LONELINESS AS A PUBLIC HEALTH CHALLENGE: INNOVATIVE STRATEGIES FOR IMPROVING HEALTH AND WELL-BEING

Natalia Kornacka; Krzysztof Bednarski; Melania Majewska; Natalia  Piasecka; Izabela  Rafalska; Jakub  Smagoń; Martyna  Kaim; Joanna  Bober; Magdalena  Bochenek; Wiktoria  Siewiera

doi:10.31435/ijitss.3(51).2026.6229

Authors

Natalia Kornacka Beskid Oncology Center Municipal Hospital of John Paul II, Bielsko-Biała, Poland https://orcid.org/0009-0003-3657-2027
Krzysztof Bednarski Beskid Oncology Center Municipal Hospital of John Paul II, Bielsko-Biała, Poland https://orcid.org/0009-0000-9801-2832
Melania Majewska County Medical Center in Grójec, Poland https://orcid.org/0009-0009-5334-6965
Natalia Piasecka University Clinical Center of the Medical University of Warsaw, Poland https://orcid.org/0009-0001-2361-8060
Izabela Rafalska Upper Silesian Medical Centre of Prof. Leszek Giec, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0003-1687-8037
Jakub Smagoń Upper Silesian Medical Centre of Prof. Leszek Giec, Medical University of Silesia, Katowice, Poland https://orcid.org/0009-0008-0109-7349
Martyna Kaim District Hospital in Limanowa, Poland https://orcid.org/0009-0001-6818-6732
Joanna Bober Provincial Specialist Hospital in Wroclaw, Poland https://orcid.org/0009-0007-0118-885X
Magdalena Bochenek Provincial Specialist Hospital in Wroclaw, Poland https://orcid.org/0009-0006-3997-2810
Wiktoria Siewiera American Heart of Poland: Ustroń, Silesia, Poland https://orcid.org/0009-0009-1875-0209

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6229

Keywords:

Loneliness, Public Health, Health Promotion, Digital Health, Artificial Intelligence, Social Connectedness

Abstract

Loneliness has emerged as one of the most significant public health challenges of the 21st century, affecting individuals across all age groups and contributing to substantial medical, psychological, and socioeconomic burdens. Increasing evidence indicates that loneliness is associated with a higher risk of cardiovascular diseases, metabolic disorders, cognitive decline, depression, and premature mortality, highlighting its importance as a modifiable determinant of health. The aim of this narrative review is to summarize current evidence regarding the epidemiology, biological mechanisms, clinical consequences, and public health implications of loneliness, with particular emphasis on innovative strategies for its prevention and management. Relevant publications were identified through searches of PubMed, Scopus, Web of Science, and Google Scholar, with a primary focus on studies published between January 2020 and March 2026. Priority was given to systematic reviews, meta-analyses, clinical studies, and reports from international health organizations. The reviewed evidence demonstrates that loneliness contributes to adverse health outcomes through multiple biological pathways, including chronic stress activation, immune dysregulation, systemic inflammation, and behavioral changes. Emerging approaches, such as social prescribing, digital health technologies, telemedicine, wearable devices, artificial intelligence, and community-based interventions, offer promising opportunities to improve social connectedness and overall well-being. Addressing loneliness requires a multidisciplinary approach integrating healthcare, public health, technological innovation, and social policy. Future efforts should prioritize early identification, personalized interventions, and evidence-based strategies that combine innovative technologies with meaningful human relationships.

References

Barjaková, M., Garnero, A., & d’Hombres, B. (2023). Risk factors for loneliness: A literature review. Social Science & Medicine, 334, 116163. https://doi.org/10.1016/j.socscimed.2023.116163

Buckeridge, D. L. (2020). Precision, equity, and public health and epidemiology informatics—A scoping review. Yearbook of Medical Informatics, 29(1), 226–230. https://doi.org/10.1055/s-0040-1701989

Cené, C. W., Beckie, T. M., Sims, M., Suglia, S. F., Aggarwal, B., Moise, N., Jiménez, M. C., Gaye, B., McCullough, L. D., & Raj, A. (2022). Effects of objective and perceived social isolation on cardiovascular and brain health: A scientific statement from the American Heart Association. Journal of the American Heart Association, 11(16), e026493. https://doi.org/10.1161/JAHA.122.026493

