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Takeaway: Loneliness is increasingly being treated as a dire public health threat. What has the young and old feeling the blues?

TREND WATCH: What’s Happening? Several recent surveys show that people around the world are feeling lonelier than ever. The issue has attracted growing attention from public officials and health experts, who have tied loneliness (in its many forms) to unfavorable health outcomes—from higher rates of emotional and physiological illness to higher mortality rates.

Our Take: The “loneliness epidemic” marks a dramatic generational reversal. In the 1960s and ‘70s, young Boomers led America toward opting out of society and embracing the individual—and now, decades later, their own kids are pushing for more social engagement and togetherness. At the same time, we're witnessing revealing changes in how generations are transforming their current phase of life: Young adults are becoming more community-oriented, and seniors are becoming more solitary. Policymakers worried about loneliness would thus be wise to focus their public-health measures on the rising generation of Millennials who are already trying to bring more social connection into their lives.

Want to talk, but have no one to call? Feel like everyone’s having fun without you? You’re not alone. According to a recent survey from The Economist and the Kaiser Family Foundation (KFF), more than two in ten adults in the United States (22%) and the United Kingdom (23%), as well as 9% in Japan, say they always or often feel lonely, lack companionship, or feel left out or isolated.

Figures like these have been ubiquitous in the press lately, with alarming statistics about loneliness now accompanied by equally alarming warnings that it’s stunting our lives and outright killing us.

The scourge of loneliness is an issue that we’re going to hear about more and more in the years to come, with leaders on both the right and the left emphasizing the importance of community and shared spaces, while pushing for action on public-good issues like infrastructure and public health. But let’s get started by diving into the data.

WHO’S FEELING LONELY?


The Economist/KFF findings add to a wave of recent research showing high levels of loneliness around the globe. Earlier this year, a survey of more than 20,000 U.S. adults from the health insurer Cigna revealed that nearly half of Americans always or sometimes feel alone (46%) or left out (47%). Fully 54% said they always or sometimes feel that no one knows them well. What’s more, 2 in 5 feel that their "relationships aren't meaningful" and that they "are isolated from others." The survey questions were drawn from the UCLA Loneliness Scale, a questionnaire that assigns point values to different responses. Overall, the survey found that, on a 20-to-80 scale, the average loneliness score in America is 44.

The new studies add to earlier research pointing to substantial growth in the number of socially disconnected Americans. Between 1985 and 2004, for example, data from the General Social Survey revealed a one-third drop in the average number of persons (from three to two) with whom Americans feel they can "discuss important issues" and a doubling in the share of Americans (to nearly 25%) who have no close confidants at all.

Abroad, research seems to point in the same direction. In a nationwide survey released in October from the BBC, a third of Britons said that they often or very often feel lonely. According to the charity Age UK, nearly half of Britons over 65 consider the television or a pet their main source of company. In Japan, a 2016 government report estimated that there are more than half a million people under 40 who haven’t left their house or interacted with anyone for at least six months. Of this group, those who had shut themselves in for seven years or more accounted for the biggest share of the total: 35%.

LONELINESS: A SERIOUS PUBLIC HEALTH HAZARD


In recent years, a growing chorus of doctors have been warning about loneliness’s devastating toll on health.

Scientists have long known that loneliness is emotionally painful and can lead to psychiatric disorders like depression, anxiety, and schizophrenia—and in cases of extreme isolation, even hallucinatory delirium. But only recently have they recognized how destructive it is to the body. In 2015, researchers at UCLA discovered that social isolation triggers cellular changes that result in chronic inflammation, predisposing the lonely to serious physical conditions like heart disease, stroke, metastatic cancer, and Alzheimer’s disease. One 2015 analysis, which pooled data from 70 studies following 3.4 million people over seven years, found that lonely individuals had a 26% higher risk of dying. This figure rose to 32% if they lived alone.

Calls to address loneliness as a public health issue have taken on a sense of grave urgency. Vivek Murthy, the former U.S. surgeon general, dubbed loneliness an “epidemic” and likened its effects to smoking 15 cigarettes a day. In an opinion piece in The Boston Globe, two Harvard faculty members suggested that loneliness plays “an outsized role” in rising suicide rates and other “deaths of despair.” Nebraska Senator Ben Sasse made loneliness the central theme of his new book, Them, and told CBS News that it’s “the biggest problem in America right now.”

Summing it all up is Kerstin Gerst Emerson, an assistant professor at the University of Georgia’s Institute of Gerontology. “In public health, we talk all the time about obesity and smoking and have all these interventions, but not about people who are lonely and socially isolated,” she observed in The Washington Post. “There are really tangible, terrible outcomes. Lonely people are dying, they’re less healthy, and they are costing our society more.”

IS LONELINESS GETTING WORSE?


