In a city of over 20 million people, Mrs. Salma, 69, has not spoken to her children for weeks. “I get it,” she says. “They’re busy.”
Despite the perception that loneliness is merely an emotional inconvenience, it is, in reality, a pervasive issue which affects the lives of millions of Pakistanis, causing emotional and physical damage. It has become a silent epidemic and disrupting the healthcare system significantly.
Loneliness and isolation are symptoms of weakened social health. Social health is the condition of a person’s relationship with family, friends, colleagues, and society. It entails one’s connections, belonging, support, and acceptance within a society.
In 1948, the World Health Organization described health as a balance of physical, mental, and social well-being, equally weighing all three components. In Pakistan, however, social health remains the neglected pillar and is absent from policies, awareness campaigns, or even the medical school curriculum. It is the forgotten pillar of our country’s healthcare system.
What is the cost? It is not only social, but also physical and economic.
The Cost of Disconnection
Doctors and psychiatrists are now in agreement that social isolation comes with the same dangers as chronic smoking, approximately fifteen cigarettes a day. The effects also elevate one’s chances of developing heart disease, depression, and anxiety. The risk of loneliness is noted to be a 26% increase in premature mortality, which is comparable to the risks of obesity and smoking.
Empirical data underscores the gravity of the situation. The National Academies of Sciences, Engineering, and Medicine (NASEM) published a 2020 report, supported by several international studies, detailing the health consequences of poor social relationships:
• 29% greater risk of developing coronary heart disease
• 32% increased likelihood of stroke
• 68% higher rates of hospitalization among patients with heart failure
• 40% rise in diabetes and 31% escalation in cholesterol levels
• 53% greater prevalence of depression.
Another study in the U.S. also estimated that 81% of lonely adults reported anxiety or depression. This isn’t just limited to a Western concern; it is already evident here in Pakistan.
Pakistan is no stranger to chronic diseases; however, the relationship between social health and physical illness is much less understood. Digestive disorders, for instance, affect 30% to 40% of the population. A study conducted at Saidu Medical College revealed that 43% of students with Irritable Bowel Syndrome also reported extreme anxiety and loneliness.
Recent research (2024) indicates that 35% of young adults in Pakistan experience loneliness, while other studies note that 12% of teenagers feel lonely almost daily. These statistics are not only alarming but also indicative of a growing public health concern.
Cardiovascular or heart disease is another red flag. According to the Journal of the American Heart Association (2022), loneliness contributes to heart disease risk by 29%. In Pakistan, 47 people die of cardiac arrest every hour, a shocking statistic on its own.
Dr. Aftab Alam Khan, a Psychiatrist and the Chairperson of Mental Health Council, highlighted the problem, “We talk about mental health, but often forget social health.” He identified how social health plays a key role in shaping mental health. “When people lose social connections, everything else; physical health, emotional well-being, even productivity, declines.”
The consequences of social disconnection extend far beyond the individual. In public health, it is more of a social health issue. Taking drug addiction as an example, various social factors such as peer influence, family disputes, and emotional neglect are driving the drug addiction epidemic. The United Nations Office on Drugs and Crime reports 6.7 million drug users in Pakistan, with 2 million categorized as addicts.
Physicians in their clinics are noticing the same thing: patients come in with persistent issues, undergo numerous tests, and walk out without a diagnosis. These gaps in the person’s life are better termed as “Social Health”.
“More than half of the medical tests carried out in hospitals for distressing symptoms would, in fact, show no abnormal findings. There is enormous waste of money, and the doctor sitting in the clinic is unaware of the person’s social and mental well-being. In Pakistan, there are hundreds of thousands of individuals visiting the hospitals daily, and they can be categorized as ‘Unhealthy Well’,” comments Dr. Mowadat Rana a psychiatrist in dialogue with the Pakistan Health Parliament.
An international study in 2025 observed that lonely individuals reported 10.9 days more of poor mental health and 5 days more of poor physical health per month compared to those who are socially connected.
What’s Causing the Social Health Crisis in Pakistan?
Stigma of Mental Health: Before we talk about anything, we must accept one uncomfortable truth: the stigma around mental health is still deeply rooted in Pakistan, which silently worsens the problem of social isolation. As mentioned in a JPTCP publication from 2024, 38% of Pakistanis reported they experience significant stigma around mental health issues, while 64% of them refrained from seeking professional help.
When emotional distress is kept hidden and mental aid is viewed as vulnerability, societal withdrawal happens. Communication ceases. Systems that should help you fail. And quiet becomes a coping technique instead of a warning signal.
From Extended Families to Nuclear Families: The shift from the rural to urban setting has caused a change in the family structure of Pakistan. Families no longer rely on extended families for help. They now prefer the nuclear family model. Currently, 34% of the population lives in urban settings. The move from rural to urban settings leads to a lack of sociocultural support networks, which suppress psychosocial stressors, alongside a decline in physical and mental resilience.
Digitalization and Social Media Influence: Smartphones were meant to bring us closer. But in reality, they are replacing real-life interactions entirely. A study shows that almost half of the participants experience mild depression who were heavy social media users.
Post-COVID Work Dynamics: The COVID-19 pandemic propelled remote work. While it does offer some flexibility, it also blurs the lines between personal and professional life while reducing contact with colleagues outside work, all of which increases feelings of loneliness.
According to a 2022 survey, 40.5% Pakistanis have reported that the COVID-19 lockdown negatively affected their mental health, and 31.4% have experienced domestic violence during this time.
What are Next Steps?
The good news is that social health can be restored and is not as difficult to regain. It requires focus, policy consideration, and unified action.
Social Health a Priority in National Health Plans: Social health holds as much importance as physical and mental health. It should become a part of health strategies on national and provincial level, education systems, and institutional policies. Medical students, public health professionals, and also policymakers need to be trained on identifying, understanding, and addressing these challenges.
Revive the Role of Communities: The erosion of neighborhood bonds or the fading sense of “Mohalla” must be restored. Community centers, shared green spaces, and libraries, to intergenerational dialogue forums, are crucial for social health. The objective is to establish tangible social gathering spaces to enable people to develop a sense of belonging again.
Integrate Social Counseling into Healthcare & Education: All educational institutions and healthcare facilities should employ qualified professionals who can identify early patterns of social withdrawal, bullying, or abusive relationships well before any trauma manifests.
Normalize the Conversation: We need public campaigns that make people to comfortably say, “I feel lonely.”
Checking in on people should be as frequent as celebrating milestones. We need to move past only checking in on people during Eid or weddings. Everyone from the media, school, workplaces, and influencers need to actively work towards addressing the issue of social disconnection and isolation.
Rethink Workplaces: Work-from-home is here to stay. Organizations need to build the culture which encourages peer networks, mentorship groups, and hybrid models while working virtually. Building such a culture will lead to stronger connections among employees and boost their well-being and efficiency.
Social health extends beyond mere physical interaction. It is about being deeply seen, heard, and valued. As Pakistan progresses, it is essential to realize that loneliness must be addressed as a problem greater than a person’s issue. It must be recognized as a public health crisis.
About the Author:
Sikandar Zaman is the Chairman of Pakistan Health Parliament, country’s pioneering social think tank and health advocacy platform. He is a social entrepreneur, health advocate and a public health leader. He works on the intersection of health systems, policy, and advocacy.