I’m one of the 28% of Americans who live alone, running feral in my house with no one to stop me, and I’ve lived that way for most of my adult life. I’ll continue to do so into the foreseeable future, because I like living alone (and no, my cats don't count); I feel more comfortable in my own space, and, honestly, I don’t like people all that much.
I am what you might call a bit of a hermit. An isolationist, if you will.
So I was rather interested by the results of a new study in Britain looking at a cohort of 6,500 subjects to determine the linkage between isolation, loneliness and mortality. The study results are rather intriguing; isolation appears to be a contributor to early death, but loneliness, according to their findings, actually does not, which honestly surprised me.
And worried me: If isolation rather than loneliness is the predictor of early death, I'm totally screwed. (If it weren't for that pesky family heritage of heart attacks, cancer, and suicide-by-gun that will probably claim me first.)
These findings go against a lot of prior research into loneliness, as well as my instincts; it seems to me that loneliness would be a greater factor than anything else because with the feeling of being lonely can come depression and less interest in the outside world.
And you can be isolated without feeling lonely; some people (like me) enjoy isolation, for example. Notably, in a 2012 study, the majority of people who expressed feelings of loneliness were married or living with their partners, illustrating that it’s possible to be surrounded by people and still feel lonely.
The British researchers were faced with a tough task because so many things are involved in mortality rates, especially among older adults, and they had to factor a lot of these out to come up with meaningful results. They also had to distinguish, for the purposes of their study, between isolation and loneliness, and they had to come up with a way to attempt to quantifiably measure these things.
Isolation, at least, can be measured by setting a given number of social contacts or interactions within a set time period and using that as a baseline; do you interact with people once a month? Once a week? Multiple times a week? All of these can help researchers come up with hard numbers.
But how do you do the same for loneliness, which is an emotion, and one experienced on both an individual and cultural level? Within some cultures, there’s heavy pressure to not discuss emotions or to claim loneliness; Britain’s among them, with its long tradition of, well, keeping calm and carrying on. And for every individual, loneliness feels different, and can be hard to articulate.
The researchers claim that when demographic factors are accounted for, loneliness actually doesn’t increase mortality; notably, people who say they feel lonely tend to be lower-income, to have health problems to begin with, and to have fewer social contacts (clearly, isolation contributes to loneliness), and these are greater contributors to early death than the loneliness.
What they saw was that people with limited social contact in their lives were more likely to die earlier, providing a rather sound argument for better social services, outreach, and support for older adults, since they tend to be more isolated.
Watching my own father age, I can readily see how feelings of isolation and loneliness can start to weigh on older adults as their friends and family start to die, and they become isolated by the nature of society. It’s hard to find work when you’re 65, for example, which means you don’t get the social contact you might otherwise get through interacting with coworkers and clients. You might be too ill to work or get out much in society, instead relying on people to visit you.
And while many people state with the best of intentions that they’ll visit older members of their communities, especially after a major medical event, the numbers of visitors tend to dwindle over time. It starts with dozens of people coming over with dubious casseroles and then trickles to a thin stream that eventually dries up, leaving a person profoundly isolated; and, for older adults who are ill or who are recovering from hip replacement, heart attacks, and other illnesses of age, that can be really dangerous.
It can be hard to get help when you’re ill and isolated, and if you live alone and don’t have much social contact, you might not be motivated to go to the doctor or get active. Or you might be incapacitated and unable to call emergency services.
I had to prod my father to talk to his physician recently about some dizziness he’d been having, and lo and behold, his blood pressure wasn’t stable and his medications needed adjustment. But without that prodding, without that contact, what would have happened?
Being around people has clear health benefits, and some of the ways in which those benefits work might not be immediately apparent. As is too often the case, the results of the study largely point at the need to do more studies; does being around other people mean that people are more likely to go to the doctor, get exercise, challenge their brains? Is there an intrinsic health benefit just to being around fellow humans? Does it help with mental health (many loneliness studies argue it does), which in turn contributes to better physical health?
With so many divides between old and young in society, in a population where living alone is increasingly common, the study also raises some interesting questions about aging, isolation, and social networks. As one of a young generation familiar with being online all the time and viewing my Internet relationships as rich, complex and valuable, I’m somewhat offended by the claim that physical interactions are needed for health, and I want to see a lot more research on this.
I wouldn’t report feeling lonely in a loneliness study, although I am frequently isolated; though the two are clearly intertwined, how closely bound are they, and what are we supposed to do about it? And how do we address isolation in older adults, especially those with a more fierce and independent bent who wouldn't appreciate our exuberant youthful meddling?