At publication time, over 97 percent of Americans in 43 states are under mandatory social distancing orders designed to reduce the spread of coronavirus. The orders are undoubtedly a smart public health strategy, though very painful economically for millions out of work.
But social distancing may also be harming people by making them lonelier. The lockdowns are increasing both social isolation—being alone—and loneliness, or feeling alone. Troublingly, both factors can affect people’s stress levels and physical health, contributing to phenomena like depression, suicide and substance use disorder.
The coronavirus pandemic has simply worsened an existing epidemic of loneliness among Americans, and it affects some demographics worse than others. A health insurance company survey found that 61 percent of Americans surveyed in 2019 reported being lonely, and the number had increased from 2018. The survey cited “not enough social support”, “too few meaningful social interactions”, and “not enough balance in our lives” as some of the reasons. About 24 percent of Americans described their mental health as either “fair” or “poor.”
The survey also revealed demographic insights about who is experiencing the most loneliness. Younger people are at higher risk than older people—about eight in 10 Generation Z members feel lonely, compared to just half of Baby Boomers. Men are lonelier than women. People identifying their race as Hispanic or “other” are the loneliest ethnic groups, followed by Black Americans. People in lower-income households are significantly lonelier than those in wealthier households. Rural dwellers are lonelier than those living in suburbs or cities.
What is the health impact of loneliness? Research has shown that it has a negative effect on an individual’s lifetime health and mortality risk, comparable to the effects of obesity or cigarette smoking. Loneliness seems to reduce immunity, making people more susceptible to disease. It can also increase inflammation and stress levels.
Julianne Holt-Lunstad, PhD has reviewed hundreds of studies representing nearly 4 million participants. She found that increased social connection is associated with about a 50 percent lower chance of premature death. Meanwhile, social isolation and loneliness increase the chances of premature death at least as much as obesity.
Other research has linked loneliness and social isolation with heart disease and stroke, immune system weakness, depression, and difficulty recovering from cancer.
“There is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators,” Holt-Lunstad wrote. “With an increasing aging population, the effect on public health is only anticipated to increase.”
Loneliness is also linked to substance use disorders. A 2014 study looked at 228 people, including those with and without substance use disorders. It evaluated how everyone experienced emotional, social, romantic and familiar loneliness on a scale. The subjects with substance use disorders had significantly higher average scores of loneliness for each category.
“The feeling of loneliness is stronger in drug abusers rather than non-drug abusers that could develop the sense of being different from community and increase the probability of taking high risk behaviors and abusing drugs,” the authors wrote. “Thus, it is suggested to consider the feeling of loneliness in all programs designed to prevent or treat addiction.”
Clearly, governments and public health officials implementing social distancing orders need to be sensitive to how prolonged social isolation can affect people’s health on a mass scale. Practical measures may include ensuring people have access to mental healthcare, or removing barriers to psychologists and therapists providing telehealth services.
But what steps can people actually take for themselves? Michael Lee Stallard and Katharine P. Stallard at Government Executive offer some simple tips.
“To be a good connector with others, we need to make sure we are physically and emotionally strong and steady,” they write. “We do this by making sure we are connecting with people who energize us. Each day, schedule phone calls or video calls online with people you enjoy. Take virtual coffee breaks in the morning and afternoon while connecting on a video call. Schedule a call each evening with relatives and friends who may need connection.”
Virtual communication can certainly be helpful, but what about for people who don’t know how to use this technology or don’t have access? The Stallards recommend other activities that improve physical or mental health, like exercise, walking, enjoying music and art, or learning something new.
“If local authorities allow it, go for a walk each day to get fresh air and sunlight,” they write. “Remember to maintain a six-foot separation from others. If possible, walk amongst nature. Even being in your own yard or walking your city block will help.”
Improving other aspects of your health can also help mitigate the dangers of loneliness. “Is the person [under social distancing] still keeping a routine, getting up at the same time every morning, going to bed at the same time?” asks psychiatrist Dr. Ellen White. “Do they have food in the house, are they preparing meals, keeping up with bathing?”
The American Society for Nutrition offers some tips for eating well in this situation. They include eating a more varied, high-nutrient diet, avoiding pre-made foods, cooking with fresh ingredients, and minimizing trips to the supermarket by planning with shopping lists.
Best of all, buying and cooking food together with the family can give you more opportunities to connect. “Make mealtimes a family affair,” they write. “Eat together at the table or spread a blanket on the floor and have an indoor picnic. Chat about things you will do this summer, tell jokes—just keep the conversation upbeat and fun.”
Photo by Clark Young on Unsplash.