Sociodemographic and geographic distribution of the problem, lonliness

Prevalence of loneliness across the globe

It is still not robustly clear how common and widespread loneliness is worldwide. Suboptimal measurement practices and lack of data prevent the robust estimation of the prevalence of loneliness.

Estimates from individual surveys vary, notably some are as high as 40-45%. For instance, reports by the UK’s Campaign to End Loneliness suggest about 45% of adults experience loneliness occasionally, sometimes or often, which would translate to about 25 million people in England (where the survey was done). Although this estimate is likely a high-end estimate, if we scale this globally, this would mean approximately 1.26 billion adults experience loneliness at least sometimes (taking 45% of UN statistics that 2.8billion people are now aged 40 or above). At a more conservative level of 20%, this would mean 560 million adults globally.

When we focus only on the most problematic forms of loneliness (severe or very frequent), there is high quality available evidence from a recent series of meta-analyses in 113 countries. There is a good degree of variance in the prevalence of evere of frequent loneliness amongst age groups and countries, ranging from about 9% for adolescents, to 3%-7% for adults in Northern European countries and 8%-24% for adults in Eastern European countries. Data for adolescents were available globally, but for all other age groups (i.e. children and adults) data was not available  anywhere outside of Europe.

Limited longitudinal data suggests there may be cultural variances in how loneliness is understood in older age. In surveys of adults aged 65+, prevalence rates of loneliness between 25.3% – 32.4% were found in Latin America (Cuba, Dominican Republic, Venezuela, Peru, Mexico), 18.3% in India, and a much lower rate of 3.8% in China (Gao et al.,  2021). Notably, there was a robust association between loneliness and mortality in Latin America and China, but there was no such association in India, suggesting the further need for global surveys of loneliness and health.

A key recommendation for funders and academics is to incorporate validated loneliness measures across ages into general health surveillance efforts. We are currently limited in what we can say about the prevalence and distribution of loneliness in LMICs.

Who faces the highest risk of being lonely?

Who should loneliness interventions and services target? In sum, this section suggests that focus is warranted on those who have recently been widowed or have poor health. Interventions should target both men and women, most likely targeting older populations, although evidence is mixed with some suggesting young people may also be facing higher risks.

Older age seems to track with increases in loneliness (with caveats)

• Loneliness seems to be experienced more often in later age, particularly after 65 (Nicolaisen & Thorsen, 2014; Dykstra, van Tilburg, & de Jong Gierveld, 2005 & 2016). However, there is nuance in understanding the importance of age and the evidence base is overall mixed in terms of quality and findings.
• In a meta-analysis examining the impacts of loneliness on mortality, lonely middle-aged adults (<65) were at highest risk for mortality (looking only at the impact of loneliness on mortality from disease; this meta-analysis excludes death by accident or suicide; Holt-Lunstad et al., 2015) rather than the older adults. One possible explanation may be that individuals who live longer are more resilient, with different social or health characteristics. Alternatively, it may be that sociocultural factors are relevant, such that the decrease in one’s social network is seen as more normative with increased age, which may lead to different risks being associated with loneliness. One study found that lonely retired people were at risk for anxiety and depression but not physical health (chronic conditions; Bekhet and Zauszniewski, 2010). In either case, it seems that relevant confounders may underpin the relationship between age and loneliness.
• Importantly, there is a small body of work that suggests that the relationship between loneliness and age could be U-shaped, such that younger and older people face the highest risk (Victor & Yang, 2012). Nicolaisen & Thorsen, 2014 also found differences underpinned by measurement choices, such as when direct measures of loneliness were used, both the oldest (65-81) and the youngest (18-29) reported experiencing loneliness most often, but when indirect measures were used there was an overall positive association between age and loneliness, such that the older people were, the more lonely they tended to be.
• Some scholars have previously suggested individual-level traits or behaviors may be relevant as well. For instance, de Jong Gierveld (1998) suggests that personality characteristics are more important in younger people than older people for loneliness. New work is emerging in the context of social media and technology changes as well.

The effect of gender on loneliness is inconclusive

• Current research tentatively suggests that differences in loneliness reporting between men and women may be underpinned by measurement selection (Nicolaisen & Thorsen, 2014). In particular, direct or indirect measures of loneliness seem to lead to differences in reporting, such that overall (combining measures) the prevalence rates are similar for men and women, but when direct measures are used, loneliness is more prevalent for women, and when indirect measures are used, loneliness is more prevalent for men. There is a limited evidence base examining measurement carefully, so this finding should be interpreted cautiously.
• There may be some gender differences when trying to measure loneliness or social isolation. For instance, 14% of older men experienced moderate to high social isolation compared to 11% of older women (Beach & Bamford, from ILC-UK). Caution should still be applied, as differences tend to be small and some have argued measures of social isolation, that track contact with friends or family, can serve as a form of indirect measure for loneliness. A further meta-analysis (n= 398, 338; k = 634 studies; 747 effects size) attempting to tease apart potential gender differences in loneliness showed a close to zero-overall effect of gender, suggesting that mean levels of loneliness are similar for men and women across the lifespan (Maes et al., 2019)
• A nationally representative study in the UK indicated that gender was not independently associated with loneliness when confounding influences of marital status, age, and living arrangement were excluded (Victor et al., 2005). In an unadjusted model, women were more likely to be lonely. Women were significantly more likely to be widowed, live alone, but also more likely to have direct contact with friends and relatives. This aligns with research from older people in Sweden that suggests that while older men and women may share some risk factors for experiencing loneliness, they also have unique risk factors (Dahlberg et al., 2014).
• Overall, at present, it seems the main effect of gender and the interaction of age and gender do not differentiate higher risk groups for loneliness. Rather, a more careful consideration of other present confounders is pertinent. It is then important to recognize the different sociocultural experiences of people from different genders that may serve as particular risk factors (i.e. older women who are widowed, as well as those living alone; older men who have little social contact).

Becoming widowed is one of the strongest risk factors

• A varied body of literature (de Jong Gierveld & van Tilburg 1987; Pinquart 2003;  Stroebe  & Stroebe  1987;  Victor et  al.  2005) indicates that losing your partner is an important risk factor for becoming lonely. This is especially so for older adults. Older adults who become widowed showed the greatest increase in loneliness in one 7-year longitudinal study from the Netherlands (Dykstra et al., 2016) and in other analyses (Nicolaisen & Thorsen, 2014). Women are more likely to experience widowhood.

Poor health: a risk factor and part of a vicious cycle

• Being in poor health, across a variety of measures, seems robustly associated with experiencing loneliness (Nicolaisen & Thorsen, 2014). Crucially, loneliness seems to be a risk factor for poor health across different domains as well, thus potentially leading to the formation of a vicious cycle.

Like Our Story ? Donate to Support Us, Click Here

You want to share a story with us? Do you want to advertise with us? Do you need publicity/live coverage for product, service, or event? Contact us on WhatsApp +16477721660 or email Adebaconnector@gmail.com