Donovan, N. J., & Blazer, D. (2020). Social isolation and loneliness in older adults: Review and commentary of a National Academies report. The American Journal of Geriatric Psychiatry, 28(12), 1233–1244. https://doi.org/10.1016/j.jagp.2020.08.005

Gallagher, S., Howard, S., Muldoon, O. T., & Whittaker, A. C. (2022). Social cohesion and loneliness are associated with the antibody response to COVID-19 vaccination. Brain, Behavior, and Immunity, 103, 179–185. https://doi.org/10.1016/j.bbi.2022.04.017

Harrington, K. D., Vasan, S., Kang, J. E., Sliwinski, M. J., & Lim, M. H. (2023). Loneliness and cognitive function in older adults without dementia: A systematic review and meta-analysis. Journal of Alzheimer’s Disease, 91(4), 1243–1259. https://doi.org/10.3233/JAD-220832

Holt-Lunstad, J. (2024). Social connection as a critical factor for mental and physical health: Evidence, trends, challenges, and future implications. World Psychiatry, 23(3), 312–332. https://doi.org/10.1002/wps.21224

Kirwan, E. M., Burns, A., O’Súilleabháin, P. S., Summerville, S., McGeehan, M., McMahon, J., Gowda, A., & Creaven, A.-M. (2025). Loneliness in emerging adulthood: A scoping review. Adolescent Research Review, 10(1), 47–67. https://doi.org/10.1007/s40894-024-00240-4

Lim, M. H., Eres, R., & Vasan, S. (2020). Understanding loneliness in the twenty-first century: An update on correlates, risk factors, and potential solutions. Social Psychiatry and Psychiatric Epidemiology, 55(7), 793–810. https://doi.org/10.1007/s00127-020-01889-7

Luchetti, M., Aschwanden, D., Sesker, A. A., Zhu, X., O’Súilleabháin, P. S., Stephan, Y., Terracciano, A., & Sutin, A. R. (2024). A meta-analysis of loneliness and risk of dementia using longitudinal data from >600,000 individuals. Nature Mental Health, 2, 1350–1361. https://doi.org/10.1038/s44220-024-00328-9

Macias Alonso, A. K., Hirt, J., Woelfle, T., Janiaud, P., & Hemkens, L. G. (2024). Definitions of digital biomarkers: A systematic mapping of the biomedical literature. BMJ Health & Care Informatics, 31(1), e100914. https://doi.org/10.1136/bmjhci-2023-100914

Marzorati, C., Voskanyan, V., Sala, D., Grasso, R., Borgogni, F., Pietrobon, R., van der Heide, I., Engelaar, M., Bos, N., Caraceni, A., Couspel, N., Ferrer, M., Groenvold, M., Kaasa, S., Lombardo, C., Sirven, A., Vachon, H., Gilbert, A., Brunelli, C., ... Pravettoni, G. (2025). Psychosocial factors associated with quality of life in cancer patients undergoing treatment: An umbrella review. Health and Quality of Life Outcomes, 23(1), 31. https://doi.org/10.1186/s12955-025-02357-z

McClelland, H., Evans, J. J., Nowland, R., Ferguson, E., & O’Connor, R. C. (2020). Loneliness as a predictor of suicidal ideation and behaviour: A systematic review and meta-analysis of prospective studies. Journal of Affective Disorders, 274, 880–896. https://doi.org/10.1016/j.jad.2020.05.004

Musacchio Schafer, K., Franklin, J., Embí, P. J., & Walsh, C. G. (2026). Loneliness, anxiety symptoms, depressive symptoms, and suicidal ideation in the All of Us dataset. JAMA Network Open, 9(3), e260596. https://doi.org/10.1001/jamanetworkopen.2026.0596

Muscatell, K. A. (2021). Social psychoneuroimmunology: Understanding bidirectional links between social experiences and the immune system. Brain, Behavior, and Immunity, 93, 1–3. https://doi.org/10.1016/j.bbi.2020.12.023

