Tackling the Loneliness Crisis at Scale

Last year, Surgeon General Dr. Vivek Murthy issued an alarming report about a public health crisis that affects one out of every five American adults: loneliness. Recognizing the considerable health and economic implications of this epidemic, the healthcare industry is seeking to develop scalable interventions that can help people establish stronger social ties and reduce their feelings of isolation. But healthcare can’t fix the problem alone: addressing it requires more than just simply facilitating access to high-quality, affordable care. It requires healthcare providers, community programs, and social services working collaboratively to develop broader community-based approaches that address the root causes of loneliness.

A treacherous rip current

During the Covid-19 pandemic, many people found it hard to maintain social connections, but even before that public health crisis, millions of Americans were disconnected from others. In his 2001 book, Bowling Alone: The Collapse and Revival of American Community, Robert Putnam noted that “For the first two-thirds of the twentieth century a powerful tide bore Americans into ever deeper engagement in the life of their communities, but a few decades ago — silently, without warning — that tide reversed and we were overtaken by a treacherous rip current.” Television, urban sprawl, and the increasing pace of life are all contributing factors to this “rip current,” exacerbated in recent decades by the emergence of the internet and the proliferation of social media, which has pushed us further into individualism. 

This trend of increasing social disconnection affects all Americans, regardless of race or gender. Across all age groups, we are spending less time with each other in person than two decades ago. The problem is especially acute among young people aged 15-24, who report having 70% less social interaction with their friends. Older Americans are also vulnerable; 43 percent of Americans aged 65 and older report feeling lonely. 

The loneliness epidemic has profound implications for our society: studies have shown it is associated with an increased risk of diabetes, high blood pressure, and dementia, as well as a 29 percent higher risk of heart attack and a 32 percent higher risk of early mortality. People who experience loneliness and social isolation are less likely to go to doctors’ appointments, take their medicine, exercise, and eat a healthy diet, further imperiling their health.

Loneliness doesn’t just take a toll on individuals; it affects the country as a whole in a myriad of ways. The Centers for Disease Control and Prevention estimates that loneliness costs the U.S. economy approximately $406 billion each year, in addition to the estimated $6.7 billion per year in Medicaid costs. Even more alarmingly, our growing isolation from each other erodes trust – trust in each other, trust in our institutions, and trust in our democratic values – further exacerbating social inequalities, and undermining the well-being of our nation.

The health benefits of social participation

Social participation—our involvement with other people and activities outside the home—plays a critical role in our health. Studies have shown that there is a clear link between social relationships and health in the general population. Adults who are socially connected are physically healthier and live longer than their more isolated peers. Socialization affects brain health as well; research indicates that social interaction can actually retrain our brains, improving memory formation and recall and protecting us from neurodegenerative diseases.

We know that socially cohesive neighborhoods can positively shape their residents’ well-being; several studies have found associations between neighborhood cohesion and improved physical and mental health. People who live in connected communities support each other, share information that is trustworthy and easily actionable, and often motivate each other to adopt better lifestyle habits. Maintaining social connections with our neighbors can help us in multiple ways, including:

• Increase confidence and self-esteem. People who report feeling lonely often exhibit lower confidence and self-esteem. Spending time with those you are familiar with and whose company you enjoy can boost confidence and improve how we see ourselves.
• Achieve a greater sense of purpose. Spending time with neighbors helps us feel useful and that our life has a greater purpose. When we have something to do, somewhere to go, and someone counting on us, it feels good. When others count on us, we are more likely to take care of ourselves, and stay healthy for as long as we can.
• Cultivate resiliency. In the face of hardship or adversity, socializing with neighbors can help individuals hone skills that can reduce stressors and recover from setbacks. 
• Adopt healthy habits.  Engaging with people who model and encourage us to keep healthful habits or achieve challenging lifestyle goals helps us to remain mindful of our eating, exercise, and other lifestyle-related habits.
• Live longer. Studies show that loneliness is a risk factor of functional decline and death, especially in older people. Staying social and connected with others can extend the length of our life and its quality.

Fostering connections at the neighborhood level

As recognition of the important role socialization plays in health has become more widespread and accepted, health plans are committing more resources to solving the problem. One model that has been proven to work to foster connections at scale is centered on building hyper-local neighborhood networks of peers, facilitated by local community engagement teams and community health workers. This approach connects health plan members with familiar neighbors who are members of the same plan to inform, support and motivate one another, empowering them to be more proactive about their health. It provides a neighborhood forum that enables participants to solve issues together and better utilize care resources and creates opportunities for members to be more physically active. Equally important, this community-based model offers a promising path toward restoring our trust in each other. 

A healthier future

Community-based social support initiatives can be powerful tools in the fight to end the loneliness epidemic. Health providers, payers, and other stakeholders should prioritize the fostering of meaningful and authentic connections at the neighborhood level if they want to achieve better health outcomes at scale.

Photo: FrankyDeMeyer, Getty Images

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