As India stares at a loneliness epidemic, a new global study links it to a heightened risk of premature death

Loneliness may be bad enough but new research shows that it may be as grave a public health hazard as obesity.

Effects of social isolation

At a recent conference organised by the American Psychological Association, Julianne Holt-Lunstad, professor of psychology at Brigham Young University, U.S. presented data from two large studies that surveyed loneliness and ageing. The first combed 148 studies, involving more than 3,00,000 participants, and found that deep social ties were associated with a 50% reduced risk of early death. The second study, of 70 studies involving more than 3.4 million individuals primarily from North America but also from Europe, Asia and Australia, examined the role that social isolation, loneliness or living alone might have on mortality.

Researchers found that all three had a significant and equal effect on the risk of premature death, one that was “equal to or exceeded” the effect of other well-accepted risk factors such as obesity.

“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,” said Dr. Holt-Lunstad in a statement. “With an increasing ageing population, the effect on public health is only anticipated to increase. Indeed, many nations around the world now suggest we are facing a ‘loneliness epidemic’. The challenge we face now is what can be done about it.”

The loneliness epidemic

Approximately 42.6 million adults over age 45 in the U.S. are estimated to be suffering from chronic loneliness, according to the ‘Loneliness Study’ led by the non-profit, AARP (formerly known as the American Association of Retired Persons). In addition, the most recent U.S. census data reveals over a quarter of the population to be living alone, more than half of the population unmarried, declining marriage rates and number of children per household. “These trends suggest that Americans are becoming less socially connected and experiencing more loneliness,” said Dr. Holt-Lunstad.

Evolving demographic trends in India suggest a latent loneliness epidemic. The population of the elderly is ballooning, both relative to the total population as well as absolute numbers (5.3% or 12.5 million in 1951 to 7.6% or 92 million in 2011, respectively). Moreover, changing living situations (living alone or living with relations and non-relations) are the main demographic “breeders of loneliness”, says a 2013 report in the Indian Journal of Psychiatry by S.C. Tiwari of the King George’s Medical University, Lucknow. Factors such as widowhood, increasing dependency ratio (10.9% in 1961 to 13.1% in 2001) as well as economic dependency (86% rural and 83% urban females and 51% rural and 56% urban males) and solvency are major contributors for developing loneliness. Further, environmental factors like type of family, social network, transportation issues and place of residence, population migrations, etc. are also some other significant correlates of loneliness. Women are reportedly at greater risk for loneliness and isolation than men.

India’s National Sample Survey Office indicated in 2004 that 1.23 million men and 3.68 million women are living alone and faced loneliness.

Dr. Holt-Lunstad recommended greater emphasis on research and resources to tackle this public health threat from the societal to the individual level. For instance, greater emphasis could be placed on social skills training for children in schools and doctors should be encouraged to include social connectedness in medical screening, she said. Additionally, people should be preparing for retirement socially as well as financially, as many social ties are related to the workplace, she noted, adding that community planners should make sure to include shared social spaces that encourage gathering and interaction, such as recreation centres and community gardens.

jacob.koshy@thehindu.co.in