Two Years Since the Act on Loneliness and Isolation — What Has a Law Only Eight Countries Have Changed?
Japan's anti-loneliness legislation took effect in April 2024. As one of eight countries with such comprehensive measures, what has changed two years on?
TL;DR
- While WHO reports 100 loneliness-related deaths per hour, Japan put into law a comprehensive policy that only 8 of 194 countries have, yet its loneliness rate remains flat at 39.3%
- Three disconnects — institutional, generational, and spatial — undermine policy effectiveness, with municipal disparities and overlooked youth loneliness as structural challenges
- Cross-cutting mechanisms like the UK's social prescribing remain at the consideration stage in Japan, signaling the need to fill the pioneering legal framework with substance
What Is Happening
WHO reports loneliness kills 871,000 annually; Japan enacted a comprehensive anti-loneliness law that only eight countries have
In June 2025, the Commission on Social Connection published a single figure. One hundred people every hour — 871,000 per year — die from causes related to loneliness. One in six people worldwide experiences loneliness, rising to one in five among young adults. The "loneliness epidemic" is no longer a metaphor; the WHO now classifies it as a public health threat.
One year before this report, Japan had enacted a law. The Act on Promotion of Measures Against Loneliness and Isolation (孤独・孤立対策推進法) — effective April 1, 2024. It is a legal framework that positions loneliness and social isolation as challenges for society as a whole, mandating the national and local governments to pursue comprehensive countermeasures.
These eight are the only WHO member states with a national policy document that directly addresses loneliness. However, the existence of a law and its effectiveness are separate issues — the UK has struggled with quantitative evaluation even 8 years after establishment.
A review covering all 194 WHO member states found that only eight countries — Japan, the United Kingdom, the United States, Denmark, Finland, Germany, the Netherlands, and Sweden have national policy documents that directly address loneliness, social isolation or social connection. The same review notes that none of those eight national policies has undergone rigorous evaluation of its effectiveness.
So what has this comprehensive law changed in the two years since its enactment?
What the Numbers Tell Us
According to the annual national survey conducted by the Cabinet Office (内閣府), the 2024 results showed that 4.3% felt lonely "often or always", 15.4% "sometimes" and 19.6% "occasionally" — about four in ten in total. These figures are virtually unchanged from the previous year (2023), showing no discernible shift before or after the law's implementation.
In April 2025, the Cabinet Office published another figure for the first time. In 2024, there were 21,856 "solitary deaths" (孤立死) — individuals who died alone at home and were not discovered for eight or more days after death. A total of 76,020 people living alone died at home, of whom 76.4% were aged 65 or older. Eighty percent were men. The very fact that the government "estimated this figure for the first time" speaks to the delayed grasp of the actual situation.
The law was enacted. A promotion headquarters was established. A priority plan was adopted. Yet the proportion of people experiencing loneliness remains unchanged, and the reality of solitary deaths has only just begun to be made visible.
Background & Context
Historical development and social factors leading to Japan's loneliness legislation
The Lineage of the "Minister for Loneliness" — From the UK to Japan
The movement to treat loneliness as a policy issue originated in the United Kingdom.
Following the murder of Labour MP Jo Cox in June 2016, a cross-party commission was established and published a report on loneliness in 2017. The following year, Prime Minister Theresa May created the world's first Minister for Loneliness. Built on three pillars — reducing stigma, building an evidence base, and identifying effective interventions — the role is currently held by Stephanie Peacock.
In 2021, Japan followed suit by appointing a Minister for Loneliness and Isolation (孤独・孤立対策担当大臣) in response to the deepening of loneliness and isolation during the COVID-19 pandemic. The law was passed in 2023 and took effect in 2024.
However, being one of those eight countries warrants caution. Even eight years after its establishment, the UK's loneliness strategy continues to struggle with quantitative evaluation of its effects. The fact that three successive administrations have continued to call for "building an evidence base" itself demonstrates how difficult measurement and evaluation of this issue remain.
Making Policy from "What Cannot Be Measured"
Herein lies the structural challenge of loneliness and isolation policy.
