Podcast Episode: Social Isolation Is as Dangerous as Smoking?

Huge, huge thank you to Dr. Harry Taylor at University of Toronto for this awesome interview.

There are certain claims that immediately trip my internal “citation needed”, (or as I call it, BS)alarm. This was one of them:

Social isolation is as dangerous to your health as smoking cigarettes.

I first ran into that line while reading about longevity in Mediterranean cultures. Sure – there was some diet stuff (and sadly it’s not chicken nuggets, so my kid might be screwed), but it was way more about community.

My gut reaction was disbelief. What’s the mechanism? There’s no way simply being alone carries the same mortality risk as smoking. Like, smoking a pack of cigarettes and sitting in a dark room by myself can’t be equally bad: right?

So I went digging.

That search led me to a 2010 meta-analysis by Julianne Holt-Lunstad showing that social isolation is associated with a 32% increased risk of early mortality, even after controlling for other factors. Enough to raise eyebrows — but still not enough to answer the real question.

How does this actually work?

To get at that, I sat down with Dr. Harry Taylor Owen, whose 2023 editorial in BMC Public Health synthesizes decades of loneliness and social isolation research. What followed reframed how I think about health, stress, and modern life.

This Isn’t a Feelings Problem. It’s a Biology Problem.

One of the most striking lines from Dr. Taylor’s paper reads:

“Loneliness and social isolation have mortality risks similar to cigarette smoking, alcohol consumption, physical inactivity, and obesity.”

That sounds absurd until you understand what researchers are actually measuring.

As Dr. Taylor explained, this isn’t about spending a quiet afternoon alone. It’s about chronic isolation:

“These are people who have been isolated for many, many years.”

Long-term isolation keeps the body in a constant stress state.

“When you’re socially isolated, your stress hormones are off the charts.”

Cortisol stays elevated. The stress-response system never really shuts off. Over time, the body wears down — a process researchers call weathering. Immune function weakens. Inflammation rises. Risk accumulates. So it feels bad, and is bad for you.

The Behavioral Spiral Nobody Talks About

The biology is only half the story.

Isolation also reshapes behavior — and not in subtle ways:

“People who are socially isolated are less likely to be physically active… more likely to have sedentary lifestyles… more likely to smoke.”

Isolation feeds habits that compound health risk. There’s also evidence linking isolation to lower medication adherence, though that’s often tangled up with income, access, and education.

That’s the key point: social isolation clusters with disadvantage. It rarely shows up alone.

Isolation Isn’t Binary

One of the most useful reframes Dr. Taylor offered was this:

“Social isolation isn’t an on/off switch.”

You can be isolated from family but close to friends.
Connected online but isolated locally.
Surrounded by people and still deeply lonely.

That nuance matters — especially when we talk about technology.

For example, research on LGBTQ youth shows online communities can be protective:

“For them, it’s a survival strategy.”

Technology isn’t automatically harmful. Context and community quality matter more than the medium.

Why Older Adults Are Especially Vulnerable

Age is one of the strongest predictors of isolation.

Retirement, loss of a spouse, reduced mobility, relocation — each shrinks social networks. Even well-meaning fixes don’t always solve it:

“They might see their children and grandchildren often — and still feel lonely.”

Presence isn’t enough. Shared experience matters.

If This Is a Public Health Issue, What Do We Actually Do?

Dr. Taylor didn’t pretend there’s a simple fix:

“This is the hardest question.”

His answer was essentially a full-system response, using a social-ecological framework.

At the individual level:
Get uncomfortable, on purpose.

“Say hi. Smile more. Talk to people you see regularly.”

At the community level:
Belonging needs infrastructure.

“Parks matter. Cafés matter. Local gathering spaces matter.”

At the institutional level:
Purpose creates connection.

One nursing home in England assigns residents chickens to care for.

“And that really brings people together.”

It sounds strange — until you realize it creates routine, responsibility, and shared meaning.

At the cultural level:
This is the hardest shift.

“Belongingness should be part of our values.”

How do we adapt our culture to be more welcoming?

The Tech Question We Can’t Dodge

Before we wrapped, Dr. Taylor pointed to something already underway: randomized trials using AI chatbots to reduce loneliness.

“Technology is going to change the way we think about isolation forever.”

These tools may help people with limited mobility or severe barriers. But they don’t replace real-world connection — especially when we remember the behavioral side of the equation.

You might calm stress hormones with a bot. You probably won’t go for a walk with one (or maybe you will, you do you).

The Takeaway

Social isolation isn’t soft science. It isn’t a mood issue. And it isn’t solved by telling people to “try harder” or “be better”. It’s a global public health issue, operating through biology, behavior, infrastructure, and culture all at once.

Stay Curious!

Sources

Cacioppo, John T., Louise C. Hawkley, Greg J. Norman, and Gary G. Berntson. 2011. “Social Isolation.” Annals of the New York Academy of Sciences 1231(1):17–22. doi:10.1111/j.1749-6632.2011.06028.x.

Holt-Lunstad, Julianne, Timothy B. Smith, Mark Baker, Tyler Harris, and David Stephenson. 2015. “Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review.” Perspectives on Psychological Science 10(2):227–37. doi:10.1177/1745691614568352.

Loades, Maria Elizabeth, Eleanor Chatburn, Nina Higson-Sweeney, Shirley Reynolds, Roz Shafran, Amberly Brigden, Catherine Linney, Megan Niamh McManus, Catherine Borwick, and Esther Crawley. 2020. “Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19.” Journal of the American Academy of Child & Adolescent Psychiatry 59(11):1218-1239.e3. doi:10.1016/j.jaac.2020.05.009.

Taylor, Harry Owen, Thomas K. M. Cudjoe, Feifei Bu, and Michelle H. Lim. 2023. “The State of Loneliness and Social Isolation Research: Current Knowledge and Future Directions.” BMC Public Health 23(1):1049. doi:10.1186/s12889-023-15967-3.