Loneliness hurts, but social isolation can kill you. That's the conclusion of a study of more than 6,500 people in the U.K.
The study, by a team at University College London, comes after decades of research showing that both loneliness and infrequent contact with friends and family can, independently, shorten a person's life. The scientists expected to find that the combination of these two risk factors would be especially dangerous.
"We were thinking that people who were socially isolated but also felt lonely might be at particularly high risk," says Andrew Steptoe, a professor of psychology at University College London.
To find out, the team studied 6,500 men and women ages 52 and older. All of them had answered a questionnaire back in 2004 or 2005 that assessed both their sense of loneliness and how much contact they had with friends and family. The researchers looked to see what happened to those people over the next seven or eight years.
And Steptoe says he was surprised by the result. "Both social isolation and loneliness appeared initially to be associated with a greater risk of dying," he says. "But it was really the isolation which was more important."
At first, it looked like people who reported greater levels of loneliness were more likely to die, Steptoe says. But closer analysis showed that these people were also more likely to have other risk factors, like being poor and having existing health problems. Once those factors were taken into account, the extra risk associated with loneliness pretty much disappeared, Steptoe says.
But people who spent very little time with friends and family, or at social events, were more likely to die regardless of income or health status, the team reports in the Proceedings of the National Academy of Sciences.
It's not clear why social isolation is linked to mortality. But one possibility is that having other people around has practical benefits as you get older, Steptoe says. For example, they may push you to go see a doctor if you are having symptoms like chest pain, he says. And if you were to lose consciousness, they would call for help.
Other researchers say they are surprised and not necessarily convinced by the new study, even though they say it's large and well-done.
"It doesn't negate the loneliness work that's been done to date," says Bert Uchino, a University of Utah psychology professor. He says this study may have reached a different conclusion than earlier ones because people's definition of loneliness is changing in the Internet age.
"People ... may think that they're connected to other people because they're on Facebook," Uchino says. So they may not report feeling lonely. But that sort of connection, he says, may not have the health benefits of direct contact with other people.
The different result might be because this study looked at people in the U.K., while many earlier studies looked at people in the U.S., says University of Chicago psychologist John Cacioppo. So in the U.K., where the culture values a "stiff upper lip," people who live alone may be "less likely to admit to feeling lonely than are residents of the U.S.," he says.
Whether or not loneliness raises the risk of dying, Cacioppo adds, it certainly reduces a person's quality of life.
And it's easy for people to do things that alleviate both isolation and loneliness, Uchino says. "Have lunch with somebody," he says. "Take a walk. Give them a phone call. I think those are all important ways that we need to stay connected with our relationships. And I think, in the long term, it can help us."
DAVID GREENE, HOST:
A lot of research has found that people who feel lonely don't live as long. But a new study in the U.K. suggests that whether you feel lonely is less important than how much contact you have with friends and family. NPR's Jon Hamilton reports that the finding came as a surprise, even to the researchers who did the study.
JON HAMILTON, BYLINE: Loneliness and social isolation are two different things. Some people have very little human contact and like it that way. Others see people regularly but still feel lonely. Previous studies have found that both loneliness and social isolation are linked to a higher risk of health problems and a shorter life. So Andrew Steptoe, a researcher at University College London, suspected that a combination of the two would be especially dangerous.
ANDREW STEPTOE: We were thinking that people who were socially isolated but also felt lonely might be at particularly high risk.
HAMILTON: To find out, Steptoe led a team that studied 6,500 men and women age 52 and older. All of them had answered a questionnaire back in 2004-2005 that assessed both their sense of loneliness and how much contact they had with friends and family. The researchers looked to see what happened to those people over the next seven or eight years. And Steptoe says he was surprised by the result.
STEPTOE: Both social isolation and loneliness appeared initially to be associated with a greater risk of dying. But it was really the isolation which was more important.
HAMILTON: Steptoe says at first it looked like people who reported greater levels of loneliness were more likely to die. But it turned out they were also more likely to be poor and to have health problems. Once those sorts of factors were taken into account, the extra risk pretty much disappeared.
Isolation, on the other hand, increased a person's risk of dying regardless of income or health status. Steptoe says the finding, published in the Proceedings of the National Academy of Sciences, suggests that there are at least two reasons to stay socially connected.
STEPTOE: One is to do with a feeling of people around you with whom you can confide, who are close to you, and that might be somewhat linked with loneliness.
HAMILTON: So you'll presumably be happier, but you won't necessarily live longer. But Steptoe says whether or not you feel lonely, having friends and family around can offer practical benefits.
STEPTOE: It could be people being advised to go and see a doctor if they have some symptoms; it could be support in terms of having healthier lifestyles, or it could even be quite basic things such as somebody developing serious symptoms of illness and not having anyone there to help them.
HAMILTON: The finding that loneliness doesn't affect health also came as a surprise to other researchers in the field. Bert Uchino from the University of Utah says he's not convinced by the new study - at least not yet.
BERT UCHINO: It doesn't negate the loneliness work that's been done to date. I think it does raise the dialogue, however, in terms of why the differences are occurring.
HAMILTON: Uchino and others say there may be cultural differences between America and Great Britain that explain why studies of Americans have reached a different conclusion. He says another possibility is that in the Internet age, people's perceptions of loneliness and isolation may be changing.
UCHINO: People may feel connected, may think that they're connected to other people because they are on Facebook or some of these other sites, but of course that doesn't mean that the quality of that relationship is being nurtured as well.
HAMILTON: Uchino says evolution seems to have programmed us to need direct human contact, not just cyber-friends. And he says there are lots of things people can do to reduce both loneliness and isolation.
UCHINO: Have lunch with somebody. Take a walk. Give them a phone call. I think those are all important ways that we need to stay connected with our relationships, and I think in the long term it can help us.
HAMILTON: Uchino says those efforts to connect are especially important as we get older. Jon Hamilton, NPR News. Transcript provided by NPR, Copyright NPR.