Study: The Medicalization of Loneliness: Addressing Social Ills Through Healthcare (DOI: 10.1093/socpro/spag034)
While loneliness has been shown to harm one's health, framing it as a health issue shifts responsibility from society to healthcare, even though healthcare alone cannot rebuild social ties, a new University of Michigan study warns.
The study, published in Social Problems, documents how chronic loneliness and social isolation gained traction as public health concerns once research linked them to higher risks of disease, death and rising healthcare costs.
Prior research discussed in the current study estimated that a lack of social connection is comparable to smoking 15 cigarettes a day. Another study found that social isolation, loneliness and living alone each raise the risk of premature death by roughly 30%. A third showed that beyond the physical toll, this experience may carry an economic price tag, costing Medicare an estimated $6.7 billion annually in elder care.
"Once people saw these findings, they began to treat loneliness as urgent," said U-M doctoral student Sofia Hiltner. "But it made me wonder: Why do we only consider problems important once they are tied to health?"
Hiltner interviewed experts and analyzed more than a decade's worth of media, medical journal articles and academic papers. She found that while linking loneliness to health gave the issue legitimacy, it also created what she calls a "logical leap"-the assumption that because a problem is related to health, the healthcare system should try to fix it.
"Not everything that relates to health belongs in healthcare," she said. "Doctors can screen patients and connect them to services, but they cannot rebuild communities or shorten work hours."
Hiltner, a predoctoral trainee in social demography at the Population Studies Center at U-M's Institute for Social Research, began studying loneliness after watching her grandmother become increasingly isolated later in life. When she started graduate school to study isolation among older people, she discovered clinical trials for a "loneliness pill". This experience raised questions about why loneliness is predominantly framed as a medical issue instead of a social one.
"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. It made me think about everything that happened throughout her life that led to that point. I wondered about the social policies, in addition to dynamics at the family level, that could have helped prevent that situation."
Cure may lie far outside the clinic
Hiltner's research also shows that members of the medical community did not initially want to claim loneliness as their responsibility. Instead, a mix of academic researchers, government health officials,and insurance companies pushed the issue into healthcare.
"There is the risk that defining loneliness as medical crowds out other ways of responding to the issue," she said. "Attention, time and resources are limited. On the other hand, framing it as medical may inspire more action than would have otherwise happened."
Hiltner hopes the study inspires policymakers to reflect on why they frame problems in certain ways and to consider upstream solutions.
"I would like them to reflect on the strengths and limitations of addressing problems through the healthcare system, and look farther upstream to understand how a problem emerges, considering ways to intervene before it occurs," she said. "Healthcare can help, but it can only go so far."