Loneliness is a subjective experience. Self-reporting in response to the question "Do you feel lonely?" remains the sole measurement instrument available. No objective physiological indicators or biomarkers have been established. A series of meta-analyses by Julianne Holt-Lunstad and colleagues at Brigham Young University clearly demonstrate the association between social connection and mortality risk. Their 2010 study reported an overall effect of OR = 1.50 for social relationships and mortality, while a 2015 study analyzed social isolation (OR = 1.29) and loneliness (OR = 1.26) as independent risk factors. Their research gave rise to the widely cited comparison that loneliness is "equivalent to smoking 15 cigarettes a day."
Evidence on health impacts continues to accumulate. However, no method yet exists for measuring whether a policy has actually reduced loneliness.
Japan's national survey shows that the proportion reporting loneliness rose from 36.4% in 2021 to 40.3% in 2022, then stabilized around 39%. Whether this trajectory reflects the law's effects, lingering consequences of the pandemic, or changes in survey methodology — there is no indicator capable of determining attribution. Japan now confronts, in its second year of implementation, the same measurement problem that the UK has been unable to resolve in eight years.
It was precisely in recognition of this measurement gap that the WHO Commission on Social Connection identified the development of a "Social Connection Index" as one of its action areas in its 2025 report.
Reading the Structure
Analysis of the legal framework and implementation mechanisms of the Act
Three Disconnects
A structural reading of the situation two years after enactment reveals three disconnects.
Siloed welfare systems and the limits of "best effort" cross-cutting legislation
Often treated as an "elderly issue" but youth loneliness is also severe
Loneliness and isolation are qualitatively different in urban vs. rural areas
Institutions, generations, space
The first disconnect — institutional fragmentation. Loneliness and social isolation are poorly served by the siloed structure of existing welfare systems. Older adults fall under long-term care insurance (介護保険), persons with disabilities under the Act on Comprehensive Support for Persons with Disabilities (障害者総合支援法), and those in financial hardship under the Act on Self-Support for the Needy (生活困窮者自立支援法). Each system has mechanisms for identifying isolation risk, but the infrastructure for cross-cutting support of those who fall between the cracks remains weak. The Act on Promotion of Measures Against Loneliness and Isolation was created precisely to bridge these silos, yet the establishment of regional councils remains a best-effort obligation rather than a mandate. While 38 prefectures have established regional platforms, many municipalities lack the human and financial resources to set up and operate them. The initial budget of 210 million yen (fiscal year 2025) is remarkably small for a policy targeting all 1,741 municipalities nationwide.
The second disconnect — the generational divide. The fact that 70% of the 22,000 solitary deaths involve individuals aged 65 or older creates a structure in which this issue is readily perceived as an elderly problem. Yet the national survey reveals that the highest rates of "always or frequently" experiencing loneliness actually occur among those in their twenties and thirties. Among men in their thirties, 10.4% report chronic loneliness; among women in their twenties, 11.2%. A survey by the found that half of employees in their twenties and thirties experience loneliness at work.
Elderly isolation and youth loneliness differ in manifestation but share common roots. The dissolution of local communities, the shrinking of family structures, and the expansion of non-regular employment — these structural changes are eroding the foundations of social connection across generations. Policy responses, however, remain biased toward monitoring the elderly, while youth loneliness tends to be relegated to the realm of "personal responsibility."
The third disconnect — the spatial divide. The structures of loneliness and isolation differ qualitatively between urban and rural areas. In cities, despite high population density, social contact points become attenuated — "loneliness in a crowd." In rural areas, population decline brings the disappearance of shops, clinics, and public transit — the "sites of incidental contact." According to projections by the (国立社会保障・人口問題研究所), single-person households rise from 38.0% in 2020 to 44.3% in 2050, up 6.3 points, reaching 23.30 million households. Among older single-person households, the never-married share climbs between 2020 and 2050 from 33.7% to 59.7% for men and from 11.9% to 30.2% for women. In both urban and rural settings, opportunities to physically encounter other people are structurally declining.
The Position of NPOs — "Contractors" or "Co-creators"?
The Act positions nonprofits and other civil society organizations as key partners in collaboration. The public-private partnership platform had 559 participating organizations as of fiscal year 2024, exceeding its targets.
However, the figures warrant closer examination. Is the role that nonprofits play that of "policy contractors," or that of "policy co-creators"?
