigham Young University, who also led the mortality study. Yet one in five Americans reports rarely or never feeling close to people. Only about half of Americans, 53 percent, say they have a long conversation with a friend or spend time interacting with family every day (Cigna, 2018).

That’s just the beginning: You can have a strong marriage and still be lonely without a happy, convivial workplace to fill your days. People who are underemployed are lonelier than over-workers, likely because they are missing out on the feeling of being useful.

We need community, but the trends are for Americans to change colleges and jobs more frequently and to do more work on a freelance basis. All incline us toward isolation.

So perhaps it’s not so surprising that in a 2019 survey from the insurer Cigna, 61 percent of Americans reported feeling lonely, up from 54 percent in 2018 (Cigna, 2018 and 2020). Nearly 80 percent of Gen Zers and 70 percent of millennials are lonely, compared to 50 percent of boomers.

Proximity and resources help. Contrary to the idea that urban professional life is especially lonely, the loneliest people are the rural poor.

How loneliness affects the body

Emotions are physical states. Over time, loneliness induces a kind of “premature aging,” University of Chicago psychologist John Cacioppo wrote in his groundbreaking 2008 book (Cacioppo and Patrick, 2008). He had volunteers fill out forms gauging their loneliness throughout the day while attached to biosensors. He saw that loneliness was linked to higher blood pressure.

That makes sense, as physiologically, we experience social isolation as a threat to our survival. Our bodies are like infants crying for milk, terrified if no caregiver arrives. Isolated people live in a state of ramped-up inflammation, as if they always had the flu.

This affects both our resistance to opportunistic infections and our ability to recover. Murthy describes how as a young doctor, he saw that some patients had no visitors and relied on the doctors and staff for emotional support and socializing.

If you develop heart disease, strong connections help keep you alive longer (Brummett et al., 2001).

When relationships go bad

Of course, not all relationships serve your health or happiness. Conflict in any close relationship shows up as higher blood pressure for women, and especially if they’re fighting with a spouse (Holt-Lunstad et al., 2008). In the same study, single people did better than did the unhappily married.

In another study, researchers fit 42 couples with small suction devices that created eight tiny blisters on their arms. Hostile couples needed two days longer for the wounds to heal (Glaser, 2005). Cacioppo also reports that married people sharing a bed are at risk for poor sleep if they feel isolated (Cacioppo et al., 2010).

Perception counts most. Loneliness arises from a mismatch between our needs and reality, and those needs vary between people. A wealthy or powerful person might have many people around him, but be lonely if he doesn’t feel genuinely liked. If early relationships or a history of trauma have made you distrustful, you may be lonely even when loved. What matters is that you perceive any core relationship as happy and sturdy, Holt-Lunstad found - not how or how much the other person provides support.

How to overcome loneliness

Murtha offers these recommendations:

  • Devote at least 15 minutes each day to connecting with those you most care about. The digital age offers endless ways to connect – use them!
  • Focus on each other. “Forget about multitasking and give the other person the gift of your full attention, making eye contact, if possible, and genuinely listening,” he writes.
  • Though it may seem paradoxical, embrace solitude. “The first step toward building stronger connections with others is to build a stronger connection with oneself. Meditation, prayer, art, music, and time spent outdoors can all be sources of solitary comfort and joy,” he writes. They renew your energy and motivation to connect with others.
  • Help and be helped. “Service is a form of human connection that reminds us of our value and purpose in life. Giving and receiving, both, strengthen our social bonds-- Checking on a neighbor, seeking advice, even just offering a smile to a stranger six feet away, all can make us stronger.” Murtha tells us.

It’s all still possible during a pandemic, and ever more necessary.

Sources:

Berkman LF, Syme SL. SOCIAL NETWORKS, HOST RESISTANCE, AND MORTALITY: A NINE-YEAR FOLLOW-UP STUDY OF ALAMEDA COUNTY RESIDENTS. OUP Academic. https://academic.oup.com/aje/article-abstract/109/2/186/74197. Published February 1, 1979.

Brummett BH, Barefoot JC, Siegler IC. Characteristics of Socially Isolated Patients With Coronary Artery Disease Who Are at Elevated Risk for Mortality. Psychosomatic medicine. https://pubmed.ncbi.nlm.nih.gov/11292274/. Published 2001.

Cacioppo JT, Patrick W. Loneliness: Human Nature and the Need for Social Connection. New York, New York: Norton; 2008.

Cigna Takes Action To Combat The Rise Of Loneliness And Improve Mental Wellness In America. Cigna, a Global Health Insurance and Health Service Company. https://www.cigna.com/newsroom/news-releases/2020/cigna-takes-action-to-combat-the-rise-of-loneliness-and-improve-mental-wellness-in-america. Published January 23, 2020.

Germine L, Dodell-Feder D. Epidemiological Dimensions of Social Anhedonia - David Dodell-Feder , Laura Germine, 2018. SAGE Journals. https://journals.sagepub.com/doi/10.1177/2167702618773740. Published June 11, 2018.

Glaser R. Stress-associated Immune Dysregulation and Its Importance for Human Health: A Personal History of Psychoneuroimmunology. Brain, behavior, and immunity. https://pubmed.ncbi.nlm.nih.gov/15581732/. Published 2005.

Holt-Lunstad J, Birmingham W, Jones B. Is There Something Unique About Marriage? The Relative Impact of Marital Status, Relationship Quality, and Network Social Support on Ambulatory Blood Pressure and Mental Health. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. https://pubmed.ncbi.nlm.nih.gov/18347896/. Published April 2008.

Holt-Lunstad J, Smith TB, Layton JB. Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine. https://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1000316. Published 2010.

Loneliness and Social Isolation Linked to Serious Health Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/aging/publications/features/lonely-older-adults.html. Published May 26, 2020.

Murthy V. Together: the Healing Power of Human Connection in a Sometimes Lonely World. New York, New York: Harper Wave, an imprint of HarperCollinsPublishers; 2020.

New Cigna Study Reveals Loneliness at Epidemic Levels in America. Cigna, a Global Health Insurance and Health Service Company. https://www.cigna.com/newsroom/news-releases/2018/new-cigna-study-reveals-loneliness-at-epidemic-levels-in-america. Published May 2018.

No Isolation. Consequences of social isolation for children and adolescents. No Isolation. https://www.noisolation.com/global/research/consequences-of-social-isolation-for-children-and-adolescents/. Published April 29, 2019.

Suttie Jill Suttie J. How Loneliness Hurts Us and What to Do About It. Greater Good. https://greatergood.berkeley.edu/article/item/how_loneliness_hurts_us_and_what_to_do_about_it?utm_source=Greater+Good+Science+Center. Published May 2020.

Teo AR, Choi HJ, Andrea SB, et al. Does Mode of Contact with Different Types of Social Relationships Predict Depression in Older Adults? Evidence from a Nationally Representative Survey. Journal of the American Geriatrics Society. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5527991/. Published October 2015.

Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. Journal of health and social behavior. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/. Published 2010.

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