Loneliness Lingers

You began working on loneliness before COVID, so this isn’t a new problem. What made you delve into this space initially?

I started focusing on loneliness because in the early 20-teens it became very clear that there were significant health consequences from loneliness. And they went beyond just the mental health ones you might think of. We were seeing research that loneliness could increase the risk of early mortality. So, we set out to address loneliness with a nonprofit which focuses on using creative expression to encourage people to connect with themselves and others by sharing their stories. It’s not the only way to address loneliness, but we have worked successfully with large employers, particularly in high-stress industries like front-line healthcare workers.

How does loneliness increase the risk of mortality?

From the mental health side, loneliness is probably the biggest preventable risk factor related to a triad of issues—depression, addiction, and suicidality. That, alone, justifies exploring it from an employee’s health and wellness perspective.

Around 2010, we started seeing work published that loneliness doesn’t just make you miserable, but it can kill you. That increase in early death is mostly because of cardiovascular death, metabolic issues like diabetes, and dementia. Inflammation is probably the major link to cardiovascular issues. The American Heart Association released a report in 2022 that said that loneliness increases the risk of heart attack, stroke, or death from heart disease by about 30%. That makes this a significant public health issue. Loneliness has also been shown to impact T cell [a type of white blood cell] function. People who are lonely don’t respond as well to vaccines because of a reduced immune response, so they also have a higher risk of having an infectious disease.

Aside from reducing healthcare costs among the workforce, why should employers be thinking about this?

Most adults spend most of their waking time at work, which makes it a time to improve, or do things to degrade, a person’s health—and employers often do both. Along with improving health, reducing loneliness can help people be more collaborative [and] productive, and help with retention, which are all pain points of employers of any size.

Where do things stand, post-pandemic? Are people feeling more connected since so many have returned to the workplace and social activities?

Evidence seems to indicate that we are even lonelier now. It’s important to understand that the loneliness from COVID was related to isolation. But loneliness is subjective. It’s a feeling that you don’t have the social connections you want to. You can be lonely in a crowd. There are different types of loneliness and that’s why it can be hard to measure.

Are there certain groups or people who are at a higher risk for feeling lonely?

Anyone in a social demographic that is already at high risk for marginalization is more likely to be lonely at work. This includes people with a mental or physical disability, older workers [there is lots of ageism in the workplace even for people in their 50s], someone who identifies as LGBTQ or has a gender identity that may be marginalized, and BIPOC [Black, indigenous, and people of color] populations. There is also a kind of loneliness associated with burnout and exhaustion. A lot of industries deal with this, especially healthcare. And young people at tech companies may feel this because of the uncertainty about the future of the industry. We have worked with big, powerhouse consulting firms, too, because they have people who may be traveling 70% of their time, which can make them disconnected from their social circles.

Businesses thought that people coming back to the office to work hybrid would be helpful, but that ended up being tougher than remote. It wasn’t coordinated well by employers. Someone may plan a day to come into the office, and then no one else was there. Amazon said they were bringing employees back [because there is a general sense people are more productive when they work in-person rather than remote] and now they are slowing that down a bit. While that [theory] may be true, people don’t like it.

Much like mental health issues, people may not always feel comfortable talking to employers about loneliness. What can an employer do to understand the extent to which it impacts their workforce?

We have done some measurements with Fortune 100 and 200 companies. There are short-form questions that can be added to health and wellness screeners, but most employers don’t do it. They don’t know that much about it, but also, they’re not really sure what to do about it. If you find out that 30% of your population is lonely, what do you do?

Good question. What do employers do if this is something with which their workers are struggling?

There are programs that we use for employers that aren’t group therapy, but they’re supportive group activities where you get employees to come together and share their stories. This could be done through employee resource groups, or ERGs, or done more broadly in the population. Employees can do periodic all-employee mental health presentations.

I’ve talked about loneliness for several large employers to their employees. This can help demystify it and reduce the stigma of it, so they feel it’s OK to talk about. Employers can have awareness campaigns about loneliness, and then they can make activities available in the workplace to foster a sense of connection. They can create volunteer programs or sponsor walking programs that give people the chance to be out together. A creative health and wellness team could easily come up with things that would give people authentic opportunities to be together. Employers can also encourage employees to take advantage of community programs like walking groups and book clubs and prioritize simple social connections.

Some organizations are baking these things into their health and wellness activities.

What about their insurance or employee assistance programs? Can employers find much help in those spaces?

Employers could go to the major insurance carriers to see what they can do to help with loneliness, but they may not get back much information. These programs often get low levels of engagement, so they would almost be doing that just to check the box and say they tried. Like with EAP programs, many companies have them, but they only get about 10% to 15% engagement.

There’s a lot of confusion about what loneliness is. For some people it may be that they are depressed. But then not everyone even knows exactly what depression looks like. Employers can try to educate people. We have short films available that relate to these topics that employers can screen. The goal of the films is to foster these conversations with the employees. They can watch and ask questions like, “What resonates for you with this film?”

Loneliness is something you can do something about. It’s not an illness; it’s a brain state. Employers need to help people change their perspective and, instead of seeing it as a character flaw or something to be fixed, loneliness is just a signal they need human connection. Like thirst is a sign we need water. It doesn’t mean you’re broken, but that’s what many people feel about themselves. If employers can provide education and offer solutions, instead of feeling burned out, guilty, and ashamed for being lonely, people can approach it in a more productive way.

They can take advantage of the resources the employer makes available, either on-site or in the community.

In Project UnLonely, you use art and creative outlets to discuss and work through loneliness, correct?

We get people engaged in activities where they can do some kind of creating or making things. It may be something like expressive writing that is used to have fun and start conversations. The idea of using creative things is to get people to relax, and for some unknown reason it encourages people to share stories together. People can see that they aren’t alone. It may get them started sharing stories about their kids or pets. And then the person across the hall at work becomes—if not a close friend—at least someone they can feel connected to. And that’s the goal.

How does an employer benefit from creating programs to combat loneliness among its workforce?

Along with fostering a sense of belonging in the workplace, there’s no question it increases productivity and retention and improves the quality of people’s work. It just changes things and helps companies become known as employers that are good to work with. The cost to replace and retrain a new worker who leaves is a full 12 months of salary. And that doesn’t include the cost of people who are there—who may not have overt mental health challenges but they aren’t fully engaged. Loneliness is a major factor in presenteeism. We hear it called quiet quitting, where an employee can show up every day to work but is basically hiding out.

I’m an optimist and think that, if employers are intentional about it, they can do tremendous things. They can’t just delegate it to HR as a wellness function. It is a bigger thing than that. They need programming and sustained leadership and visibility on the topic. So, it really comes down to culture, creating a culture of connection and collaboration. Almost every large employer talks about that. But very few are willing to make the commitment to build real cultures of connection, because it’s hard work.