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Raising public awareness about loneliness and its cardiovascular effects 09 Feb 2018

Heart disease is the number one cause of death globally. Around 17.7 million people died from cardiovascular diseases (CVDs) in 2015, according to the World Health Organisation. Nigeria is also at the verge of a cardiovascular epidemic, with growing cases of sudden and unexpected deaths mostly caused by heart disease and related illnesses.
    
Hypertension, also known as high blood pressure (HBP), is the most prevalent heart disease in Nigeria. It has the highest occurrence of mortality in the country, compared to other CVDs. These are not mere statistical facts. Many of us or people we know have lost friends or family members who died of hypertension. It is not an "old people's disease." In fact, an alarming number of hypertension deaths are people in their 30s, 40s and 50s. Doctors say a lot of people have the condition without knowing it. Therefore, more awareness about HBP can help to save our lives and the people we love.

Prominent Nigerians who have died unexpectedly in recent years include former Super Eagles coaches Stephen Keshi and Shuaibu Amodu who both died just few days apart in 2016 of apparent heart attack. On the 25th of last month, Deji Tinubu, who was Special Adviser to the Lagos State Governor Akinwunmi Ambode on Commerce, Industry and Cooperatives, slumped during a football match with other members of the state executive council. He was later pronounced deceased. The cause of death is still undisclosed.     

Leading risk factors for heart disease include hypertension, smoking, high cholesterol, physical inactivity, harmful use of alcohol, obesity, and diabetes. But as recent studies have conclusively shown, top on this list of major risk factors for cardiovascular disease have to be loneliness and social isolation.

Former Surgeon General of the United States, Vivek Murthy, wrote in a Harvard Business Review article that, "Loneliness is a growing health epidemic." While implementing lifestyle changes – such as not smoking, proper nutrition, good cholesterol, physically activity, less alcohol consumption – can reduce the risk factors for heart disease, combating loneliness and social isolation is a matter of public advocacy and providing social support to the isolated.

A recent report by the Jo Cox Commission in the United Kingdom shows that more than nine million adults (about 14% of the population) are often lonely. The American Psychological Association says up to 40% of Americans over the age of 45 suffer from chronic loneliness. This is a public health concern that led the UK government to recently create the office of Minister of Loneliness.

As the Prime Minister, Theresa May, said, loneliness is "the sad reality of modern life." It affects both the physical and mental health of people across demographics, including young kids, teens and adults. Loneliness is a condition whereby an individual subjectively feels isolated. It is different from social isolation, which is the actual absence or low degree of social connections. Evidence suggests that sometimes people can have a large social network of family and friends and still feel lonely. The opposite is also true. The feeling of lonesomeness is about finding it difficult to connect emotionally, trust someone or be understood, especially during times of great need.  

Social connection is a fundamental human need akin to food and water. Various scientific research show how social interactions are crucial to well-being and survival. Infants who are deprived of direct human contact suffer from psychological and physical retardation, and some even die.

Findings by researchers at the University of York, England, show that loneliness or social isolation increases the risk of CVD by 29%, while increasing the risk of stroke by 32%. Chronically lonely people are also likely to develop cancer, dementia and cognitive decline. A causal explanation is that people who lack social support or feel lonely are more likely to have poor eating habits and unable to maintain healthy lifestyles. But some studies have found that loneliness raises the levels of stress hormones, which are linked to heart disease and other health problems.

Part of the public awareness that is required to reduce cardiovascular risks is to encourage young people to reduce the use of social media, especially as a means of finding meaningful social connections. Although social media in itself does not cause loneliness, researchers have found that the illusory search for validation online increases the feeling of isolation, which leads to cardiovascular effects.

In today's hyperconnected world, face-to-face interaction is increasingly being replaced by virtual reality with attendant social ramifications. In his HBR article, Murthy also wrote: "We live in the most technologically connected age in the history of civilization, yet rates of loneliness have doubled since the 1980s."

Psychologists at the University of Pittsburgh, USA, published a report last year showing that people who spend over two hours per day on social networks have twice the odds of feeling socially isolated than people who spend less than 30 minutes a day on social media. Indeed, an emoji of a smiling face cannot supplant the emotional dynamics of the smile on a person's face, neither can virtual social networks be substituted for face-to-face interactions.

Loneliness literally breaks hearts. Chronic loneliness leads to huge social and economic costs on families, while also putting significant burden on the health system. Addressing loneliness and social isolation as a policy imperative for the Nigerian government falls squarely within the economics of well-being, a concept that many economists and world leaders insist must be used to assess national progress, besides Gross Domestic Product.

Wellbeing is critical to achieving corporate and national goals. It is the responsibility of the Nigerian government as well as the private and social sectors in the country to identify people at risk of isolation and loneliness and devise initiatives to provide them with social support. But as policymakers seek interventions to reduce the impacts of cardiovascular diseases and the rising death toll associated with social isolation, what Nigeria needs now is more empathy and less division.

Martins Hile is Executive Editor, Financial Nigeria magazine