Do doctors appreciate that social isolation and loneliness are health issues?

In 2023, The Lancet published an editorial entitled “Loneliness as a health issue,” which underscored the complexity of addressing loneliness and emphasized the key role that health professionals can play (1). Reports from the US Surgeon General (2) and the National Academies of Sciences, Engineering, and Medicine (3) also stress the importance of mobilizing the health sector, recognizing that healthcare professionals have a crucial position in addressing loneliness and social isolation, particularly due to their interaction with high-risk populations. Despite an increased awareness of social isolation and loneliness during the COVID pandemic, it remains uncertain whether the healthcare community fully recognize it as a significant health risk (4, 5). Historically, a patient's level of social connections was considered a personal matter (6), yet since the 1980s, there has been growing recognition of the impact of social connections on health. In House's seminal paper published in Science in 1988, the authors provided evidence that the quality of social relationships has the same impact on health and mortality as cigarette smoking and other major biomedical and psychosocial risk factors (7). Over the past 40 years there has been increasing siloing and demarcation between the health and social care systems and professions. This separation has not served patients well and may also have contributed to why medical specialties see loneliness as more of a social issue. However, loneliness and social isolation are important risk factors for all-cause mortality, stroke, heart disease, depression, suicide and dementia (8–10). Both are also key contributing factors and potentially treatable aspects of multimorbidity and the geriatric giants of cognitive impairment and frailty (2, 3, 11).