This article delves into the profound impact of loneliness on individuals’ health and well-being, highlighting its equivalence to smoking 15 cigarettes a day. Through an evidence-based approach, I explore original research reports, including an extensive booklet from the US Surgeon General, to shed light on the wide-ranging implications of loneliness on physical and mental health. The article emphasises the need to define and understand loneliness, particularly in the context of retirement and ageing. It emphasises the importance of fostering social connections and offers practical suggestions for individuals to combat loneliness, such as joining community groups, volunteering, and nurturing existing relationships. By embracing change and proactively addressing loneliness, individuals can leave a lasting legacy that goes beyond financial considerations, making a meaningful impact on their own lives and the lives of others.

Loneliness can be as damaging to your health as smoking 15 cigarettes a day. That was the headline to an article in The Mail, and  The Times (behind a firewall). The Washington Post also covered it and probably many more. It’s quite a dramatic headline.

As an evidence-based practitioner I set out to explore this further, delving into the original research report and an 82-page booklet from the US Surgeon General. It’s been quite a deep dive.

Loneliness can affect us at all ages, and we can feel isolated and alone despite living with family. Here’s the diagram from the US Surgeon General’s report (1), showing how a lack of social connection can be worse than smoking, heavy drinking, inactivity and obesity.

Health implications

Research found lonely people are 50% more likely to die prematurely than people with strong social relationships. Some medical doctors have a greater focus on getting people to seek social connections rather than to give them a pill.

Studies have found links between loneliness and health with an impact on heart disease and stroketype 2 diabetesrheumatoid arthritis and cancer. It’s not just physical health, loneliness can also lead to an impact on our mental health such as depression, sleep issues, alcohol abuse and a loss of hope. The list goes on …

A systematic review of 90 studies related to loneliness (total of 2.2 million participants) found Social isolation (SI) was associated with a 32% higher risk of premature death from all causes, while loneliness was linked to a 14% increased risk.

Japanese researchers from Kyushu University found that facilitating the establishment and maintenance of social connections among older individuals may have a positive impact in preventing brain atrophy and the onset of dementia.

Let’s step back and define loneliness

Loneliness is a “distressing feeling that accompanies the perception that one’s social needs are not being met by the quantity or especially the quality of one’s social relationships.”

It may increase with ageing because of changes in the quantity and quality of social relationships. My mum is 90 and many of her friends, and the three men in her life have all died. It’s certainly harder to go out and make friends when you are unsteady on your feet and need to use a walker.

It’s ok to enjoy your own company

Just because people like their own company and are comfortable alone it doesn’t mean that they are lonely. I’ve spent a week without talking to anyone and really enjoyed the peace of being alone with my thoughts. Many others are fine with time alone, but this is easier when you know you have a social network you can turn to.

Loneliness and older people

Some of our social needs can be met in the workplace. On retirement that stops, hence the importance of developing social connections before retirement – joining groups, volunteering, and rekindling friendships. A study looking at the relationship between loneliness, depression and working, or not, found that it takes more effort to stay connected after retirement. The situation is worse for those who were lonely before retirement, but were focused on their work. On retirement they are forced to confront their lack of social relationships.

Different types of loneliness

Did you know there are different types of loneliness? Social loneliness refers to the absence of meaningful social connections and networks, while emotional loneliness refers to the absence of close and intimate relationships. It is anticipated that upon retirement, individuals may experience a heightened sense of social loneliness, indicating a lack of valued social interactions and networks. On the other hand, emotional loneliness is less likely to be significantly impacted by retirement, as it pertains more to the absence of deep emotional bonds rather than social engagement.

Brief connections

It’s not just the deep conversations with friends, or the camaraderie of being in a social group. Just a 30 second conversation can have an impact on others such as saying hello to a dog walker you see each morning, and exchanging a few words with the barista who gives you your morning coffee.

I generally smile and say hello as I walk past people and I’m happy to have a conversation with someone when in a queue, mindful that although I’m ok without the connection the person next to me may appreciate this.  

What can be done?

There is a need for individuals, families, communities, organisations and Government departments to work on this together. Its less easy to change things at a societal level but we can all play a small part.

To support others, we can

  • Put away our phones and concentrate on the person we are with.
  • Join a leisure group or get involved with a community group so we meet up with people with a different background and age to ourselves.
  • Take time to talk with people, pay attention to the person who serves us at a store, invite a neighbour in for a cup of tea or to share a meal.

It’s ok to say you are lonely

Loneliness is attached to shame and guilt and for many people it is hard to talk about it. Decide on at least one of the suggestions below

If we are feeling lonely, we can:

  • Find a social group to meet with at least once a week – if you struggle to get out, you can seek a virtual group.
  • Sign up for a telephone friendship call such as via Age UK – link in the references section.
  • Reach out to someone each day – to stay connected with our friends through meeting for coffee or a walk, or scheduling a Zoom call or face time.

Specific groups may help

I remember Darby & Joan clubs from when I was young, and a search found some are still around. Whilst these clubs may appeal to some, there is more of a link to the old-old and perhaps Oddfellows and U3A are options for a younger age group. For me, a mixed age group would be beneficial

There are some community pubs such as The Stoke Canon Inn, in Devon, that offer coffee, cake and conversation during the day. I’ve just found out about the chatty café scheme and found a venue close to me that meets fortnightly and there are all over the place, not just the UK.

Building friendships

I’m over my word limit … I’m going to focus on this in a companion article.


(1)   https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf

Supa Pengpid; Karl Peltzer; (2021). Associations of loneliness with poor physical health, poor mental health and health risk behaviours among a nationally representative community‐dwelling sample of middle‐aged and older adults in India. International Journal of Geriatric Psychiatry, –. doi:10.1002/gps.5592 

An overview of systematic reviews on the public health consequences of social isolation and loneliness – ScienceDirect

Loneliness and depressive symptoms: the moderating role of the transition into retirement: Aging & Mental Health: Vol 22, No 1 (tandfonline.com)

Useful links