Loneliness may feel like a 21st century problem. But today’s fears have their roots in the 19th century, when intellectuals brooded over the rise of urban and industrial society. Max Weber and Emile Durkheim established social science as an academic discipline in order to ask essentially this one question—how do people cope with the individualism and anonymity of modern life when they are wrested out of “community” and thrust into “society”?

Google’s Ngram Viewer shows that terms like “loneliness,” “social isolation,” and “anonymity” were rarely used in books until the late 1800s, when usage began to accelerate upward. In the aftermath of World War II, these concepts were explored in bestsellers like David Riesman's The Lonely Crowd (1950), Philip Slater’s The Pursuit of Loneliness (1970), Robert Putnam’s Bowling Alone (2000), and Sebastian Junger's Tribe (2016), all of which framed loneliness as the problematic challenge of modernity.

Most of these thinkers discussed loneliness as a modern mindset or lifestyle. Few made much of an effort to quantify it.  But the newest findings about loneliness’s health consequences make it important to speak with more precision. Now that we’re talking about tangible effects, how do we measure loneliness? What is happening to loneliness over time?

The most direct method is to ask people how lonely they feel. However, there’s no standard measure of loneliness that has been applied to the same nationally representative population over many years. Because loneliness is a fleeting, subjective feeling, small changes in the wording of a question about it can result in big changes in response. Sociologist Eric Klinenberg noted in The New York Times, for instance, that some studies count respondents as lonely if they feel this way only some of the time, which arguably isn’t so much pathological as it is a normal part of life. Social stigma can also prevent people, particularly men, from admitting that they’re lonely.

Given these limitations, a more effective approach is to use measures of social isolation—for example, living alone or single marital status—as proxies for loneliness. There’s plenty of good data about social isolation across many time periods and societies. And social isolation is known to be highly correlated with feelings of loneliness (better than any other proxy). What’s more, some researchers find that social isolation has its own effects on health independent from those of loneliness: Just being away from other people can impair our health as much as (or even more than) the feeling that we are lonely without them.

EVER-MORE SOLITARY LIVES


So what does the trend in living alone look like over time? Basically, we see a sweeping upward curve, with rates that begin near zero but have since exploded. In pre-industrial societies, single-person households were rare. Across the United States, Europe, and Japan, the average was around 5% of households. Most of these were elderly widows or widowers. For nonelderly adults, living alone was almost unheard of. Living-alone rates in modern industrial societies began to increase in the late 19th century, ramping up gradually before surging in the 1960s and 1970s.

All the Lonely People - chart2

Today, single-person households have become the new norm. Over the past 50 years, the share of U.S. households consisting of one person has more than doubled, from 13% of total households in 1960 to 28% in 2017. It’s now the second most common household type, well ahead of married couples with minor children (19%).

All the Lonely People - chart3

Living alone is most prevalent in large cities, where around 40% of households have single occupants. In some neighborhoods in Manhattan and Washington, D.C., the share is as high as two-thirds­. But single-person households are also common in smaller cities with lower living costs, such as Grand Forks and Santa Fe.

The growing popularity of living alone is mirrored around the world, with rates generally rising in conjunction with affluence and urbanization. In Canada, the share of solo households is now 28%. Across the European Union, it’s 34%, with higher rates in Northern Europe—home to the world’s leader in solo households, Sweden (51%)—and lower rates in Southern Europe. The extra two years of life expectancy in Spain over Denmark may not be entirely attributable to the Vitamin D and the Mediterranean diet. It may also be due to more contact with other people.

All the Lonely People - chart4

East Asia, meanwhile, has recently witnessed the most rapid solo-living growth in history. Although solo household rates remain in the single digits in most Asian countries, they’ve risen dramatically in China, South Korea, Taiwan, and Japan to levels starting to rival those of their Western counterparts. At 35%, Japan leads the region, drawing widespread media attention for stories about elderly facing “lonely deaths” and worries about the country’s social recluses, or hikikomori.

how OUR SOCIAL WORLDS ARE GETTING narrower


The measured rise in solo living across America over the past few decades is indeed dramatic. But this is just one of many behavioral changes that is contributing to a national loneliness epidemic. Consider the following:

  • Young people are delaying marriage and having fewer children. Even if they do not live alone, they are deferring a choice that typically leads to substantial community engagement.
  • Traditional sources of social support, such as civic organizations, neighborhood groups, labor unions, and churches are steadily losing membership and influence. This decline has been exhaustively chronicled by sociologist Robert Putnam.
  • Declining job security and the rise of the gig economy have weakened workers’ sense of attachment to their workplaces.
  • The amount of time that Americans spend socializing face-to-face has fallen about 11% over the past decade, according to time-use data from the Bureau of Labor Statistics.
  • Trust in institutions has plunged to new lows. Trusted institutions are often the “excuse” people have to come together, socialize, and work on shared civic projects.

