A loneliness epidemic: BGSU researchers are working to uncover why lonely individuals face an increased risk of heart disease

The four-year study is funded by a $710,000 grant from the National Institutes of Health

By Laren Kowalczyk '07

A person who smokes 15 cigarettes a day likely knows the damage they're causing to their body.

Someone who frequently feels lonely probably doesn’t, yet researchers at Bowling Green State University say both face a similar risk of premature death.

“If you tell someone smoking a pack of cigarettes a day is bad for your health, no one is going to question that,” said Dr. Daniel Maitland, an associate psychology professor and director of clinical training at BGSU. “But if you say loneliness is a significant health issue, no one understands the gravity of that.”

Maitland is studying the connection between loneliness and predictors of increased risk of cardiovascular disease as part of a $710,000 grant from the National Institutes of Health, the primary federal agency for conducting and supporting medical research.

While past studies have identified a connection between loneliness and cardiovascular disease, the mechanism of that pathway is unclear. Maitland’s research will focus on understanding what it takes for lonely individuals to build social connections and how those interactions affect the sympathetic nervous system — the body’s fight or flight response.

The intensive four-year study will involve 200 participants ages 18-30 years old from Wood and Lucas counties, in a representative sample of the population.

‘Slamming on the brakes’

One factor common to both loneliness and cardiovascular disease is the engagement of the sympathetic and parasympathetic nervous systems.

The sympathetic nervous system is activated during times of threat, increasing the body's heart rate and oxygen flow, while the parasympathetic nervous system lowers heart rate, blood pressure and respiration.

Maitland’s theory is that lonely individuals experience excessive engagement of the sympathetic nervous system in social situations, such as a racing heart, which disrupts their ability to form social connections.

Social connection occurs when a person engages in a vulnerable self-disclosure and the other person responds in an understanding and caring way. Maitland used the example of telling someone an embarrassing story or sharing feelings of love.

“If someone responds poorly to those disclosures, you don’t do it again,” he said. “It could be years before you make a similar disclosure, perpetuating those feelings of loneliness.

“It’s like slamming on the brakes of your car, backing out of the conversation and choosing not to make a vulnerable self-disclosure. We think what’s happening is you’re repeatedly stressing out your heart because you’re constantly pumping the brakes.”

Details of the study

To identify the connection between loneliness and the sympathetic nervous system, study participants will wear a small heart-monitoring device, similar to an electrocardiogram, for 30 days.

They’ll be surveyed about their social interactions every four hours during the day through a mobile app. Participants will also have the option to hit a button on the device to indicate when a social interaction has started and ended.

Using data from the device, Maitland, principal investigator on the project, said he and his team can determine how the heart performed during various social interactions.

BGSU graduate student Jennifer Truitt, who is pursuing a doctorate degree in clinical psychology, and eight undergraduate psychology students will assist Maitland in the study — key to the University’s commitment to supporting student success and outcomes through experiential learning opportunities.

Truitt will serve as a project manager, assisting in training and mentoring undergraduate students, recruiting and training study participants on using heart-rate devices, data analysis and numerous other responsibilities.

“This is an incredibly relevant and important topic to study, and I’m excited to be a part of it,” Truitt said. “I’m looking forward to taking a leadership role on this project and seeing the data come together.”

Lonelier than ever

In 2017, U.S. Surgeon General Dr. Vivek Murthy called loneliness a growing health epidemic. Murthy raised the alarm again in 2023, releasing a Surgeon General Advisory on the public health crisis of loneliness, isolation and a lack of connection and its effect on mental, physical and societal health.

The study’s targeted age group, which encompasses both millennials and Generation Z, has reported increased feelings of loneliness in the past 10 to 15 years. Maitland said as many as 79% of 18 to 24-year-olds regularly reported loneliness in 2022.

“As a society, we’re lonelier than ever, and it’s gotten worse since the pandemic,” Maitland said. “We’re not talking about loneliness as it pertains to sitting alone in a room or being isolated. We’re interested in the people who are surrounded by others but feel lonely even with that social interaction. Isolation and loneliness are different constructs.”

Based on the project’s outcome, Maitland plans to propose an intervention study to develop treatments to mitigate loneliness and prevent socially influenced cardiovascular morbidity and mortality.

Truitt is particularly interested in using data to develop interventions for marginalized identity groups who often face additional challenges in developing social connections.

“If you have fewer people in an identity group, it’s harder to find people with the same shared experiences,” Truitt said. “But what does give me hope is we’re doing the work to understand what leads to loneliness. If we know the little building blocks contributing to loneliness, we can hopefully develop ways to remove them and replace them with ones that help people form meaningful connections.”