Loneliness among US adults in the 2024 National Health Interview Survey
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Rationale
Loneliness is associated with premature mortality and poor mental health and was declared an epidemic by the US Surgeon General in 2023, yet national surveillance has relied on state-based or experimental online surveys. In 2024, the National Health Interview Survey (NHIS), the principal household health survey of the United States, measured loneliness directly for the first time.
Objective
To estimate the national prevalence of loneliness among US adults, identify the groups with the highest burden, and quantify associations with mental health, health status, and health care use.
Methods
Cross-sectional analysis of the 2024 NHIS Sample Adult file (n = 32,629; response rate 47.9%; 31,470 with valid loneliness data). Frequent loneliness was defined as feeling lonely always or usually. Survey-weighted prevalence and design-based logistic regression accounted for the complex sample design.
Results
In 2024, 4.9% of US adults (95% CI = 4.6, 5.2), an estimated 12.2 million people, felt lonely always or usually, and 23.7% (95% CI = 23.1, 24.3), an estimated 59.3 million, felt lonely at least sometimes. Frequent loneliness was highest among adults with family income below the federal poverty level (10.3%), adults with disability (13.6%), adults living alone (9.0%), and American Indian or Alaska Native adults (12.2%). Adults aged 65 or older had the lowest prevalence of any age group (4.0%) and adults aged 18-29 the highest (6.3%). Adjusting for sociodemographic characteristics, frequent loneliness was associated with serious psychological distress (adjusted odds ratio = 14.5; 95% CI = 12.1, 17.3), life dissatisfaction (9.0), cost-related unmet mental health care need (4.3), and emergency department use (1.8).
Conclusions
Loneliness among US adults is patterned by poverty, disability, and household structure rather than older age. These first NHIS estimates provide a national benchmark for monitoring loneliness and suggest that strategies for social connection should address material hardship and access to mental health care.
