Long before the hammer of social distancing shattered our ways of connecting, causing us to quickly pivot to figure out ways to be together, and worry about the emotional effects of isolation, sirens were sounding about loneliness as a global public health problem. Former Surgeon General Dr. Vivek Murthy declared loneliness an epidemic in 2017. He penned an HBR piece citing that “over 40% of adults in America report feeling lonely,” and repeated the oft-quoted research finding that “loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day.” In 2018, the UK appointed its first Minister for Loneliness on the heels of reports showing that “more than 9 million people in Britain — around 14 percent of the population — often or always feel lonely.”

Lonely in plain sight

In a recent HBR Ideacast timed with the publication of his new book, Together, The Healing Power of Connection in a Sometimes Lonely World, Murthy described loneliness as “. . . the feeling that the connections that we need in life are greater than the social connections that we’re experiencing right now. You can feel that gap whether you have hundreds of people around you or if you only have a couple of people around you. And conversely, you may be surrounded by just a few people but feel very enriched and fulfilled by those relationships.” One specific marker for loneliness is whether or not we have a confidant — someone we can trust and talk to about our most intimate thoughts.

We’ve long known loneliness to be a heartbreaking challenge for older, isolated people. Murthy and many others find strong evidence of it in our homes, at work, at school, in our communities, society at large, and multiple stages of life.

But, is it true that it’s on the increase, and seriously affects our health? Freakonomics podcast host Stephen Dubner, called out that “the data aren’t so clear,” and went behind the headlines in a recent podcast to understand what’s known, not known, and the implications for us.

Is There Really a “Loneliness Epidemic”?

Dubner assembled loneliness studiers, including Dr. Murthy, Dr. Julianne Holt-Lunstad of Brigham Young University and the source of the “15 cigarettes” analogy, and Dr. Eric Klinenberg of NYU to answer three questions: How real is the loneliness epidemic? Is there any upside to loneliness? And, are there any solutions to it?

Loneliness is believed to be a biological drive — a survival instinct, like hunger and thirst — that causes us to seek out others who can provide protection and resources. “Loneliness is our bodies’ cue that we need to get out in the world and participate in social life,” says Klinenberg. “The problem [starts] when it becomes chronic,” Holt-Lunstad points out. This leads to negative health effects such as high blood pressure and inflammation.

Is loneliness really an epidemic? The short answer is we think so, but there is no definitive proof. “. . . we have a lot of data that shows strong associations between loneliness and health outcomes, including shortened life spans and conditions like heart disease. What we have far less of are the kind of studies, that beyond a shadow of a doubt, prove causation,” said Murthy. And that 15 cigarette claim? Dubner connected the dots with Holt-Lunstad and found that the headline distorts the truth. While she found a link between some measures of social connection and life expectancy in a meta-analysis using data from over 150 studies, there are many nuances in the data, and loneliness was only one of the measures.

Sociologist Eric Klinenberg says, “. . . we have been worried about loneliness since the rise of industrial society. Since we started moving away from the village and we agglomerated into towns where we didn’t know as many of our neighbors.” And the rise in one person households in the US is dramatic: from nine percent in 1950 to an estimated 28% in 2018, and as high as 44% in Manhattan. Living alone does pose risks. For example, 739 people died in a 1995 heat wave in Chicago, far more than any model would have predicted. Klinenberg discovered that because so many people were living alone, no one was there to see that they were in distress. It appears that is proving to be a factor in this pandemic as well, particularly in hotspots like NYC. But, Klinenberg’s subsequent research didn’t show a link between living alone and feelings of isolation or loneliness.

All that said, there’s something just intuitive about a loneliness overhang. We just feel it and see it around us — that person at work who hasn’t formed any relationships. Isolated and lonely relatives. Kids not connecting at school. Our own feelings of being alone. Rising suicide rates.

And, Dubner agrees, “even if loneliness isn’t growing . . . even if loneliness is not as damaging as some people believe it is . . . unwanted social isolation can’t be a good thing.” So, what do we do about it?

Reach out and connect

In my world, the pandemic has had a silver lining. Virtual family dinners, happy hours, birthday parties, old friends reconnecting, and people reaching out to help: Need a mask? Need some groceries? You doing ok? And, lots and lots and lots of gratitude and appreciation.

Murthy tells us, “Number one, it turns out, is that service, serving other people, is a powerful back door . . . out of loneliness . . . it shifts the focus away from you and onto other people. And it also reaffirms for you that you have value to give and share with the world.” He also urges us to spend time each day with people we love and care about. When interacting with others, try to focus, make eye contact, and truly listen. And, somewhat counterintuitively, he suggests building a stronger connection to ourselves with some me-time that brings comfort, joy, and a feeling of wholeness: mediation, art, music, time outdoors in nature.

Klinenberg leans toward better social infrastructure, such as “gathering places that are public and accessible, like libraries and parks and playgrounds, and public transit systems that work well.”

Hello in there, hello

We lost John Prine to the coronavirus this month. If you’ve never heard his gravel-voiced good-as-Dylan ballads, or even if you have, there are so many must-listens. Hello in There hauntingly echoes the loneliness and forgottenness of “old people.”

So if you’re walking down the street sometime

And spot some hollow ancient eyes,

Please don’t just pass ‘em by and stare

As if you didn’t care, say, ‘Hello in there, hello’

Thoughts are welcome