Why Focus on Loneliness?

Loneliness impacts us all. Over one-third of American adults are lonely, a recent study by the AARP shows, a number nearly doubled since the 1980s.[i] That means, of course, that we all know someone afflicted by feelings of loneliness. Moreover, in an increasingly digital world that seeks to connect us, it is all too easy to feel disconnected from other people. Some dozens of studies over the past two decades have indicated that Internet use positively correlates with feelings of alienation and social disconnectedness, as well as depression and a negative impact on overall well-being.[ii]

For many people, then, loneliness is not simply an occasional feeling, but a corrosive burden on their health, well-being, and sense of self. Researchers know, from decades of scientific study, the pernicious physical, mental, and social health effects of loneliness.

A 2009 meta-analysis of more than eighty studies published in the Journal of Health and Social Behavior appraised this issue: “Health risks associated with social isolation have been compared in magnitude to the well-known dangers of smoking cigarettes and obesity. Individuals who lack social connections or report frequent feelings of loneliness tend to suffer higher rates of morbidity and mortality, as well as infection, depression, and cognitive decline. Yet, compared to health behaviors such as smoking and obesity, much less is known about how and why social isolation affects health.” That study concluded that while we know how deleterious loneliness and social isolation can be, more research is urgently needed to determine the causal mechanisms of loneliness and comprehensive public policy to address loneliness and improve health outcomes.[iii]

Another 2015 meta-analytic review of over thirty years of research substantiated the claim that loneliness impacts more than mental health: the mortality risk of loneliness and social isolation is comparable to well-established risk factors like smoking and obesity, with loneliness increasing the likelihood of mortality by up to thirty-two percent.[iv]

The authors of the study, led by Julianne Holt-Lunstad of Brigham Young University, write: “A substantial body of research has also elucidated the psychological, behavioral, and biological pathways by which social isolation and loneliness lead to poorer health and decreased longevity. In light of mounting evidence that social isolation and loneliness are increasing in society, it seems prudent to add social isolation and loneliness to lists of public health concerns.”[v]

A Major Impact on Public Health

When we talk about the ongoing health crisis in the United States, too often loneliness goes unmentioned. Reducing loneliness is one of the single most effective things we can do to improve the health and wellbeing of individuals and the vitality of communities across America. “This is something we need to take seriously for our health. This should be a public health issue,” Dr. Holt-Lunstad, author of the BYU meta-analysis and many others on loneliness, explained to Time this year. She went on: “If we just tell people to interact with more people…that might not solve the loneliness issue… People often say ‘What are you going to do, tell everybody to give someone a hug?’ But there are many ways this could be implemented.”[vi] That is, we have to get creative in our approach to reduce loneliness.

In fact, there is a growing body of scientific evidence that creative arts expression is an extraordinary means to reduce feelings of loneliness, isolation, and alienation, reducing too the correlated negative health effects. The simple acts of making art, sharing art, or receiving art increasingly seem the most effective and affordable treatment available to heal the loneliness epidemic.

The Art & Healing Connection

Creative arts expression may be especially effective in treating individuals facing illnesses like PTSD, cancer, diabetes, as well as caregivers, the highly stressed, adolescents, and the elderly, for whom there is higher incidence of loneliness, compounding those preexisting health conditions. That 2015 meta-analysis at BYU showed that poor initial health status significantly exacerbates the effects of loneliness.[vii] Another study, published in 2013 by researchers at Ohio State University examined breast cancer survivors to find that lonelier individuals were at higher risk for immune dysregulation, as well as higher rates of pain, depression, and fatigue.[viii]

It is unsurprising, then, that a growing medical practitioners prescribe creative expression to help individuals with conditions like these deal with a range of negative feelings, including loneliness. The benefits of creative arts therapies have been well documented as an efficacious treatment for patients facing a variety of conditions. A study at NYU Langone in 2008 found that art and music therapy had “extremely positive” outcomes in reducing both anxiety and physical pain in pediatric cancer patients.[ix] In a review of the impact of creative expression engagement on older adults in the U.K., the Mental Health Foundation concluded: “it is evident that engaging with participatory art can improve the wellbeing of older people and mediate against the negative effects of becoming older.”[x] A study published by Iranian researchers this year found that adolescents who engaging with painting had significantly reduced feelings of loneliness and emotional disorder, and performed better in academic settings.[xi]

