The Loneliness Epidemic: A Hidden Threat to Women’s Health

Podcast Introduction and Loneliness Epidemic 0:00

The sociologists tell us, yes, we are definitely social people and that we need about three to five close relationships in order to feel happy and satisfied. And apparently that also determines how healthy we are. Have you made it past menopause or are you going through it now? I'm Dr. Pat McShane and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menopausal years and beyond. Guiding the way to thriving in this powerful era of your womanhood. Hello and welcome.

Today, in this episode, we're going to be talking about an epidemic that you may never have heard about, and that is the epidemic of loneliness in the developed world and in the middle-income countries as well. It's impacted about 40% of people over age 60, according to a number of different studies, And it has a wide range of medical implications with an increase in all-cause mortality, which means the chance of dying for everybody, as well as specific instances of cardiovascular disease and stroke, an increase in dementia, an increase in depression and anxiety, as well as probably other conditions that are lesser conditions.

This has been noted in a number of studies through the UK Biobank as one, the Mayo Clinic is another.

Defining Loneliness and Social Isolation 1:24

And there have been a number of scientists who've done meta-analyses, lumping a bunch of smaller studies together. And all of these studies basically have come up with the same general conclusion. that there is an epidemic of loneliness and that loneliness does have an impact on our health. So let's start by some definitions. When you think of loneliness, it's mostly a subjective experience. There's a difference between my perception of what I would like and how my life is actually going, a disparity there.

And that's certainly an important feature of all of this. The other is what we call social isolation, and that is people who spend very little time with others who aren't involved in a lot of activities with other people and who oftentimes live alone. are oftentimes single or divorced or widowed. And these can be lumped together, these two definitions, loneliness and social isolation. And a lot of studies have actually teased them apart, and they're each important. They're obviously highly correlated, although some people who do not have social isolation do have a profound sense of personal loneliness.

So they're not necessarily going in parallel, but they often are, of course. With any kind of information like this, we always wonder about correlation versus causation or reverse correlation.

Causes and Risk Factors 3:00

In other words, are people who have these medical conditions such as heart disease or dementia, is that the cause of their loneliness or their social isolation? Or is it the other way around? Or are they both related to a third factor that we haven't defined? So whenever we look at this kind of research, we always have to ask ourselves those questions. And of course, the researchers do the best job that they can teasing out these different things that might be related but not direct cause and effect.

On a personal level, what might cause someone to be socially isolated or to feel lonely? Well, for many of us, it's separation from a partner or the death of a partner. Fewer people are married now than have historically been married in the developed world. Oftentimes our friends will have moved away. Often our families will live far away from us. This is again a current status of our social constructs here. And we, as part of our growing older, may have conditions that make it more difficult for us to get out and about.

Difficulty with driving, transportation, nighttime driving, sometimes hearing or vision will keep people from being involved in the activities or the social activities that they wish to be involved in, and they historically have been involved in. Other factors that have been noted broadly in our culture are a reduction in religious attendance at religious services, although people still perceive themselves as being spiritual. But the piece about being in a group with another set of people with similar beliefs and goals is not as prevalent today.

We just are not joining the same numbers of organizations as we previously had been. There's a great book by Robert Putnam called Bowling Alone, which I recommend. And this was born out with a lot of the social trends in the last 30 years since he wrote this book.

Symptoms and Health Mechanisms 5:18

Social media has tended to be a substitute for some of the involvement that we used to have in other social activities, but it certainly has a different texture to it than actually being with people. The sociologists tell us, yes, we are definitely social people and that we need about three to five close relationships in order to feel happy and satisfied. And apparently that also determines how healthy we are. When looking at populations, some of these larger studies have identified some other risk factors for loneliness and social isolation.

Education is a protective factor, so the more educated you are, the less likely you are to be lonely or socially isolated. People who are smokers tend to have more social isolation. People with poorer health and physical limitations, as we just mentioned, will have difficulty interacting with other people. And income is a positive impact. The more income we have, the more likely we are to be involved in social activities and to report less loneliness. Sometimes people have symptoms of loneliness and they can tell you about that.

Mostly it's emotional, lack of support or a feeling of loss. Insomnia, sleep issues can be an issue. Feeling detached even when you're around friends and family is not uncommon. Increased anxiety and overthinking. Does that one ring a bell for anybody? Trouble focusing. lack of motivation or pleasure in everyday activities. Some of these seem to cross over with depression in my mind, but I'm not an expert in these symptoms. Many people don't really have symptoms, and they just feel like this is the way their life is.

As I mentioned, a number of studies have proven the impact of loneliness and social isolation on medical conditions. So while we may ask, well, what might be some of the mechanisms? And there have been studies looking at the brain per se. There have been studies looking at the brain per se, and some of the neurotransmitters are definitely impacted.

Ways to Reduce Loneliness 7:42

And some animal studies as well. There's certain areas of the brain that have been impacted by isolation of the animals versus social impact when they're living more normally with other animals. The immune system is definitely a big piece of this as well and certain immune cells are more activated and less activated under conditions of loneliness and isolation. Another large piece is cortisol, that stress hormone that we're going to be talking about quite a lot in this series. And that in turn impacts on our insulin levels and makes us more resistant to insulin and raises our glucose levels, which of course would then have to do with our risk of vascular disease and stroke and probably dementia as well.

I saw an interesting report that mentioned that the brain needs a workout to stay healthy and social interaction provides that workout. And I don't know exactly what the research behind that was, but it kind of made sense to me that we are wired to be in situations with other people and that there are undoubtedly parts of our brain that are specialized in that and that if we don't use them, use it or lose it. Given the risks of loneliness and isolation, what can we do about this? Well, Some of the obvious things are join a book club, join a group, join a church, participate in community activities, volunteer for something, seek opportunities to be with other people and put it on your calendar, civic engagement involved in politics or issues that you care about, And again, purpose here, we're going to be coming back to purpose in a number of our episodes, but having a life of purpose has been shown repeatedly to lead to healthier and longer lifespan and health span.

One of the things to be paying attention to is one of the mechanisms that people may engage in to try to circumvent or numb down their feeling of loneliness. And that is drugs and alcohol. And of course, those are not healthy for us. So if there's a tendency to have that second or third glass of wine or a cocktail because you're feeling lonely, it's something that you should try to avoid if at all possible.

Closing Remarks and Call to Action 10:12

And of course, if you are already a smoker, try to minimize or give it up as much as possible. So I hope I've provided you today with some of the concepts and the strategies behind the loneliness epidemic that we are establishing here in our normal modern culture. The risk of loneliness is said to be as great as the risk of smoking. And that's certainly something to be very aware of and try to do some of the things that we just mentioned. So I hope this is helpful and that you will come back and hear more about healthy health span for older women.

Thank you. Thanks for listening to the Women's Health Span Voices podcast. If today's episode spoke to you, follow the show and share it with a friend ready to take charge of her health. And please leave a review. It helps more women find us.