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6 Ways Loneliness Can Harm Your Health — and How to Cut Your Risks

Surgeon general’s report is a reminder that stronger social ties mean longer lives


spinner image a lonely woman in a green shirt resting her chin on her hands in her bedroom
South_agency / Getty Images

Doctors check your blood pressure, cholesterol and weight. Maybe they should ask you about your social life, too.

That’s because people who struggle with social connection — whether they feel lonely, have few relationships or have troubled relationships — face multiple physical and mental health risks, according to a 2023 advisory from U.S. Surgeon General Vivek H. Murthy. The nation’s “epidemic of loneliness and isolation has been an underappreciated public health crisis,” Murthy said in his announcement about the report, released May 3, 2023.

The impact is big. Social disconnection shortens lives by about as much as smoking 15 cigarettes a day, according to the advisory. The causes are complex, and loneliness and isolation affect everything from inflammation levels in our bodies to the odds that we’ll exercise, eat well or get to a hospital quickly in a crisis. And the problem is widespread: Even before the start of the COVID-19 pandemic, surveys found nearly half of U.S. adults felt lonely.

We’re spending more time alone, and we have fewer friends. Half of adults counted three or fewer close friends in 2021, up from a quarter of adults in 1990. The evidence that all of this is very bad for our health “has been building for decades and across multiple scientific disciplines,” says Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University in Provo, Utah. Holt-Lunstad was the scientific editor for the advisory.

Here are six health risks that people who are chronically lonely or isolated face, according to the report.

1. Premature death

People with strong social bonds live longer and are less likely to die from any cause. One review of 148 studies that followed people for an average of more than seven years found that such bonds increased survival odds by 50 percent. That made social disconnection more dangerous than drinking too much, weighing too much or exercising too little, the advisory said.

2. Heart disease and stroke

Evidence is particularly strong that social disconnection is linked with poor cardiovascular health. People with poor social relationships face a 29 percent increased risk for heart disease and a 32 percent increased risk of stroke, according to data from 16 studies. 

Additional research published in 2024 in the journal eClinicalMedicine found that participants 50 and older who reported feelings of loneliness at the beginning of the study had a 25 percent higher risk of stroke than those who were not lonely at baseline. Participants who were very lonely at two different points in the four-year-long study had a 56 percent higher risk of stroke than those who reported low levels of loneliness.

“Especially when experienced chronically, our study suggests loneliness may play an important role in stroke incidence, which is already one of the leading causes of long-term disability and mortality worldwide,” lead study author Yenee Soh said in a news release. The study was led by researchers at Harvard T.H. Chan School of Public Health.

A 2022 statement from the American Heart Association (AHA) said social isolation and loneliness can increase the risks of having or dying from heart attacks and strokes. Lonely or isolated people who have heart disease are more likely to die from it; and those who’ve had one stroke may be at higher risk for another, says Crystal Wiley Cené, M.D., a professor of clinical medicine and chief administrative officer for health equity, diversity and inclusion at University of California San Diego Health. She chaired the writing group for the AHA’s statement.

3. Diabetes

People with weak social ties are more likely to get diabetes and are less able to manage it well, studies have found. They are more likely to suffer complications from the disease, such as heart attacks, vision loss, foot problems and kidney damage, regardless of their blood sugar levels.

4. Infections

In one study, people exposed to a cold virus were much less likely to get sick if they had at least six social roles (parent, spouse, friend, family member, coworker or club member), compared with three or fewer roles. A study of COVID-19 vaccination showed weaker immune responses in people who felt disconnected from their neighbors.

5. Cognitive decline and dementia

An analysis published in 2024 in the journal Nature Mental Health and led by researchers at Florida State University College of Medicine found that adults experiencing loneliness had a 31 percent greater risk of developing dementia.

Previous research has reached similar conclusions. Adults over age 50 who were followed for an average of six years were about 50 percent more likely to develop dementia if they experienced prolonged loneliness and social isolation, one review found.

Another study that looked at midlife adults found those who were persistently lonely were more likely to develop Alzheimer’s disease, the most common type of dementia, and additional research has found faster cognitive decline in adults over 65 who report loneliness.

6. Depression and anxiety

It may not be surprising that loneliness and isolation can lead to poor mental health. And the connection goes both ways: Depression and anxiety can cause people to withdraw and feel lonelier. Research shows that having someone to confide in can sometimes stave off depression, even in people at high risk. Social connection also may lower the risk of suicide, especially for men. 

The link between loneliness and your health

The links between social disconnection and poor health are rooted in our most basic biology, as well as our psychological and behavioral responses, experts say.

“Penguins who huddle together stay warmer,” and humans aren’t much different, says researcher Kerstin Gerst Emerson, a clinical associate professor at the University of Georgia. “We’ve always survived better if we are together.”

Brigham Young University’s Holt-Lunstad says multiple biological mechanisms are at work. One that may be particularly important, she notes, is chronic inflammation, which is linked to many different diseases and is often elevated in socially isolated people.

Spikes in stress hormones, immune system disturbances and changes in gut microbes also may play roles, the surgeon general’s advisory says. All that dysregulation can cause a lot of “wear and tear on the body over time,” Holt-Lunstad says.

Loneliness and isolation change how people behave. Having someone around to encourage you to take your medications and go to the doctor when needed may help you manage your health problems, says Cené of UC San Diego Health.

Other people may help you eat better and move more, Emerson says. “If you’re lonely and alone — and this happened to a lot of us during the pandemic — maybe you just eat a bowl of cereal for dinner because you can’t be bothered to make a whole meal for yourself.”

The person who walks half a block on their own might take a much longer walk with a friend. And having a friend or neighbor who checks in on you regularly can literally save your life, she says.

How to Widen Your World

Feeling lonely or isolated? Start changing that with small steps, researcher Kerstin Gerst Emerson suggests. That might mean something as simple as walking outside and smiling at another person. “It’s going to make a difference to you, but also the person you just smiled at,” she says.

Can’t get out? Call and check in on a neighbor. “Making that conscious effort to reach out is really important,” Emerson says. “And if you don’t want to do it for yourself, maybe think, I’m going to make a difference in someone else's life.”

Other ideas from the surgeon general’s advisory on social connection:

  • Reach out to at least one friend or family member every day.
  • Minimize distractions when you are with other people. Don’t check your phone at a meal.
  • Join fitness, hobby, religious, professional or service groups.
  • Spend less time on activities that make you feel disconnected. This can include time on social media.
  • If you are struggling, tell your health care providers.

Some people with social anxiety or other deep-rooted difficulties will benefit from therapy, Emerson says. For others, she says, practical solutions — such as a regular ride to church or the senior center — can make a world of difference.

Editor's note: This story, first published June 22, 2023, has been updated to include new information.

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