If engagement in creative arts expression has repeatedly proven effective in improving health outcomes for diverse populations facing a multiplicity of conditions, so too is there increasing evidence that the arts can relieve social alienation and loneliness as a discrete health risk, whether or not they are associated with other conditions. Theresa Allison, MD, PhD, of the University of California San Francisco, who has extensively studied art creation as medical treatment, says: “We are finally at a tipping point, where the health sciences recognize the impact of loneliness and depression on health care outcomes, and we recognize the positive impact of visual and performing arts on symptoms management. Now we’re starting to ask why, and to bring in the science to study art’s impact. National funding agencies are starting to support this, and we’re going to see a lot of research emerge in upcoming years. We’re a long way away from being able to prescribe music or art like we would a medication. But one day I think what may find ourselves doing is prescribing music the way we prescribe exercise or other behavioral intervention.”[xii]

A Signature Initiative for the Foundation’s Community

That is why the Foundation for Art and Healing is launching The unLoneliness Project, an initiative to promote and facilitate creative expression of all kinds to reduce loneliness across various impacted populations. AtThe unLoneliness Project, we raise awareness about the public health crisis that is loneliness, and erase the stigma surrounding it. We want to develop the resources to sound the alarm and provide a creative escape from loneliness across traditional and social media. We, too, are providing innovative programs, tools, and exercises, to enable individuals and communities to make, share, and receive art to be less lonely. We want to make our toolkits available to communities across America, and optimize them for use anywhere, by anyone, online. We’re also continuing medical research into precisely how and why creative arts expression fights loneliness in order to ensure the efficacy of our programs and in an effort to bring such treatment into wide and regular use in the medical community.

We know that loneliness has quantifiable and harmful behavioral, physical, and mental health effects. We know, too, that creative arts expression is powerful medicine in reducing a variety of painful physical and mental conditions. We are at a crucial crossroads in bringing the treatment the arts offer to combat the public health threat that loneliness poses. Loneliness impacts us all. But the creative arts expression can reach us all. We, as medical professionals and patients, artists and art-lovers, organizations and individuals, can make un-loneliness through art. Together, we can become unLonely.

[i] Wilson, C., & Moulton, B. (2010) Loneliness among Older Adults: A National Survey of Adults 45+. Prepared by Knowledge Networks and Insight Policy Research. Washington, DC: AARP.

[ii] Kraut, R., Patterson, M., Lundmark, V., Kiesler, S., Mukophadhyay, T., & Scherlis, W. (1998). “Internet paradox: A social technology that reduces social involvement and psychological well-being?” American Psychologist, 53(9), 1017-1031.

Huang, C. (2010). “Internet use and psychological well-being: a meta-analysis.” Cyberpsychology, Behavior, and Social Networking, 13(3), 241-249.

[iii] Cornwell, E. Y., & Waite, L. J. (2009). Social Disconnectedness, Perceived Isolation, and Health among Older Adults. Journal of Health and Social Behavior, 50(1), 31–48.

[iv] Holt-Lunstad, J., Smith, T., Baker, M., Harris, T., & Stephenson, D. (2015)

Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review

Perspectives on Psychological Science, 10(2), 227-237.

[v] ibid.

[vi] Worland, J. (2015). “Why Loneliness May Be the Next Big Public Health Issue.” Time. <http://time.com/3747784/loneliness-mortality/>.

[vii] Holt-Lunstad, J., Smith, T., Baker, M., Harris, T., & Stephenson, D. (2015).

Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review

Perspectives on Psychological Science, 10(2), 227-237.

[viii] Jaremka, L.M., Fagundes, C.P., Glaser, R., Bennett, J.M., Malarkey, W.B., Kiecolt-Glaser, J. (2013). “Loneliness predicts pain, depression, and fatigue: Understanding the role of immune dysregulation.” Pscychoneuroendocrinology, 38(8), 1310-1317.

[ix] Nesbitt, L.L., & Tabatt-Haussmann, K. (2008). “The role of creative arts therapies in the treatment of pediatric hematology and oncology patients.” Primary Psychiatry, 15(7).

[x] McLean, J. (2011). An Evidence Review of the Impact of Participatory Arts on Older People. Mental Health Foundation, Edinburgh.

[xi] Alijanzadeh, R., Donyavi, R., Heydari, S. (2015). “Effects of Painting Therapy on Loneliness and Emotional Regulation of Students with Learning Disorder.” GMP Review, 18(1), 310-314.

[xii] Masterson, K., & Leigh, S., (2014). “The Art of Healing.” USCF News Center. <http://www.ucsf.edu/news/2014/12/121776/art-healing>.