We are, according to Surgeon General Vivek Murthy, experiencing an “epidemic” of loneliness. Chronic loneliness is associated with earlier death, more illness and slower recovery, depression, addiction, and an array of other negative physical and mental health outcomes. Post-COVID policymakers have been paying attention: in 2021 Japan established a Minister for Loneliness, and many other countries are addressing loneliness as a public health priority. But real solutions have proved elusive.
Loneliness is a painful emotion linked to the personal sense that your social relationships are unsatisfactory or inadequate. We are lonely because we perceive that we live in a solitary and unshared world. Importantly, feeling lonely and being alone are not the same thing. Solitude can be utterly delightful in the right circumstances, while the most purposefully un-alone condition — marriage — can sometimes prove painfully lonely.
A recent review of research on loneliness in different countries found feelings of “being unneeded” was the crucial recurring theme. But how people understood “being unneeded” varied dramatically across societies and in complicated ways. It could stem from being a sage elder whose wisdom is ignored by younger people, being a teetotaler in a place where social lives are built around drinking, or feeling compelled to hide your sexual identity because those around you react to it as deviant or pathological.
The vital role of local beliefs about what makes you needed and valued is a point made especially clear in detailed anthropological case studies. Midlife in Moscow, people describe loneliness as stemming from a relative inability to exchange favors and gifts with others due to the difficulties of post-Soviet economics. Teens in the US and across the globe find loneliness in being confined to the home, even with the constant company of other family and social interaction online. Turkana pastoralists in East Africa find loneliness in the loss of prized animals as much as people. Mexican migrants to the US identify loneliness in being physically unable to join their extended families for key events like births and funerals. Pockets of heightened loneliness also emerge where people are already socially marginalized within their wider communities, such as those living with chronic illness or addiction, people with felony records, those living in very low-income neighborhoods, and so on.
One of the complex twists here is that expressing loneliness – and especially reaching to others for help — is itself stigmatized. Lonely people don’t display more social deficits that others and they don’t necessarily spend more time alone, but this is often how they are judged by others. By acknowledging loneliness, we can be exposed to the additional emotional pain of being embarrassed or humiliated. Societies or social groups that identify independence as a core value, often tied intimately to neoliberal economies, seem to make loneliness more likely and harder to fix because this supports a world view that amplifies the stigma of loneliness. This is – not surprisingly — more harmful for men when they are expected to exemplify self-reliance.
Those with awareness of such stigma can become adept at hiding their loneliness from others. This then stops people from seeking social services or other help, makes designing effective community-based interventions tricky, and complicates efforts to track the prevalence of loneliness. The extent of suffering is accordingly underestimated.
As governments work to address loneliness as a wider public health and social concern, there have emerged no one-size-fits-all effective solutions. Individual-level interventions, such as community exercise classes or neighborhood block parties, often fail to recognize the triggers for loneliness are so different across and within societies. A recent analysis of 52 national policies concluded that this necessary subtlety was missing. The researchers suggested the most effective interventions might be nested in existing community interventions that bring people into more frequent contact, such as encouraging pedestrian travel so more people are out walking. But this also highlights that efforts are too often focused on ensuring people are alone less, rather than addressing the root causes of chronic loneliness.
What can be done to address an emotion based on “feeling needed,” well beyond the simpler challenge of reducing physical isolation? Normalizing loneliness and reducing its stigma is obviously important, and public awareness campaigns with this goal (launched in many countries post-COVID) at the very least do no harm. But the current social science shows that we need to ensure we are tackling loneliness as an issue of how we perceive our value within a very specific social context, instead of just increasing opportunities for social contact . Effective solutions that can thread this nuanced needle will require carefully designed collaborations among policymakers, public health actors, social scientists, and communities.