Framing loneliness as a health issue shifts responsibility from society to healthcare, even though healthcare alone cannot rebuild social ties, according to a University of Michigan study released on July 15.
The study, published in Social Problems, documents how chronic loneliness and social isolation have become public health concerns after research linked them to higher risks of disease, death, and rising healthcare costs. Prior research discussed in the study estimated that lacking social connection is comparable to smoking 15 cigarettes a day. Another cited finding was that social isolation, loneliness, and living alone each raise the risk of premature death by about 30%. Additionally, the experience may carry an economic cost for Medicare of approximately $6.7 billion annually in elder care.
Author Hiltner interviewed experts and analyzed more than ten years' worth of media coverage, medical journal articles, and academic papers. She found that linking loneliness to health gave legitimacy to the issue but also created what she calls a "logical leap"—the assumption that because a problem is related to health, the healthcare system should fix it. "Not everything that relates to health belongs in healthcare," Hiltner said. "Doctors can screen patients and connect them to services, but they cannot rebuild communities or shorten work hours."
Hiltner began studying loneliness after observing her grandmother's increasing isolation later in life. When she started graduate school focusing on older adults' isolation issues, she discovered clinical trials for a "loneliness pill." This led her to question why loneliness is predominantly framed as a medical rather than social problem. "After my grandfather died, my grandmother lived alone and there was little structure in her life," Hiltner said. "She didn't seem to have many friends or activities... I wondered about the social policies...that could have helped prevent that situation."
Her research shows members of the medical community did not initially want responsibility for addressing loneliness; instead, academic researchers, government officials, and insurance companies pushed it into healthcare discussions. "There is the risk that defining loneliness as medical crowds out other ways of responding," Hiltner said. She added: “Attention, time and resources are limited…framing it as medical may inspire more action than would have otherwise happened.”
Hiltner hopes policymakers will reflect on why problems are framed certain ways and consider upstream solutions: “I would like them to reflect on the strengths and limitations of addressing problems through the healthcare system…Healthcare can help but it can only go so far.”
