I recently had the privilege of doing a TEDx talk on the importance of loneliness. You can watch it here if you haven’t had the chance yet. The theme of the day was all about connections. I wanted to highlight the importance of loneliness (i.e. not having enough connections that you need to thrive) and its impact on our health. I compared it unfavourably to cancer, in terms of survival, and suggested how we can screen for it, and do something about it. The audience reaction was really good, and over 2000 people have watched it since it went live, with 100% positive comments. It’s gratifying to know that so many people have found it helpful, including some going through very difficult periods in their lives.
What I found interesting is not that the TEDx editorial team felt the need to issue a disclaimer stating that my talk didn’t constitute medical advice (fairly standard practice if a clinician is giving the talk) but their statement that it fell “outside of the content guidelines that TED gives to TEDx organisers”. Interesting both because I had actually followed all the guidance and submitted all the references for any statements I made during that talk and because they still decided to release it anyway. All of which suggests to me that they both uncertain about joining the dots between the data on loneliness (and cancer) and translating it into clinical practice, whilst being intrigued and excited by the idea. Overall, I’ll take it as a compliment. As a fellow TEDx speaker pointed out to me, controversy is only likely to increase views!
So what was it that perturbed the editorial team enough to make this statement?
Was it the scary statistics?
In my talk I explain that your lifetime chance of being affected by loneliness is about the same as that of being affected by cancer (1 in 2) and that there are more people living with loneliness in the UK (3.8 million) compared to those living with cancer (3 million). Loneliness may be worse for you than smoking, physical inactivity or obesity, and increases your risk of dying prematurely by up to about 30% – a figure that has been cited in numerous studies. I came across it again just this week whilst reading the excellent “Myth of Normal” by Gabor Maté.
Maybe the comparison with cancer?
Whilst we have screening programmes for breast, bowel and cervical cancer (saving an estimated 10,000 lives per year) , there is no equivalent for Loneliness. Interestingly the number needed to treat (NNT) to save one life via these screening programmes is 1000 people. And yet we don’t invest anywhere near the kind of money in trying to address loneliness that we do in these screening programmes which, if we’re honest, produce a fairly modest bang for their buck.
In my talk I also make the point that outcomes from cancer are improving, with a 5 year survival rate of 90-100% for some cancers. A stat I didn’t include in the talk is that mortality from cancer (all types combined) has dropped by 20% since 1970. Perhaps my comparing this with worsening loneliness and worse outcomes caused a degree of uneasiness amongst the editors who had visions of people declining cancer screening, turning down treatments, and eating, smoking and drinking more in their pursuit of avoiding loneliness!
Or was it the 3 L’s of loneliness?
I proposed that the only question which we need to ask to detect loneliness is “Do you often feel lonely?”(which has been shown to be pretty much as good as the more complicated loneliness scales which vary from 5 to 20 point scoring systems) and that all we need are to remember the 3 L’s of Loneliness
To be fair, the 3 L’s is something of my own making (albeit based on common sense) and the randomised controlled trials will be undertaken just as soon as I find someone with deep pockets and a fascination with loneliness who wants to fund the research!
How well connected are you?
The point of all of this slightly depressing talk of loneliness is, of course, how we can either prevent it, or identify and address it – whether in our own lives or the lives of others. We all have the part to play in whatever capacity we are operating, whether as friends, family members, carers, business owners, community leaders, politicians, or clinicians.
2023 has been a pretty challenging year for most of us. 2024 is likely to have more challenges. Ask yourself whether you have the connections that you need for this. Do you need to plant new friendships? To grow and strengthen some of the ones you have, or to prune or even weed out others that are toxic and draining your time and energy? Do you need to reach out to others for support? Are you in a position to be the person that other people need to connect to, so you can help each other?
As a doctor and lifestyle medicine specialist with my many years of experience, both personally and professionally, it’s my job to ask these questions of myself and others, to take the evidence that we have (particularly in neglected areas like loneliness) and to find new ways of integrating it into every day life whether as a patient or health professional. Finding new ways of doing things will always be disruptive, even controversial. But if we don’t do it, we’ll be left with what we’ve always done and we know what results that gets. Here’s to 2024 and to us all being better connected!
Happy New Year!
