- Social isolation and loneliness have important independent effects on mental and physical health.
- Various aspects of social connectedness have been in decline in the United States.
- We need multiple approaches to improve social connection and build more connected communities.
Humans, Aristotle observed, are political animals. We do not typically live alone, but in a community. We receive many of the conditions for our survival as a gift from others: no one chooses his or her mother tongue, or the caregivers who provide nurture and support in infancy and childhood. One result of this profoundly communal way of being is that we long for connection and belonging. We need others. We desire to be loved. Our social connections are part of who we are—they are a part of our flourishing.
There are both objective and subjective aspects to social connectedness. On the one hand, there is the set of relationships and communities that we have, the time we spend with and in them, and the objective support that they offer. On the other hand, there is also a subjective sense of connection and belonging, of being loved, cared for, and understood. Both the objective and the subjective sides of social connectedness are important. Both are a part of, and shape, our health and well-being.
Prior research and meta-analyses of longitudinal studies have indicated that both the objective and the subjective sides of social connectedness are important for health: those with higher levels of social isolation or with higher levels of loneliness are at greater risk of early death. In our most recent empirical work, we have further examined these objective and subjective sides of social connectedness not only as they relate to mortality risk but also to a host of other health and well-being outcomes. Understanding this is important in its own right, but it is also important in motivating efforts to build more connected communities.
The Effects of Social Isolation and Loneliness
In our recent paper, published in Social Science and Medicine–Population Health, we used data from 13,752 older adults in the Health and Retirement Study and employed our outcome-wide methodologies to examine longitudinal associations of both social isolation and loneliness with 32 different health and well-being indicators four years later. We employed various methodological approaches to try to provide evidence for causal inference that we have described elsewhere.
Similar to much prior research, we found evidence for important effects of both loneliness and social isolation on numerous health and well-being outcomes, including mortality risk, physical functioning limitations, happiness and life satisfaction, optimism, purpose in life, depression, and hope. One of the additional interesting insights in this study, however, was that by using the same sample and the same design and analysis, we could more directly compare the respective effects of loneliness on the one hand and those of social isolation on the other. What we found was that the objective side of connectedness, e.g. whether a person was socially isolated (living alone, not spending time with friends and family, etc.), had larger effects on physical health, such as mortality risk and physical functioning limitations, than did loneliness.
Conversely, however, loneliness had larger effects over time on a number of mental health and well-being outcomes than did social isolation (e.g., on happiness, optimism, purpose in life, sense of mastery, depression, and hope). So, both loneliness and social isolation matter for these outcomes, but they matter to different degrees for different outcomes. Interestingly, however, even when we made simultaneous control for both loneliness and social isolation, each had separate important effects, independent of the other, on numerous outcomes, again including mortality risk, physical functioning limitations, happiness, purpose in life, and hope. Both the objective and the subjective side of social connection matter. Both contribute above and beyond the other. Both should be addressed.
Building Connected Communities
Social connection is, of course, important not only because of its effects on physical and mental health but also in its own right. Close social connectedness, as we’ve noted elsewhere, is an end sought for its own sake. We all want to be close to others; we all want to be loved. There is, however, unfortunately now considerable evidence that various aspects of social connectedness have been in decline in the United States in recent years. A recent advisory report released by the U.S. Surgeon General notes that from 2003 to 2020, the average American’s self-reported time spent with friends and in social engagement with others decreased by two-thirds and one-third, respectively, while time spent in social isolation increased by 17 percent; about 50 percent now report being lonely; marriage- and birth-rates are at all-time lows; religious affiliation is down; and other forms of civic participation are in long-term decline as well. This is cause for concern in its own right, and a cause for concern with regard to health and well-being also. We need to work towards addressing these declines and building more connected communities.
To that end, in collaboration with the Foundation for Social Connection and Healthy Places by Design, and with generous support from Einhorn Collaborative, we will be hosting a conference next month, October 12-14, at Harvard University and in the wider Boston community, to bring together various community, civic, and corporate leaders, along with academics and the general public, to discuss the topic. The conference is open to everyone, and registration details can be found here.
The problem is, of course, complex, and numerous societal and technological trends have contributed. The Surgeon General’s advisory offers not only a diagnosis of the problem and some analysis of its causes but also offers helpful suggestions as to ways forward, focusing on six “pillars” to structure public health responses. These are to (1) strengthen social infrastructure in local communities; (2) enact pro-connection public policies; (3) mobilize the health sector; (4) reform digital environments; (5) deepen our knowledge; and (6) build a culture of connection.
We believe each of these is important in its own right, and, all together, could go a long way in fostering greater social connectedness and reducing loneliness and social isolation. However, our hope with the conference is also to broaden the set of considerations yet further. To that end, we have recently released a draft version of a “Supplement” to the Surgeon General’s advisory, going into greater detail on various facets of the decline in social connectedness and on various additional approaches to try to address it. These include greater emphasis on improving economic conditions of the working class; addressing the decline of free play and independence among American children; the growing isolation of America’s elderly as households shrink; and the critical role that the decline of religious participation and marriage rates play in the United States; along with what might be done about these various trends. As always, comment and critique are most welcome, especially since the document is still in an early draft form, and one we hope will be shaped further by responses from our readers.
We very much hope that the various discussions and additional research on these questions, and further communal and policy efforts, will help us together to build more connected communities.
Hong, J.H., Berkman, L.F., Chen, F.S., Shiba, K., Chen, Y., Kim, E.S., and VanderWeele, T.J. (2023). Are loneliness and social isolation equal threats to health and well-being? An outcome-wide longitudinal approach. Social Science and Medicine - Population Health, 23:101459.
Case, B., Corbin, I.M., Teubner, J., Cowden, R., Bachiochi, E., Cratty, F., and VanderWeele, T.J. A Supplement to the Surgeon General’s Advisory “Our Epidemic of Loneliness and Isolation. Working Paper. Available at: osf.io/preprints/socarxiv/y4pqx.
Weziak-Bialowolska, D., Bialowolski, P., Lee, M.T., Chen, Y., VanderWeele, T.J., and McNeely, E. (2022). Prospective associations between social connectedness and mental health. Evidence from a longitudinal survey and health insurance claims data. International Journal of Public Health, 67, Article 1604710: 1-9.
VanderWeele, T.J. (2019). Measures of community well-being: a template. International Journal of Community Well-Being, 2:253-275.
Chen, Y., Mathur, M.B., Case, B.W., and VanderWeele, T.J. (2023). Marital transitions during earlier adulthood and subsequent health and well-being in mid- to late-life among female nurses: an outcome-wide analysis. Global Epidemiology, 5:100099.
How We Can Rebuild Communities After the Pandemic. Psychology Today. Human Flourishing Blog. December 2021.