February 6, 2023

Loneliness, the silent killer

Doctors need to pay more attention to social isolation and loneliness (SIL) in treating patients, according to a “Perspective” article in the New England Journal of Medicine.

The authors observe that Covid highlighted these issues, but it merely accentuated a pre-existing trend.

… even before the pandemic, U.S. Surgeon General Vivek Murthy sounded the alarm on what has been called a loneliness epidemic. From 2003 to 2020, objective measures of social exposure (in minutes per day) obtained from the American Time Use Survey revealed progressive declines in social connection and increases in social isolation in the U.S. population that began well before the pandemic and worsened during it. And the pandemic’s potential longer-term effects on SIL and health are not yet known. Getting “back to normal” is not enough.

In 2020 National Academies of Sciences, Engineering, and Medicine reported that SIL substantially increases the risk of many diseases, including heart disease and strokes. “Countless studies have shown that people experiencing SIL have an increased risk of anxiety and depression, dementia, infectious disease, low functional status, and death from overdose or suicide.” SIL’s impact on health may rival better-known mortality risks, such as obesity.

The authors point out that doctors also suffer from SIL:

At the same time, health care providers are struggling, often with SIL, themselves. Nearly two thirds of doctors report having at least one symptom of burnout. Among the recommendations in the U.S. Surgeon General’s recent advisory on health care worker burnout is to “recognize social connection and community as a core value of the health care system.” Social connection is important not just to patients but also to health care workers. If we aren’t taking care of ourselves by prioritizing social connection, it will be difficult to do so for others.

Bioethicists are beginning to understand that loneliness is an important issue which cannot be solved with technology.