Loneliness has become a significant public health issue that can be dangerous for the person as well as for the whole community. Lederman (2021) notes that loneliness is not just the temporary condition of feeling alone but a chronic state experienced by many people globally. Loneliness is not restricted to a specific age group, those with physical limitations, caregivers, people in the LGBTQ community, and individuals with mental health issues. The consequences of loneliness are not entirely restricted to emotional distortion, physical deterioration, and use of health care services. According to Lederman (2021), loneliness is strongly correlated with ill health, and experiencing chronic loneliness is equivalent to the negative health impacts of smoking or obesity. Loneliness is known to contribute to a higher rate of coronary heart disease, stroke, depression, cognitive deterioration, and early death. The physical and mental impact of being alone shows the social determinant of health loneliness- it affects a person’s overall well-being and quality of life.
On the other hand, loneliness carries a heavy economic burden on the healthcare systems and society overall. The high economic burden brought by both physical and mental health consequences of loneliness calls for immediate action, considering the heavy toll on the public health system (Liu et al., 2021). Besides, loneliness results in behavioral and cognitive impairment, reduced productivity, and increased absenteeism and healthcare utilization, thus worsening the societal issues associated with healthcare delivery and resource allocation. As a result of the growing number of lonely people with numerous adverse consequences for their health, policymakers, healthcare professionals, and advocacy groups are increasingly paying greater attention to the implementation of interventions designed to reduce loneliness and provide social connections. Yet, it is tackling loneliness on a holistic and comprehensive basis that requires professionals with expertise in different fields to work together and provide innovative solutions in public health.
Loneliness merges with the social determinants of health (SDOH) in no less complex way, being one of the major issues behind the health outcomes and the welfare of people. SDOH involve the structural and societal components responsible for discerning individuals’ health experiences, such as socioeconomic status, social support system, education system, health care access, and community resources (Padala et al., 2021). As a ubiquitous social thing, loneliness is a part of this broader framework, acts as a determinant and is determined by many social things. Besides this, the most essential characteristic of loneliness is its correlation with social support systems. The loneliest people tend to be the ones who have very few social relationships and support (Padala et al., 2021). Without these, they become vulnerable to different adverse health outcomes. On the other hand, that social isolation caused by, among many others, the poor income and the remote areas leads to the escalation of the sense of loneliness, reinforcing the circle of social deprivation and ill-health.
Loneliness is also interlinked with other SDOH elements, such as economic stability and education, reinforcing health disparities within vulnerable population groups. Socioeconomically underprivileged people often have to cope with more significant obstacles in incorporation into society and utilization of healthcare services that increase the likelihood of them suffering from loneliness and its adverse health effects. To tackle loneliness as a health determinant at the social level, a multi-faceted approach is needed to address both the social causes and the adverse effects on social inclusion by promoting community life. Long-lasting consequences on health are the adverse impact of loneliness. Health-promoting social connections, environment with support, and socioeconomic gap-filling programs are the pillars of the comprehensive approach.
In the context of loneliness as a public health concern, ethical principles are the key elements that underlie policymaking, healthcare services, and community initiatives. The concept of ethical principles, respect for autonomy, beneficence, nonmaleficence, and justice offers a way to resolve the question of loneliness. At the same time, the individuals’ rights and well-being are protected (American Nursing Association, 2024). Respect, which is autonomy, implies assigning people a right to self-decision and self-determination concerning their social contacts and safety nets. Health practitioners and authorities must respect individuals’ choices and personalized treatment programs to ensure cultural sensitivity, inclusivity, and the best treatment programs tailored to particular individuals.
Moreover, the evolution of compassion and non-maliciousness means choosing interventions that preserve social relationships, limit health damage because of loneliness and prevent harm. Such programs are community-based programs, mental health services, and social support initiatives that promote resilience within social networks, and overall wellness. Justice concerns reflect the significance of overall structural injustices and inequalities, which lie at the basis of loneliness and are detrimental to people’s general health. Ethical solutions to loneliness lie in targeting vulnerable populations, giving out resources, opportunities for social inclusion, and culturally tailored care equally.
Abiding by the ethics codes of the American Nurses Association (ANA) Code of Ethics for Nurses promotes individual-centered care and thus upholds the importance of providing care that addresses social and health inequities. Provision of the ANA Code specifies the commitment of a nurse to treat everyone with compassion and respect for the individual’s invaluable dignity, no matter their socioeconomic status (ANA, 2024). This provision helps healthcare professionals deliver care in a respectful and dignified manner, showing the sick and lonely compassion and understanding by considering their situation and needs. This translation conveys that loneliness is a real issue and should be prioritized by working on lessening its impact.
Furthermore, Provision 3 emphasizes the nurse’s role in activism, which includes standing up for patients’ health, safety and rights (ANA, 2024). Thus, bringing this provision into practice, healthcare experts of all specialities seek opportunities to develop and bring to life policies targeting social determinants of health, including loneliness. This implies the advocacy of programs that help with social integration, provide support networks and ensure material and physical resources are available to reverse loneliness. Healthcare professionals establish an approach to tackling the issue of isolation by implementing these provisions into public health programs and clinical practice while adhering to et, ethical standards. Through this method, those feeling lonely are guaranteed to receive to receive empathetic care, which in turn promotes good health outcomes and equity within the communities.
American Nursing Association. (2024, February 12). Why Ethics in Nursing Matters: Ethical Principles in Nursing. ANA. https://www.nursingworld.org/content hub/resources/workplace/why-ethics-in-nursing-matters/
ANA. (2024, October 26). Code of ethics for nurses. https://www.nursingworld.org/practice policy/nursing-excellence/ethics/code-of-ethics-for-nurses/
Lederman, Z. (2021). The bioethics of loneliness. Bioethics, 35(5), 446–455. https://doi.org/10.1111/bioe.12870
Liu, S., Haucke, M. N., Heinzel, S., & Heinz, A. (2021). Long-term impact of economic downturn and loneliness on psychological distress: Triple crises of COVID-19 pandemic. Journal of Clinical Medicine, 10(19), 4596. https://doi.org/10.1093/geroni/igab046.2726
Padala, K., Crawford, C., Gauss, C., Wright, B., Phillips, O., Dennis, R., … & Padala, P. (2021). Relationship between social determinants of health and loneliness during COVID-19 pandemic. Innovation in Aging, 5(Supplement_1), 732–732. https://doi.org/10.1093/geroni/igab046.2726