Experiencing social isolation or loneliness is associated with a higher risk of early death, a new study has found.

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If you’re visiting with loved ones this holiday season, a new study suggests you make that a habit on a regular basis, if you haven’t already. Those who don’t socialize with friends or family may see their risk of dying early increase by 39%.

Many previous studies have linked loneliness or social isolation with a higher risk of premature death and other health outcomes. But few, if any, have looked into how these associations depend on the combined impact of different types of social interaction, according to a new study published Thursday in the journal BMC Medicine.

“We examined two different types of loneliness and three different types of social isolation … and we found that each of these were associated with a higher risk of dying,” said Hamish Foster, first study author and clinical research fellow at the School of Health and Wellbeing of the University of Glasgow in Scotland, during a press briefing.

READ MORE: Alone and lonely are not the same. How to feel connected no matter how many people are around

A sense of loneliness, as defined by the authors, was measured by two factors: how often participants felt they could confide in someone close to them and how frequently they felt lonely. Participants’ social isolation was gauged by how often they were visited by friends or family, how often they engaged in weekly group activities, and whether they lived alone.

Experiencing a lack of any of the study’s five types of social connection — to any degree — was associated with higher risk of dying early from any cause, the authors found.

The large group of over 458,000 participants was part of the UK Biobank study, which has followed the health outcomes of more than 500,000 middle-aged people in the United Kingdom — aged between 40 and 69 — for at least 10 years. When the participants, who were around age 56 on average, were recruited between 2006 and 2010, they answered a questionnaire about their social life.

The study’s researchers then followed up with participants after a period of around 12 years. They found that, compared with people whose family and friends visited them daily, the risk of premature death for those who lived alone and never had visits increased by 39%. And engaging in activities with groups of people who weren’t loved ones didn’t help reduce this risk at all, suggesting that connections with friends or family may be more valuable than potentially surface-level interactions.

But time with loved ones at least monthly meant a lower risk. These close contacts may have provided “more practical support or be more likely to identify subtle deteriorations in the health and well-being of an individual,” the authors said.

Experts not involved in the study praised its thorough contribution to the growing amount of research on the relationship between social connections and health.

“This large cohort study … provides important and nuanced insights into the complex relationships between different aspects of social connection and mortality outcomes,” said Dr. Anthony Ong, a professor of psychology at Cornell University in New York state, via email. The findings “provide an empirical basis for future research into whether enhancing certain types of social connection could yield health benefits for the most isolated groups.”

Social connections and health

More research is needed to nail down the reasons for the study’s findings and whether its participants could have also been affected by other mental or physical health factors, the authors said — but they do have some ideas.

Social disconnection has previously been linked to poor immune function, cardiovascular issues such as high blood pressure and neurodevelopmental impairment, according to the study. It can also be a form of stress, which can negatively affect the body.

Those who reported any degree of social disconnect were more likely to have a higher body-mass index; have more long-term health conditions; and have unhealthy habits such as smoking, drinking alcohol in excess or not getting enough physical activity. It’s also possible that any of these factors could lead to loneliness or social isolation rather than result from them, according to the study.

The authors didn’t have information on the quality of relationships with people participants lived with, Foster said — a detail that could explain how sharing a home with someone may not necessarily be sufficient to reduce the negative impact of loneliness or isolation.

Overall, the study offers “implications on what we do to try and help people that are isolated,” said study coauthor Jason Gill, a professor of cardiometabolic health at the University of Glasgow, at a press briefing. “Because what our data also suggest is that one type of intervention is probably not going to fully solve that situation. … You need to do multiple things to try and address the multiple different components of this.”

People who had visits from loved ones did further benefit from also joining other group activities, so both are important in helping people feel more connected, said Dr. Olivia Remes, a mental health researcher at the University of Cambridge in England, who wasn’t involved in the study. Such activities could be a hobby-based class or a religious service, Gill added.

Social organizations, such as the Befriending Networks organization in the UK, can help you find a new friend or become a companion for someone in need, he added.

The authors didn’t look into the effect of animal companions, Foster said, but other research has shown having a pet may be beneficial if you’re living alone.