Addressing loneliness as a path to health equity

Individual Author(s) / Organizational Author
Pociask, Maxwell
Kelly, Christina
Partners for Advancing Health Equity
October 2023
Abstract / Description

Article headlines in the past year have grabbed readers’ attention by with claims like “loneliness is just as dangerous as smoking fifteen cigarettes per day.” While this statement isn’t entirely correct, loneliness can have a similar impact on heart heath, mental wellbeing, and a number of other health determinants.  a number of other health determinants.

These findings come at a time when feelings of loneliness have risen steadily, with the problem only getting worse as a result of the COVID-19 pandemic. According to a report from the U.S. Department of Health and Human Services, young people ages 15-24 report 70% less social interaction with their peers than people at their age two decades ago.

While social isolation and loneliness is caused by a variety of factors, researchers and organizations should consider how structural and social determinants contribute to inequity in loneliness. Disparities in social isolation leads to broader disparities in public health outcomes. 

Public health officials and researchers are increasingly aware of social isolation and its effect on health outcomes. The National Academies of Sciences, Engineering, and Medicine (NASEM) finds that almost a quarter of seniors are socially isolated, and one in three adults over 45 feel lonely. As such, much of the existing research on inequalities in loneliness focuses on demographic groups within elderly populations. One particular study established a link between income inequality higher loneliness in older adults, and another study of neighborhoods in Denmark found that poorer areas tend to have more people at risk of feelings of loneliness. Other studies have found linkages between social isolation and race – with data showing that Black Americans are more likely to experience social isolation than all other racial and ethnic groups (i.e., white, Hispanic, and non-Hispanic).

Given the comorbidities and disparities linked to social isolation, what can be done on a policy level to combat loneliness-related health issues? 

  1. Assess Patients for Loneliness. The NASEM recommends that clinicians assess patients for loneliness using pre-established questionnaires as a first step. 
  2. Create Community Connections. True mitigation of social isolation comes from connecting at-risk patients to well-implemented programs and resources in their community. There are a number of social programs and environmental conditions proven to reduce feelings of loneliness. The Coalition to End Social Isolation and Loneliness outlines several policy priorities which local and state governments can implement to decrease social isolation. Encouraging civic engagement, expanding funding to elderly caregiving programs, and developing workforce programs which help connect people with rewarding careers and fulfilling relationships are among the many priorities listed.
  3. Consider Public Spaces. One study found that those living near urban green space may be less likely to feel lonely. By investing in parks, public spaces, and nearby affordable housing, officials can improve residents’ ability to live near- and participate in- the communities they love. Minority neighborhoods in the United States have fewer green spaces on average, so policy priorities should encourage more equitable access to resources which lower rates of loneliness.

Loneliness and social isolation cause major issues for both mental and physical wellbeing. Access to social relationships is often tied to where we live, where we work, and transportation. As a result, significant disparities exist among income, age, and racial demographics. To combat social isolation and advance health equity, policymakers must support equitable, affordable, and accessible social and public infrastructure through: 

  1. Emphasizing the importance of community through legislation at a national level.
  2. Supporting legislation targeting the epidemic of loneliness on a national level.
  3. Advocating for continued research efforts on the impacts of loneliness.  
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