Nakou, A., Dragioti, E., Bastas, N.-S., Zagorianakou, N., Kakaidi, V., Tsartsalis, D., Mantzoukas, S., Tatsis, F., Veronese, N., Solmi, M., & Gouva, M. (2025). Loneliness, social isolation, and living alone: A comprehensive systematic review, meta-analysis, and meta-regression of mortality risks in older adults. Aging Clinical and Experimental Research, 37, 29. https://doi.org/10.1007/s40520-024-02925-1

Napierala, H., Krüger, K., Kuschick, D., Heintze, C., Herrmann, W. J., & Holzinger, F. (2022). Social prescribing: Systematic review of the effectiveness of psychosocial community referral interventions in primary care. International Journal of Integrated Care, 22(3), 11. https://doi.org/10.5334/ijic.6472

National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. The National Academies Press. https://doi.org/10.17226/25663

Office of the Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General’s advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf

Patil, U., & Braun, K. L. (2024). Interventions for loneliness in older adults: A systematic review of reviews. Frontiers in Public Health, 12, 1427605. https://doi.org/10.3389/fpubh.2024.1427605

Reinhardt, G. Y., Vidovic, D., & Hammerton, C. (2021). Understanding loneliness: A systematic review of the impact of social prescribing initiatives on loneliness. Perspectives in Public Health, 141(4), 204–213. https://doi.org/10.1177/1757913920967040

Sha, S., Loveys, K., Qualter, P., Shi, H., Krpan, D., & Galizzi, M. (2024). Efficacy of relational agents for loneliness across age groups: A systematic review and meta-analysis. BMC Public Health, 24, 1802. https://doi.org/10.1186/s12889-024-19153-x

Shah, S. G. S., Nogueras, D., van Woerden, H. C., & Kiparoglou, V. (2021). Evaluation of the effectiveness of digital technology interventions to reduce loneliness in older adults: Systematic review and meta-analysis. Journal of Medical Internet Research, 23(6), e24712. https://doi.org/10.2196/24712

Slavich, G. M. (2020). Social safety theory: A biologically based evolutionary perspective on life stress, health, and behavior. Annual Review of Clinical Psychology, 16, 265–295. https://doi.org/10.1146/annurev-clinpsy-032816-045159

Smith, K. J., Gavey, S., Riddell, N. E., Kontari, P., & Victor, C. (2020). The association between loneliness, social isolation and inflammation: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 112, 519–541. https://doi.org/10.1016/j.neubiorev.2020.02.002

Smuck, M., Odonkor, C. A., Wilt, J. K., Schmidt, N., & Swiernik, M. A. (2021). The emerging clinical role of wearables: Factors for successful implementation in healthcare. npj Digital Medicine, 4, 45. https://doi.org/10.1038/s41746-021-00418-3

Surkalim, D. L., Luo, M., Eres, R., Gebel, K., van Buskirk, J., Bauman, A., & Ding, D. (2022). The prevalence of loneliness across 113 countries: Systematic review and meta-analysis. BMJ, 376, e067068. https://doi.org/10.1136/bmj-2021-067068

Torres, A., Wenke, M., Lieneck, C., Ramamonjiarivelo, Z., & Ari, A. (2024). A systematic review of artificial intelligence used to predict loneliness, social isolation, and drug use during the COVID-19 pandemic. Journal of Multidisciplinary Healthcare, 17, 3403–3425. https://doi.org/10.2147/JMDH.S466099

Uchino, B. N., Landvatter, J., Zee, K. S., & Bolger, N. (2020). Social support and antibody responses to vaccination: A meta-analysis. Annals of Behavioral Medicine, 54(8), 567–574. https://doi.org/10.1093/abm/kaaa029

Vidovic, D., Reinhardt, G. Y., & Hammerton, C. (2021). Can social prescribing foster individual and community well-being? A systematic review of the evidence. International Journal of Environmental Research and Public Health, 18(10), 5276. https://doi.org/10.3390/ijerph18105276

Wang, C., Qiu, X., Yang, X., Mao, J., & Li, Q. (2024). Factors influencing social isolation among cancer patients: A systematic review. Healthcare, 12(10), 1042. https://doi.org/10.3390/healthcare12101042

World Health Organization. (2025). From loneliness to social connection: Charting a path to healthier societies: Report of the WHO Commission on Social Connection. World Health Organization. https://www.who.int/publications/i/item/978240112360