Loneliness is no longer just a personal struggle; it’s a silent epidemic. The US surgeon general has compared it with smoking, claiming it’s as harmful as up to 15 cigarettes a day. The toll on health is staggering, from cardiovascular risks to mental health struggles. It’s time to face the brutal truth: Loneliness isn’t just hurting hearts, it’s a threat to our very well-being.
In older adults, loneliness is linked to a 50% higher risk of developing dementia, a 30% increased risk for incident coronary artery disease or stroke, and a 26% increased risk for all-cause mortality. It is also associated with a higher risk for heart disease in people with diabetes. In fact, loneliness is a stronger predictor of cardiovascular disease in people with diabetes than diet, exercise, smoking, or depression.
Recognizing loneliness as a global public health priority, the World Health Organization (WHO) has launched a Commission on Social Connection, which aims to provide clear evidence to policymakers and practitioners about the best ways to improve social interaction.
Europe’s Loneliness Evaluation
How big is the problem? According to the first-ever European Union (EU)–wide survey on loneliness, EU-LS 2022, conducted by the Joint Research Centre (JRC), around 13% of 20,000 respondents reported feeling lonely most or all of the time in the 4 weeks preceding the survey.
People in Ireland, Luxembourg, Bulgaria, and Greece felt the loneliest, while the Netherlands, Czech Republic, Croatia, and Austria reported the lowest levels of loneliness.
Loneliness by Age
Perhaps counterintuitively, loneliness does not only affect older adults.
“Some studies show a U-shaped relationship, with high levels of loneliness among both young and older adults, while others indicate a continued decrease in loneliness with age,” Elizabeth Casabianca, a socioeconomic analyst at the JRC, explained to Medscape Medical News.
“Loneliness interventions are often targeted at older adults. Yet interventions are also needed for young people. Different age groups experience loneliness differently, so it is important to carefully consider the needs of the target group and tailor interventions accordingly,” she said.
Ties With Social Media Use
Loneliness has also been linked to an increased use of social networking sites, indicating that these platforms might substitute offline connections with online ones.
Courtney Queen, assistant professor at the Department of Public Health, Texas Tech University, Lubbock, Texas, and guest professor at Riga Stradiņš University, Riga, Latvia, told Medscape Medical News: “While many studies suggest an association between social media use and loneliness, we need to learn more about other fundamental questions, such as: Does increased social media use always result in increased loneliness? Surely not? Does everyone who engages in social media use automatically feel lonelier? Also, surely not. And does this loneliness last forever? Also not likely.”
“Sometimes, it is tough to tease through these associations since there is a greater likelihood that lonely people engage with social media more than those who feel socially connected already,” noted Queen, who has extensively studied technology use among Europeans as a mediator for loneliness.
Healthcare Professionals Can Do Their Bit
Healthcare professionals play an essential role in identifying loneliness and minimizing its impact on mental and physical health.
“The first step for healthcare professionals is to screen for loneliness and its causes so that they can provide personalized care, emotional support, and access to community resources,” said US-based geriatrician Michael Cantor in an interview with Medscape Medical News.
According to Cantor: “The best practice is to use a proactive approach, integrating mental health assessments into routine checkups, linking with community engagement programs, welcoming technological advancements, and training providers to recognize and address loneliness.” He added: “These initiatives ensure that healthcare providers are not only treating medical conditions but also actively contributing to the overall well-being of older individuals.”
Call for Coordinated Action
The journey from isolation to inclusion should involve not only acknowledging the problem but also implementing targeted policies and interventions.
At the local level, community-based programs can be highly effective. They offer a wide range of activities and resources that cater to diverse needs and create an environment that fosters social connection.
“There are a few good examples of community-based programs across the EU, such as Barcelona’s strategy against loneliness [Spain] and the City of Pau anti-loneliness plan [France],” noted JRC socioeconomic analyst Casabianca.
Many European cities are implementing such programs, including social clubs, group activities, and events designed to bring people together and create a sense of community.
In the winter months of Luleå, a city in northern Sweden where the sun barely shines during winters, the Säg hej! (say hello!) campaign urges people to greet each other. Advertisements on buses and workshops in schools aim to encourage small, meaningful social interactions.
Casabianca stresses that targeted initiatives at national level can have a significant impact. For instance, the Een Tegen Eenzaamheid (One Against Loneliness) program in the Netherlands has shown promise.
“The appointment of a minister of loneliness, following the example of the UK and Japan, can send a powerful message about the importance and prevalence of this issue,” she added.
On an international level, collaboration and knowledge-sharing between countries and international organizations could lead to the development of global strategies to tackle loneliness.
Casabianca highlighted that the JRC collaborates closely with key stakeholders such as the WHO, Global Initiative on Loneliness and Connection, UK’s Campaign to End Loneliness, academic scientists, and practitioners in the field.
Innovation and Technology
Innovative projects, like the I2I (from Isolation to Inclusion) in the North Sea Region, have implemented various initiatives, including community theatre, neighborhood cafés, and park renovations. The I2I project in Norway utilizes a specially designed application for transport services and free screens to connect individuals, particularly older adults, with their families.
US-based company Intuition Robotics has developed a chatbot named ElliQ, which uses artificial intelligence (AI) to engage with older adults, providing companionship and support. ElliQ is a small table lamp–like device that tailors interactions based on users’ interests.
“ElliQ uniquely establishes a long-term, trusted, and empathetic relationship between an AI-powered robot and older adults. It intuitively connects older adults with family and friends, helping them navigate the complexities of the digital world,” explained geriatrician Michael Cantor, who also serves as the chief medical officer of Intuition Robotics.
“ElliQ makes it easy for users to access engaging online content, set reminders, and stay physically active. It also helps monitor and support healthy behaviors like better adherence to medications and can ask about whether a person starting a new medication has picked up their prescription, is having side effects, or has questions about the medication,” he added.
Mapping Interventions on the Ground
The JRC has also developed a new map of loneliness interventions available across Europe as an information resource for policymakers, practitioners, researchers, and the general public.
“The mapping serves as a non-exhaustive repository of initiatives and, therefore, may help to inform future development of interventions, promote collaboration, and identify potential gaps in the offer of interventions, with the ultimate goal of informing and supporting policymaking,” noted Casabianca.
“The mapping illustrates that most interventions are targeted at older adults. Although this group faces specific risk factors, research on loneliness prevalence, including results from the EU-LS 2022, calls for more support efforts also for other risk groups including youth,” she said.
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