Many of these trends have been the product of multiple forces as structural shifts in the economy and politics have collided with changing attitudes. Millennials are having fewer children, for example, in part because they don’t think they can afford them and in part because they’re less likely to want them.

To be sure, not all forms of social connectedness are declining. Some are improving—family time, for instance. From 1965 to 2010, the average number of hours that parents spend with their children each week rose 30% among mothers and nearly tripled among fathers. This has made an important impact on Millennials, and (as we shall see) may help explain their enthusiasm about pushing society in the direction of more community.

It’s also possible that technological innovation is masking new forms of social cohesion. Some argue, for example, that the loss in face-to-face minutes has been compensated by the rise of social media engagement. Others disagree. While neither the Cigna study nor the Economist/KFF study reported any correlation between social media use and feelings of loneliness, researchers who control for all variables conclude that heavy social media use may be highly correlated with (and causal of) depression. (See: “Tech-Lash Batters Silicon Valley.”)

On balance, it’s fair to say that our social bonds are weakening and our social horizons are narrowing. Living alone is more common today than it’s ever been in history. Fewer adults are marrying, and those who marry do it later in life. We are less connected to churches, neighborhoods, workplaces, and even friends—at least in the sense that we spend less time talking with them. The very idea of “friending” has mutated into an electronic affiliation, which is unlikely to fulfill the role of human contact in its effect on our health and well-being.

HOW IS LONELINESS AFFECTING DIFFERENT GENERATIONS?


Even as they rise over time, loneliness rates also show revealing differences by age and generation.

Let’s start with age. In most societies, the general pattern seems to be a U-shaped curve: Subjective loneliness is high in adolescence and young adulthood, declines through middle age, and rises again in old age. While loneliness is highest early and late in life, most researchers agree that the cause (and perhaps the meaning) of loneliness changes with age. When we’re young, loneliness tends to be future-oriented as we search for identity and a sense of belonging. We worry that real life will never begin. When we’re older, it tends to be past-oriented and associated with irreplaceable losses and bereavement. We worry that real life is over.

In affluent democracies like the United States, the back end of the U curve tends to disappear. In the recent U.S. loneliness surveys, the rates fall from the young to middle age without much uptick for the elderly. In the Cigna study, overall loneliness scores fell steadily with age: from a score of 48 at age 18-22, 45 at every bracket through age 51, 42 at age 52-71, and 39 for 72+. Young adults (ages 16 to 24) were also the loneliest in the BBC study. And in a recent study from the U.K.’s Office of National Statistics, they were three times as likely as those 65 and older to say they have always or often felt this way. In the Economist/KFF study, 18- to 49-year-olds, on average, were lonelier than those 50 and older in all three countries.

In less affluent and rapidly modernizing societies, on the other hand, seniors are the loneliest age bracket. A 2015 study by researchers at Oslo Metropolitan University found that “quite severe” loneliness among older people ranged from 30 to 55% in Eastern Europe, versus 10 to 20% in Western and Northern Europe. Why the disparity? Eastern European countries lack strong social safety nets, and the elderly in these countries have expectations that their children would take care of them that are not being met. This pattern is also evident in traditional societies seeing rapid modernization like East Asia, where there are high rates of loneliness (and suicide) among the elderly.

Now let’s add generational effects, which push the phase-of-life curve up or down according to birth cohort. Members of the G.I. Generation, all their lives, have been renowned for their strong civic instincts and group cohesion. Paradoxically, however, their rising living standards and high savings rates after World War II—combined with their success at expanding social insurance for seniors—made possible an increasingly solo lifestyle as they grew older. This happened first in the birth of the suburban nuclear family in the 1950s and 1960s and then in the spread of independent "senior living" in the 1970s and 1980s.

In nearly every affluent democracy, the maturing of this war generation coincided during these decades (as we have seen) with a big boost in living alone. In the United States, we see soaring rates of solo-living seniors in the late ‘60s and ‘70s, coinciding with large boosts in Social Security benefits protected by 100% CPI COLAs and the founding of Medicare and Medicaid. The Silent Generation began retiring at age 65 in the 1990s at the peak of senior solo-living rates. Over the last two decades, they have pulled the rate down a bit—by just over five percentage points. This decline is due in part to more seniors living with their grown children (typically in the parents’ home) and to the recent rise in the longevity of senior men relative to senior women, which has resulted in fewer widows living alone.

All the Lonely People - chart5

All the Lonely People - chart6

The retirement of the G.I. Generation coincided with Boomers coming of age. It was the peak of the “generation gap,” and Boomers were as eager to leave their parents as their parents were to leave their kids. The result? The 1970s saw the sharpest decline of any decade in the 20th century in the average number of persons per household. As they’ve aged, Boomers have continued to drive up rates of solo living in each age bracket they’ve occupied. (See: “Boomers Go Solo.”) As they approached midlife, for example, the rate of solo living in the 35- to 44-year-old age bracket was nearly 80% higher than it was in 1962. Now, Boomers’ individualistic bent has them shunning senior communities and pushing up divorce rates among retirees.

