Increased loneliness has become a global public health issue

Loneliness has become a new pandemic across many countries, creating a range of mental and physical health problems for people on a global scale

An analysis of evidence from 113 countries and territories during 2000 to 2019 finds that loneliness has become a widespread problem globally.

Evidence shows that loneliness not only affects mental health and wellbeing, but also induces a range of physical health problems and could lead to early death.

The study highlights critical data gaps, especially across low- and middle-income countries, verifying a substantial geographical variation in loneliness – however, northern European countries did consistently show lower levels of loneliness in comparison to other regions.

The negative effects of loneliness on health and longevity, the study’s findings reinforce the urgency of approaching loneliness as an important public health issue.

Roger O’Sullivan at the Institute of Public Health in Ireland and colleague argues that loneliness is costly to individuals and society and should be a political priority.

Scoping the severity of the problem

Published by The BMJ, US researchers estimated that around a third of the population in industrialised countries experience loneliness, and one in 12 people experiences loneliness at a level that can lead to serious health problems.

However, it remains unclear how widespread loneliness is on a global scale – so a team of researchers led by the University of Sydney set out to analyse the broad scale of loneliness internationally, potentially helping decision makers make policies to tackle scope and severity of the problem.

Taking information from research databases, they unveil 57 observational studies reporting national estimates of loneliness from 113 countries or territories during 2000-19.

Data was available for adolescents (12-17 years) in 77 countries or territories, young adults (18-29 years) in 30 countries, middle aged adults (30-59 years) in 32 countries, and older adults (60 years or older) in 40 countries. Data was considerably higher in high income countries – particularly Europe – as opposed to low- and middle-income countries.

Including 212 estimates for 106 countries from 24 studies were included in the meta-analysis, the data for adolescents showed that prevalence of loneliness was around 9.2% in South-East Asia, and 14.4% in the Eastern Mediterranean region.

For adults, meta-analysis was conducted for the European region only, and a consistent geographical pattern was found for all age groups.

From this, the lowest prevalence of loneliness was consistently seen in northern European countries (2.9% for young adults; 2.7% for middle aged adults; and 5.2%, for older adults) and highest in eastern European countries (7.5% for young adults; 9.6% for middle aged adults; and 21.3% for older adults).

Loneliness has negative effects on health and longevity

The researchers highlight that even if the problem of loneliness had not worsened during their search period from 2000 to 2019, COVID-19 probably had a large impact on loneliness – lessening the myth that loneliness is just an older person’s problem.

The authors note that the data gaps in low and middle income countries raise an important issue of equity, and that the disparities were subject to limitations, such as different sampling procedures and measures adopted by studies.

They call for health providers and decision makers to address the social factors which can also increase the risk of loneliness, such as poverty, education, transport, inequalities, and housing – incorporating the need for increasing protective measures, like public awareness campaigns that deal with stigma and stereotypes around loneliness, valuing community involvement.

Authors stated: “our review provides an important pre-pandemic baseline for future surveillance. Public health efforts to prevent and reduce loneliness require well coordinated ongoing surveillance across different life stages and broad geographical areas.

“Sizeable differences in prevalence of loneliness across countries and regions call for in-depth investigation to unpack the drivers of loneliness at systemic levels and to develop interventions to deal with them.”

Even though data on this was lacking for any conclusions about trends of loneliness over time on a global scale, the authors state that public health interventions must now take loneliness into account and take a life course, mental health-focused approach.