Cancer Death Is Higher for Those Living Alone, Study Suggests
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An increasing number of adults are living alone in the United States, and this social isolation appears to be taking a toll on the health of Americans.
A new study published in the journal Cancer suggests that adults who live by themselves have a 32 percent higher risk of death from cancer than adults living with others. That risk is particularly high for adults between the ages of 45 and 64 who live alone. Their likelihood of cancer death is 43 percent greater than that of their counterparts who live with others.
“Findings in this study underscore the significance of addressing living alone in the general population and among cancer survivors, and call for interventions to reduce adverse effects of living alone and social isolation,” says the lead study author, Hyunjung Lee, PhD, a principal scientist with the cancer disparity research team at the American Cancer Society.
Drawing on data collected between 1998 and 2019 by the National Health Interview Survey and the National Death Index, Dr. Lee and her team analyzed outcomes for nearly 475,000 adults who were between the ages of 18 and 64 at the study’s start. About a quarter of these individuals lived by themselves, while three-quarters lived with others.
Over the course of 22 years, there were close to 6,000 cancer deaths, or around 1.6 percent of people living with others — versus about 3,000 cancer deaths (about 2.5 percent) among those living alone.
Death Risk Is High Among Men and White Individuals
In addition to finding an especially high cancer death risk among middle-aged adults, the scientists noted that men who lived alone were 1.3 times more likely to die of cancer than women. In part, this may be because more men (56 percent) than women (44 percent) were living alone.
“I wonder about the cultural values instilled in American educated men by a culture that promotes and values autonomy and independence to a fault,” says Lidia Schapira, MD, an oncologist and the director of the Stanford Cancer Survivorship Program in California. “It makes me wonder if these men who were living alone were conditioned to shy away from asking for help or connecting to others.”
The association was also stronger among white adults living alone than non-Hispanic Black adults living alone, with a 33 percent higher cancer mortality risk for white adults versus 18 percent for Black adults.
Adults with higher education levels living on their own faced greater risk as well. Individuals with less than a high school education living alone were 1.26 times more likely to die of cancer, while those with a college degree living alone had a 1.41 times greater risk than their cohabitating peers.
Dr. Lee and her colleagues suggested that stronger social support from the community among racial and ethnic minorities, as well as among low-income people, might play a role in alleviating the association between living alone and cancer mortality in these groups.
As Isolation Grows, So Do Health Problems
U.S. Census figures reveal that the proportion of one-person households has more than doubled, from 7 million households (13 percent) in 1960 to 38 million households (29 percent) in 2020.
In May of this year, the U.S. Surgeon General, Vivek Murthy, MD, issued a surgeon general advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country. He highlighted how the lack of connection can increase the risk of premature death to levels comparable to smoking daily.
“Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health,” said Dr. Murthy in a statement. “Our relationships are a source of healing and well-being hiding in plain sight — one that can help us live healthier, more fulfilled, and more productive lives.”
Those who are isolated tend to have more unhealthy habits, according to the study authors. They cited previous research finding that people who live alone are less likely to follow healthy diets and more likely to be severely obese, currently smoke or drink heavily, and have severe psychological stress.
“What intrigues me is the possible relationship between lack of human connection and physiological processes that may affect biological phenomena such as immunity and stress in such a way as to increase susceptibility to cancer,” says Dr. Schapira, who was not involved in the research.
Mental Health America notes that when we are lonely, our bodies produce more of the stress hormone cortisol, and we feel stress more intensely. Scientific investigation has shown that stress may promote cancer development.
Tackling the Loneliness Problem
For Dr. Lee and her team, the excess cancer deaths associated with solo living underscore the need for more resources and training for clinicians and more research to develop interventions that might reduce these negative effects.
For example, programs that focus on cancer screenings for those living alone may in turn lead to more timely diagnosis, treatment, and attendance of medical appointments, which can lower the death rate in this population.
“We need to ask individuals if they live alone and if they are lonely, and be ready to respond with specific recommendations,” says Schapira. “It will take a major societal shift, however, to find solutions, and we should pay attention and get started.”
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