All the Lonely People - chart7

Generation X has taken these trends in the opposite direction. While “group-oriented” isn’t exactly the first word that comes to mind to describe Xers, they’ve consistently driven rates of solo living down throughout their lives in whichever age bracket they have entered. While Xers haven’t campaigned for togetherness on a societal level, they have sought it in their own lives and families.

All the Lonely People - chart8

Millennials are prioritizing groups both on a personal and societal level. They haven’t had time to impact rates of living alone over the long term. But for now, they’ve largely stabilized the rates in their age bracket. Solo-living rates have ticked up a bit among young people since 2012, but the rise could have been much larger considering how long they are delaying (or avoiding) getting married or having kids. Millennials are congregating in makeshift communities: living with each other in ersatz families, flocking to co-working spaces, and using technology to stay in close communication.

All the Lonely People - chart9

All the Lonely People - chart10

All the Lonely People - chart11

Interestingly, there’s evidence that loneliness among American high school and college students has actually declined over the past few decades.

Yet loneliness is still something that greatly troubles Millennials. According to the 2016 VICELAND UK Census, a broad-based survey of U.K. Millennials, loneliness is the number one fear of young people today—ranking ahead of losing a home, losing a job, and becoming the victim of a terrorist attack. A separate survey by Everyday Health finds that 42% of Millennial women are more afraid of loneliness than a cancer diagnosis, by far the highest share of any generation. This fear has been ingrained into the very lexicon of Millennials, immortalized in acronyms like “FOMO” and its many companion terms. Apparently, FOMO is a fate so cruel that Millennials will go into debt just to avoid it. (See: “Millennials Spend Money to Keep Up with Peers.”)

Millennials may be the most active seekers of togetherness. In some respects, they have plenty. But clearly they want more.

THE STRONGEST ANTI-LONELINESS PUSH IS yet TO COME


So far, much of the alarm surrounding loneliness has been met with efforts by public officials to help older residents build social connections. In January, for example, the United Kingdom appointed a minister for loneliness. Health care providers and other businesses are stepping in with their own solutions as well, launching hotlines, home visits, and clinics that double as gathering spaces. More nursing homes are offering residents the company of a robot or an animatronic pet. In Japan, a popular “anti-loneliness” café chain seats solo diners with stuffed animal companions.

Building social connections isn’t an unwelcome goal. But these policy initiatives are hardly sufficient to stop or even slow the momentum of a social trend which has been gathering steam in the Western world for a century and a half—and which has since been joined by most of the rapidly urbanizing developing world as well. And when we can’t easily slow something, we had better brace for the consequences.

One consequence will be rising rates of chronic physical and emotional illness triggered by loneliness and social isolation. These often lead to the so-called “deaths of despair” (from suicide, addiction, and alcohol-related liver disease) highlighted by Nobel laureate Angus Deaton. This headwind may already be revealing itself in America’s age-adjusted mortality rate, which has reversed its historical downward trend and has actually risen over the last six years. (See: “Annual Demographics Outlook.”)

At the leading edge of this loneliness epidemic (and mortality regression) are Boomers. While recent government initiatives encouraging connection and community are mostly aimed at older people, these could be a tough sell for the individualistic Boomers currently filling up the 65+ age brackets. If America is generating some genuine enthusiasm about orienting society more around groups and communities, this is probably coming from younger age brackets. In their personal lives, unmarried Millennials are increasingly living with their parents or with each other. In their public lives, Millennials are voting two-to-one for the party seeking to enlarge the public sector (see: “Who Says Millennials Don’t Vote?”) and believe (more than today’s seniors, by a 30-percentage-point margin) that government ought to “promote community” rather than “promote self-reliance” (see: “Generation Snowflake: Really? (Part 2 of 3)”).

Another consequence will be a further drift in politics toward communitarian agendas. This is already happening around much of the world, on both the left and the right. Whether it’s recommitting to infrastructure and education, bolstering national service, protecting national industries and national borders, or finding ways to “include” the destitute, we’re going to hear a lot more about why life is better together. It’s no accident that voters are rejecting individualist (neoliberal and democratic) platforms and seeking instead the comfort of tribes at the same time that health professionals and public leaders are raising storm warnings about the perils of loneliness.

Rootlessless, isolation, and social disconnection are emerging public health issues, to be sure. But more broadly they are regarded as symptoms of a social dysfunction (what Prime Minister Teresa May calls the alienated “citizen of nowhere”) for which populism and strongman authoritarianism is now being advertised everywhere as the political cure—from the United States, Hungary, and Italy to India, the Philippines, and Brazil.