Last week’s Newsletter triggered me to look at loneliness. It might induce us to watch more TV, but does it do us any other harm? It turns out that loneliness and social isolation are dangerous. They are worse for our health than smoking and drinking too much! The heightened risk of mortality equals that of smoking 15 cigarettes a day. It creates the same health risks as being an alcoholic. It is also more dangerous than obesity.

But what is loneliness? There is a distinction between social isolation and loneliness. According to social psychologists, loneliness is a subjective experience. Loneliness is the gap between the social connections you would like to have, and those you feel you experience. Social isolation is more of an objective measure. We can measure whether people live alone. How many times they meet friends. But we can find people who live alone but do not feel lonely. We can also find people who seem to have lots of friends but claim to feel lonely. They are different.

Twenty two percent of adults in the United States say they often or always feel lonely or socially isolated. In the United States loneliness has become a serious issue of public health. The United Kingdom started to appoint a “Minister for Loneliness” at the time of Theresa May.

Loneliness and Social Isolation

Large studies have shown that there is an overlap between these two but they are different. Each adds something to the impact on health. A recent paper looked at 70 different studies and 3.4m participants. It showed that loneliness increased your chances of dying by 26%. Social isolation alone increased your chances by 29% and living alone 32%. Their combined effect has the biggest impact on death.

Loneliness can also have a major impact on quality of life. Studies have shown a 50% increased chance of dementia for those who are socially isolated. Heart failure patients have a much higher chance of ending up in hospital if they live alone. Social isolation and loneliness increases your chances of a heart attack or a stroke. Your chances go up by 30%.

COVID-19 gave us ” “self-isolation,” “shelter in place” and “social distancing” . All increased loneliness and isolation. Research is still going on to discover how much that has impacted the mental health of the world. Many studies have shown the association between loneliness, depression and anxiety.

Ageing and Loneliness

The old are not the loneliest group. That “honour” goes to people between 18 and 24. There are studies that show the risk factors for becoming lonely and isolated. Age itself is not a factor. Ageing is however associated with many other risk factors. Sensory impairment is an issue. Losing sight and /or hearing is especially likely to increase isolation. So too are the illnesses associated most with age. A chronic illness, depression, mobility issues are high on the risk list. The relationship is two way. They can cause loneliness. Loneliness can also increase the chances of getting them. It is a viscous circle. Major life traumas such as the death of a spouse or friend also can cause loneliness. Other risk factors include those that would tend to be isolating at any age. These include many sources of discrimination such as being an immigrant, sexual orientation, race.

What is the link between loneliness and health? Loneliness tends to create pathological behaviours. Smoking and substance abuse are more common. Lack of exercise, lack of sleep and obesity are all associated with loneliness. As we saw last week, even television watching can have a negative effect if done whilst eating (Newsletter #094 “Distracted Eating”). Researchers are also now looking at a deeper cause. The hypothesis is that isolation stresses the body and induces background inflammation.

The Rise of The Japanese Super Solo.

Loneliness has become stigmatized. People fear to tell others that they are lonely. If you feel lonely you are less likely to want to reach out to others. If there is a stigma attached the problem becomes compounded. As usual Japan is leading the way. Twenty years ago the Japanese had a word for this stigma. Roughly translated it meant “toilet eating”. Some students were afraid to admit that they were eating alone. Instead they would have their lunch in the toilet cubicles.

The times have changed in Japan. “#partyforone” on Japanese Instagram will produce thousands of pictures of businesses. Each catering to people alone. These range from restaurants and bars to tents in campgrounds. The most surprising are bars offering solo karaoke parties. Not only is it socially acceptable to be alone it has become a huge market.

In other Newsletters we have seen the reason why. The number of Japanese single person households has risen from 25% of the total to 35% (Newsletter #065 "Japanese “Herbivores”). Euromonitor forecasts a worldwide 12% increase in single households by 2030. Investors are becoming interested in the space. Analyst reports are appearing.

Loneliness as a Market 

One of the most common suggestion for investment is the "pets" industry. Especially for older people a pet can be a solution to loneliness. Certainly during COVID there was a boom in pet ownership. The research is ambiguous that it works to reduce loneliness. Pets are still growing as a market. Electronic pets are also appearing for those who don’t want the hassle of taking care of the real thing. A doll like electronic comforter worked very well for those with dementia (Newsletter #064 C-3PO,R2-D2, or A.T.M.?).

During the Longevity Week I attended a presentation from an Accenture technology team. They have developed an AI enhanced Alexa, as a companion for older people. It is already in trial. It is programmed with the background of the older person. This includes their medication schedule and key telephone numbers. It can learn their daily routine. It learns there favourite music. It can greet them by name and keep their diary. It has been trained to encourage movement and “exercise”.

COVID itself reduced the digital divide amongst the older consumers. Many more people learned to use Zoom, email and internet shopping. Entrepreneurs are developing novel ways of web enabling contact to tackle loneliness. The same team that looked at happiness looked at the impact of COVID (Newsletter # 090 “Happy Christmas”). They point out that we think our relationships will take care of themselves. They argue that the pandemic has played a part in disabusing people of that notion. It forced people to think harder about the social interactions they are and aren’t having. It highlighted how they can be maintained, even on the web.