Under the law's structure, regional councils are established by local governments, with nonprofits positioned as participants. They join deliberations concerning support for individual cases. In practice, however, restrictions on sharing personal information, coordination costs with siloed administrations, and the difficulty of sustaining operations under single-year subsidy cycles — these institutional barriers impede the effective participation of nonprofits.
Given that measures against loneliness and isolation are inherently community-based endeavors — creating gathering places, conducting outreach, providing counseling — their implementation falls to nonprofits and other civil society organizations. Yet within the current law and institutional framework, there is no adequate mechanism for implementers to participate as equals from the policy design stage onward.
The Promise of Social Prescribing
In the United Kingdom, a system known as social prescribing has been deployed nationwide. When patients visit a healthcare provider, physicians "prescribe" participation in local social activities and community groups alongside — or instead of — medication and testing. This approach addresses loneliness and isolation at the intersection of healthcare, welfare, and community life. Reductions in medical consultations and healthcare costs have been reported. The for intervention programs has been reported at 2.28 to 13.72 dollars per dollar invested.
In Japan, social prescribing (社会的処方) was included in the 2020 Basic Policy on Economic and Fiscal Management and Reform, yet as of 2026 it remains at the "under consideration" stage. With the UK approaching a decade since nationwide rollout, this gap is significant. As a mechanism for bridging institutional fragmentation — the silos between healthcare, welfare, and community — social prescribing represents one of the most critical missing pieces in Japan's loneliness policy.
What to put in the advanced framework
The law is in place. Yet the difficulty of addressing loneliness — something that "cannot be measured" — through policy has only become more apparent over two years. Disparities among municipalities, generational gaps in perception, structural differences between urban and rural areas — bridging these three disconnects requires more than a legal framework alone.
Japan possesses a comprehensive policy that only eight of the world's 194 countries have adopted. The question is what substance will be placed within this pioneering vessel. The reality that one hundred people lose their lives to this issue every hour does not permit remaining at the "under consideration" stage.
For nonprofit practitioners, loneliness and isolation policy is a theme that may directly intersect with their organization's mission. For approaches to structuring such efforts, see the practical guide on Designing Collective Impact（このサイトの記事）; for stakeholder analysis and engagement, see How to Draw a Stakeholder Map（このサイトの記事）; and for frameworks on measuring policy effectiveness, see the framework set out in Introduction to EBPM（このサイトの記事）.
Related Columns
- Japan's Welfare Take-up Rate: 20%（このサイトの記事）
- The "Depth" of Child Poverty（このサイトの記事）
- The Financial Reality of the Nonprofit Sector（このサイトの記事）
References
Paving the Way for a World that Values Social Connection — WHO Commission on Social Connection (2025). World Health Organization
Act on Promotion of Measures Against Loneliness and Isolation — Cabinet Office (2023). Cabinet Office, Loneliness and Isolation Policy Promotion Office
National Survey on the Actual State of Loneliness and Isolation (FY2024) — Cabinet Office (2024). Cabinet Office
Social Relationships and Mortality Risk: A Meta-analytic Review — Julianne Holt-Lunstad, Timothy B. Smith, J. Bradley Layton (2010). PLoS Medicine, 7(7)
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review — Julianne Holt-Lunstad, Timothy B. Smith, Mark Baker, Tyler Harris, David Stephenson (2015). Perspectives on Psychological Science, 10(2), 227-237
Recommended Reading
Statistics cited in this article
- 1WHO Commission on Social Connection（2025） Open source
- 2Goldman et al., "National policy responses to address loneliness: A global scoping review of 194 WHO member states," Health Policy（2026） Open source
- 3Cabinet Office, Key Points of the FY2024 National Survey on Loneliness and Isolation（published 2025） Open source
- 4IPSS, Household Projections for Japan (National Estimates), 2024 revision, press release（2024） Open source
Questions to Reflect On
- What role has loneliness played in your own mental or physical wellbeing?
- In what ways could your community create stronger support systems for socially isolated residents?
- Consider the social connections in your workplace or neighborhood — how have these patterns shifted over time?
Key Terms in This Article
- Evidence-Based Policy Making
- An approach to policy making and evaluation based on objective evidence such as statistical data and research findings.
- Social Return on Investment (SROI)
- A social impact evaluation method that converts social, environmental, and economic outcomes into monetary values and expresses them as a ratio to input costs.
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