Some people do not feel lonely when alone, while others may feel lonely even when surrounded by other people. The most widely described examples of this dichotomy come from studies of older residents in community dwelling facilities. Nearly all such residents feel at least moderately lonely (60%) or severely lonely (35%).

Loneliness is a very expensive  health problem.

The association between loneliness and multiple negative health outcomes has been well described, however, new evidence relates loneliness to what is happening in our cells. Loneliness has a negative effect on the cellular workings of our immune systems causing them to dysfunction. Indeed, many conditions with a basis in immune dysfunction have been linked to loneliness – though the relationships may not be causal but rather just coexistent.  These conditions include dementia, cognitive decline, depression, anxiety, alcoholism, aggression, impulsivity, hypertension, obesity, stroke, insomnia and heart disease.

Furthermore, loneliness can be deadly, as it can predict suicidal thoughts and death by suicide, increasing the risk of early death by suicide by 26%. 

Until recently loneliness has been characterised as a problem of institutionalised older persons and those suffering from pre-existing mental ill health. COVID has changed all that.  Younger people appear to have been more affected by loneliness and the impact of the pandemic in comparison to older people.

Worldwide, data is emerging to show that loneliness is a very expensive health problem. For example, the total annual health costs attributable to loneliness in the UK are estimated to be GBP 2,265 per person. An Australian study estimated the annual health cost of loneliness in relation to adverse health behaviours is AUD 1,565 for each person. 

Traditionally, interventions to combat loneliness have involved increasing human or animal contact – either face-to-face or virtually. Recent research has turned to exploring more novel interventions such as green space. A systematic review of the relationship between green space and protection against loneliness found that more than two thirds of the studies showed some benefit of green space on loneliness and in at least halfof these studies, the relationship reached statistical significance. 

The picture is not quite that straightforward nor ecologically sound. Different types and qualities of outdoor spaces afford different experiences. A Dutch study found that green was not the only way to go. Time spent sightseeing and visiting amusement parks and zoos was also associated with lower levels of loneliness.

So, it may require a range of outdoor experiences to counter the loneliness of confinement that now seems to be the major progenitor.  At any rate, the annual loneliness expenditures of GBP 21 billion in the UK and the AUD 2.7 billion in Australia and countless other billions around the globe surely could be better spent, whether on parks or roller coasters or big cat habitats.