The Canadian Coalition for Seniors’ Mental Health (CCSMH) has created the first clinical guidelines to address SI&L, urging healthcare professionals to recognize these issues as national concerns. Executive Director Claire Checkland tells us more
Social isolation and loneliness are relatively recent social constructs, with the earliest uses of the term ‘loneliness’ dating back to the 1800s, when it was used to describe both physical remoteness and potential danger. Over the past two centuries, societal changes, including increased urbanization, longer life expectancies, and a growing number of individuals living alone or far from their families, have contributed to a shift in how we experience and understand disconnection. Today, loneliness is recognized not simply as a lack of social contact, but as a profoundly personal emotional state that can persist even in densely populated settings (Lepore, 2020; Worsley, 2018).
Defining social isolation and loneliness and their impact on health
While the terms ‘social isolation’ and ‘loneliness’ are often used interchangeably, they describe distinct but related experiences. Loneliness is the subjective distress experienced by an individual when their social relationships are perceived as inadequate, while social isolation refers to the objective lack of social contacts or interactions (Hawkley & Cacioppo, 2010; Wu, 2020). Historically, these experiences have been viewed as matters of personal concern or social circumstance, rather than medical or policy issues.
However, over the last two decades, a robust body of evidence has established that both social isolation and loneliness are significant determinants of health. Landmark reports, such as the 2020 National Academies of Sciences, Engineering, and Medicine consensus report (National Academies, 2020), and foundational work by Holt-Lunstad and others (Holt-Lunstad et al., 2015), have made it clear the extent to which social isolation and loneliness (SI&L) impact morbidity and mortality. In response to this growing body of evidence, the Canadian Coalition for Seniors’ Mental Health (CCSMH) developed the world’s first Clinical Guidelines on Social Isolation and Loneliness in Older Adults to support frontline healthcare and social service professionals (HCSSPs) and elevate social isolation and loneliness as a national concern.
SI&L among older adults is no longer a silent epidemic; it is a recognized public health crisis with serious consequences. In Canada, recent estimates suggest that up to 58% of adults over 50 have experienced loneliness, and 41% are at risk of social isolation (National Institute on Aging, 2022). These issues are not just emotional burdens; they are risk factors for a host of health complications, including cardiovascular disease, depression, anxiety, cognitive decline, and even premature death (Conn & Ubels, 2024).
Social connection on par with major behavioural risk factors
In 2025, the World Health Organization (WHO) formally recognized social connection as a global public health priority in its report, From Loneliness to Social Connection: Charting a Path to Healthier Societies. The WHO now places lack of social connection on par with major behavioural risk factors, such as physical inactivity and poor nutrition. It urges governments and health systems to embed social connection throughout the life course, in healthcare, education, housing, and policy.
Despite growing awareness, Canada has yet to adopt a national strategy to combat SI&L. A 2025 CCSMH policy scan found that while most jurisdictions in Canada emphasize age-friendly and community-based solutions, few have committed to systematic surveillance or long-term investment in solutions to SI&L. Some provinces have made SI&L a stand-alone priority in their healthy aging strategies, while others have included the issue under broader themes, such as social participation or mental health. However, without dedicated funding or clear metrics, the sustainability of these initiatives remains elusive. This gap between recognition and action ultimately hampers efforts to address SI&L effectively, particularly among older adults (Horgan & Prorok, 2025).
Social connection should not be a luxury; it is essential for healthy aging. The WHO Commission on Social Connection unequivocally states that high-quality social relationships are protective against a wide range of health risks and enhance resilience and well-being (World Health Organization, 2025). CCSMH’s clinical guidelines adopt this same view, advocating for the systematic integration of SI&L screening and response into clinical practice. Without intentional design, health systems risk overlooking this invisible determinant of health.
What healthcare and social service professionals can do
HCSSPs are uniquely positioned to respond to SI&L in older adults. However, they face numerous barriers such as a lack of training, time constraints, and limited referral pathways. Even when loneliness is identified, HCSSPs may not know how to intervene or feel uncertain about available community resources or the degree to which the system they are working within will support their efforts. The stigma (real or perceived) surrounding loneliness compounds the issue, making it harder for HCSSPs to raise this issue with the older adults in their care (Conn & Ubels, 2024). The WHO highlights these same professional barriers and recommends workforce training, capacity-building, and policy advocacy as critical solutions (World Health Organization, 2025).
To bridge these gaps, CCSMH’s guidelines include 17 actionable, evidence-informed recommendations covering prevention, screening, intervention, and reassessment. They promote practices such as social prescribing, animal-assisted therapy, psychological interventions, and the use of validated screening tools like the UCLA Loneliness Scale. Importantly, the guidelines also encourage healthcare professionals to treat loneliness as a biopsychosocial issue, rather than just a lifestyle concern.
Social health must be a national priority
Across Canada, a range of promising initiatives, such as social prescribing pilots and curricular integration, are beginning to reflect a growing awareness of social isolation and loneliness in health systems and education. However, many of these efforts remain small-scale, inconsistently evaluated, and disconnected from broader policy frameworks. To move from innovation to impact, long-term investment, standardized measurement, and integration into provincial and national systems will be required. Internationally, countries like Japan and Denmark offer leading examples, where social connection is embedded into health assessments, statutory mandates, and national performance indicators (World Health Organization, 2025).
Canada has the opportunity to learn from international models and build a coordinated, national response to social isolation and loneliness. Recent initiatives across the country, including clinical guidelines, pilot programs, and community-led strategies, are increasingly aligned with the WHO’s strategic recommendations. Canada is well-positioned to lead globally on this issue, but only if we take deliberate, collaborative steps forward.
As educators, policymakers, clinicians and engaged citizens, we must work together to ensure that no older adult feels invisible, disconnected, or unsupported. SI&L is not inevitable; it is modifiable, and the right tools, training, and policies can change the trajectory. With the WHO Commission on Social Connection offering a global vision and CCSMH’s Clinical Guidelines on Social Isolation and Loneliness offering a strong foundation for further collective action, the message is clear…now is the time to come together and make social health a national priority in Canada and around the world!
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