Loneliness as a public health issue

‘High rates of social isolation and loneliness around the world have serious consequences for health and well-being’

By Dr R Neerunjun Gopee

During a trip to Bali a few years ago, we went on an excursion in a forest, quite a large one, starting from a village adjoining it where we were putting up. On our return journey a couple of hours later, we saw a little hut deep in the woods where an elderly couple stayed.

Our guide told us that this is not an uncommon practice in the island – which is about four times the size of Mauritius – where an elderly person or a couple who felt they had completed their social responsibilities retired to forest to live in the midst of nature which provided them with their needs which were not many. Luckily there were no major threats from wild animals there. From time to time, they received the visit of children or passers-by but mostly they were on their own.

Loneliness. Pic – Gallup News

Because Hinduism prevails in Bali, perhaps this practice there should not surprise: in fact one of the tenets of Hindu culture is that in the four stages of life (student, family/social life, retirement, retreat), the last or fourth stage of life is to be spent in purely spiritual pursuit as a sanyasi. This refers to somebody who has actually retreated to the forest away from all and lives a life of contemplation on a quest for the Self. In modern times and societies, alas, forests have dwindled, urbanization has taken over and this quest is therefore to be pursued in different settings.

Later this reminded me of the ‘experiment’ conducted by the American author and philosopher Thoreau, who for some time in the 1840s went to live in the woods in Massachusetts, as a form of ‘rejection of materialism’. His experience was captured in the book he wrote about this episode in his life, ‘Walden Pond.’

An extract from a summary of the book informs us that Thoreau ‘cultivates a modest bean-field, a job that tends to occupy his mornings. He reserves his afternoons and evenings for contemplation, reading, and walking about the countryside. Endorsing the values of austerity, simplicity, and solitude, Thoreau consistently emphasizes the minimalism of his lifestyle and the contentment to be derived from it. He repeatedly contrasts his own freedom with the imprisonment of others who devote their lives to material pursuits.’

The above describes people who chose to live alone – but were not lonely. This brings us to the important distinction between loneliness and solitude, which are respectively defined in an article titled ‘Loneliness: Causes and Health Consequences’ by Kendra Cherry, MSEd (December 05, 2023) in the online source ‘Very well Mind’ as follows:

• Loneliness is marked by feelings of isolation despite wanting social connections. It is often perceived as an involuntary separation, rejection, or abandonment by other people.
• Solitude, on the other hand, is voluntary. People who enjoy spending time by themselves continue to maintain positive social relationships that they can return to when they crave connection. They still spend time with others, but these interactions are balanced with periods of time alone.

However, increasingly nowadays, many people have to live alone by the sheer force of social circumstances, a situation well captured in the definition of loneliness above.

In fact, loneliness has now become a major public health issue, even in a country as rich as the USA, where last year its Surgeon-General Dr Vivek Murthy came up with an 82-page report and made a call to action based on the findings of studies presented in the report, that linked loneliness to several serious medical conditions. Nearly 50% of the American population, according to that report, have feelings of loneliness.

Subsequently, it was the turn of the WHO to take up the matter, and according to a press release in November 2023, ‘The World Health Organization (WHO) has announced a new Commission on Social Connection, to address loneliness as a pressing health threat, promote social connection as a priority and accelerate the scaling up of solutions in countries of all incomes.’

Co-chaired by US Surgeon General, Dr Vivek Murthy, and African Union Youth Envoy, Chido Mpemba, the Commission consists of 11 leading policy-makers, thought leaders and advocates. Running for three years, it will analyse the central role social connection plays in improving health for people of all ages and outline solutions to build social connections at scale. The Commission will consider how connection enhances the well-being of our communities and societies and helps foster economic progress, social development, and innovation.’

Further, ‘contrary to the perception that isolation and loneliness primarily affect older people in high-income countries, they impact the health and well-being of all age groups across the world. One in four older people experience social isolation and the rates are broadly similar in all regions. Among adolescents, between 5–15% experience loneliness, according to research findings. However, these figures are likely to be underestimations…’

“High rates of social isolation and loneliness around the world have serious consequences for health and well-being. People without enough strong social connections are at higher risk of stroke, anxiety, dementia, depression, suicide and more,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “This WHO Commission will help establish social connection as a global health priority and share the most promising interventions.’

The well-known scientific publication Nature (Nature 628, 22-24 (2024) has also published an article on the subject, ‘Why loneliness is bad for your health’ which highlights that ‘a lack of social interaction is linked to a higher risk of cardiovascular disease, dementia and more. Researchers are unpicking how the brain mediates these effects.’

We are far from the days of the English romantic poet William Wordsworth, who extolled the virtues of ‘recollections of tranquility’ in the midst of the solitude of nature, captured in such unforgettable poems as ‘Lines written a few miles above Tintern Abbey’, ‘The Daffodils’,‘The Solitary Reaper.’

The forthcoming report from the WHO will no doubt be awaited impatiently by health professionals and social workers so as to gain a comprehensive view of the problems and the solutions that will be proposed. This doesn’t prevent the rest of us from giving serious thought to the matter and explore how best we can help lonely people, or people who live alone and need help.

Such as the 100-year-old lady whom I had the pleasure of meeting several years ago during a function to honour the elders at La Sourdine, L’Escalier. She had lost her only son, lived alone and was so fit that she refused my help to climb the few steps to the dais. Every Saturday morning, a kindly soul came by to whom she handed money for buying some food items for her.

So perhaps we should not despair, and even such little acts of kindness can go a long way. A way to begin solving the problem, maybe…

Mauritius Times ePaper Friday 26 July 2024