Loneliness was declared a public health epidemic just two years ago, with then-U.S. Surgeon General Vivek Murthy citing links to increased risk of heart disease, depression, cognitive decline, dementia, and early mortality.

But now come findings that could challenge that—specifically, the connection to early mortality, which had come out of a body of research including a 2015 meta-analysis and another from 2018.

The new international study, led by researchers at the University of Waterloo’s School of Public Health Sciences and published in the Journal of the American Medical Directors Association, has found that loneliness, while common among older adults receiving home care, is not associated with an increased risk of death.

“Our findings suggest that loneliness may not independently increase the risk of death after controlling for other health risk factors among older adults in home care,” said lead author Bonaventure Egbujie, a professor in Waterloo’s School of Public Health Sciences, in a news release. “This contradicts much of the existing literature based on the general population.”

For the latest study, researchers analyzed data from more than 380,000 home care recipients aged 65 and older in Canada, Finland, and New Zealand. “Home care recipients are a particularly important population to consider because they may be especially vulnerable to adverse effects of loneliness,” the study authors write. “Mobility problems, sensory impairments, and complex health needs may limit their engagement in the community, leaving them relatively isolated in their homes.”

But what researchers found was that lonely individuals actually had a lower risk of dying within one year compared to their non-lonely counterparts (after adjusting for health conditions, age, and other risk factors).

Still, said senior study author John Hirdes, a professor in Waterloo’s School of Public Health Sciences, that doesn’t mean it isn’t still a serious health concern.

“Loneliness is a serious threat to psychological well-being,” Hirdes said in the news release. “The mental health consequences of loneliness make it an important priority for public health, even if loneliness doesn’t kill you.”

In the new research, loneliness prevalence—meaning the number of people per 100 who reported feeling lonely—ranged from 15.9% of home care recipients in Canada to 24.4% in New Zealand. “Interestingly,” notes the news release, “people in better physical shape and who got less help from family or friends were likelier to feel lonely, suggesting a complex link between health status, caregiving needs, and social connection.”

The authors call for more longer-term studies and for policymakers and health-care providers to treat loneliness as a quality-of-life issue, not only focusing on its potential link to mortality.

“Home and community care services,” said Hirdes, “must play a protective role by supporting social contact for isolated people.”