More people are dying alone—and the global economy isn’t prepared for it

People between 16 and 24 are said to be the loneliest age group.
People between 16 and 24 are said to be the loneliest age group.
Image: AP Photo/Natacha Pisarenko
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In the middle of the day recently, I received a text message informing me that a good friend had been diagnosed with stage-four cancer at 33 years old.

She and I went to university together. We lived together. We spent a lot of nights singing songs and languishing at friends’ dinner parties together.

It was the first time anyone this close to me, this young, had used “the c word” in reference to themselves.

In the following days, I was added to a WhatsApp group chat made up of people who, like me, wanted to be kept up-to-date on our friend’s condition. I saw how loved ones sent cards, gifts, and money to help with her medical bills not covered by her health insurance. Because her father lived in another city, he flew in about a day before her chemotherapy began.

Then, suddenly, a message appeared in the group chat from her mother. It stated that at 4:20 am, her daughter had passed away, 13 days after her diagnosis.

“I am so grateful for her beautiful life and the 33 sweet and lovely years I knew her,” she wrote.

I locked myself in the bathroom stall at work and cried.

The frailty of independence

Perhaps as a way of staving off grief and delaying having to deal with the sorrow, I seized up and became fixated on logistics. I wondered: Who’s running the Whatsapp group? Who’s delegating tasks? Who’s helping the family?

In the absence of a spouse or partner, it seemed that this work was mainly taken on by friends from different stages in my friend’s life. I though about how the support system would have had to look if her convalescence had extended for months, or years.

A similar thought crossed my mind months earlier, when I broke my arm. While obviously a completely different situation, the experience nonetheless exposed how utterly frail my independence is as a single person in my 30s.

Because I broke my dominant arm, I couldn’t brush my teeth properly. Getting dressed in the morning and tying my shoelaces became an entirely new type of challenge.

It showed me how, no matter how successful and respected I become on my own, I am one crisis away from debilitation.

Eventually, our problems cannot be solved by money, or a new app. At some point, we just need people to literally be there.

If you live alone, do you die alone?

Perhaps because of experiences like these, I’ve started to spend more time wondering things like: If I died in my apartment, how long would it take before someone found my body?

It’s a morbid thought, I know, but it’s not actually so far-fetched. People in Japan die alone in their apartments so often that an entire industry has been created to deal with the aftermath of “lonely deaths,” where paid professionals go into people’s homes and clean up the remains of the solitary deceased. It can take weeks for anyone to notice the smell, and then days of bureaucracy for the police to get clearance to open the door and enter the premise. Once that is finally achieved, strangers mop up the mess and scramble to find someone, anyone, to notify.

The thought of this scenario unnerves me to my core because, to be frank, the dots between those people in Japan and me are not difficult to connect: I live alone and I’m single. Given that I often work as a freelance writer, if I were to perish alone at home no colleagues or boss would be puzzling about my whereabouts if I didn’t show up to work at the normal time.

Even if my editors were annoyed that I missed a deadline (pun intended), they would send some emails, maybe call if they felt particularly pressed, but then probably assume I was just being flakey and vow never to work with me again—unaware of just how right they would be.

Singles digits

In Berlin, the city where I live, around 50% of residential apartments are single-person households. I only know one of my neighbors’ names. Most of them are single males who represent various stages of the bachelor entropy.

For instance, my ground-floor neighbor, whose apartment I can see into, seems to be unemployed. His living-room floor is littered with beer bottles that have been converted into ashtrays, each refracting flickers of light from the always-on flat screen. He usually wakes up after 2:00 pm and proceeds to smoke so much marijuana that I have to close my windows in order to get some fresh air.

In the hypothetical event of my own solitary death, not only would my neighbors likely be unbothered by the smell of my decaying sinews (as it would likely be hard to distinguish it from the smells they produce in generous amounts), I doubt they would care enough to soldier through all the bureaucratic tasks it would take for my body to be cleared, processed, and laid to rest in some form.

My neighbor and I are both part of the more-than 300 million single-person households around the world, accounting for 15% of the global population.

This ratio tends to be larger in many European countries: More than 50% of households in Sweden, Denmark, and Lithuania are made up of just one person, and its 40%-50% in Germany, Finland, Estonia, the Netherlands, France, Latvia, and Austria. In the United States, it’s 28%. In developed countries, the proportion of people living on their own has doubled since the 1960s.

The marriage construct

Don’t get me wrong—I love my life. I have work I enjoy, friends I cherish, and a bunch of hobbies that are only possible to maintain in a vibrant city like Berlin. After having shared apartments with roommates for more than 10 years, I am relieved to be able to come home at around 11:30 pm most nights to the quiet of my own place and recede from my busy schedule, which can include anything from performing standup comedy to attending the opera. Yet, despite how happy I am in the hubbub of my yuppy life, I sometimes forget just how unprecedented this mode of existence is, in the grand scheme of things.

At least since the modern period, humans have gone from living in family units of varying descriptions to starting their own families—with a brief transition period in between in which they might sow some so-called wild oats.

In accordance with societal norms, we have eventually tended to settle down and enter into the community life, with our own families at the core. Barring divorce, marriage has not only provided us with companionship in life but also with an established mechanism for body disposal upon death.

But a lot has changed in the last 50 years or so. For many people, this wild-oats period is lasting longer and longer. And for more and more people, it may be permanent—for some by choice, for others it’s a source of frustration, and sometimes it’s just a practical matter of circumstance.

The vows that bind us

But however we single people arrived at our singular status, most of us have found ways to supplement what used to only be available inside a marriage. Sex can be obtained guilt-free with  very little to no  relationship commitment at all. More young professionals are able to meet their financial needs on their own. Children can be obtained in various extra-monogamous constellations.

To put it another way, the “to have and to hold” part of the traditional Christian wedding vows can now be comfortably outsourced.

We haven’t quite worked out how to replace the “in sickness” part of the vows, though. Or, in the superlative case, the “till death” clause.

We haven’t worked out how to get a support system that takes care of the grunt-work of human life—the act of making someone proverbial (or actual) chicken soup when they’re sick, or compensating financially when they lose their job. For single people, these tasks, which otherwise would have fallen to a spouse or family members, must now be taken up by other parties.

But by whom? The state? Friends? Colleagues? Tinder matches?

Perhaps that is what I find so jarring about the Japanese singles death industry: That strangers in masks might eventually have to handle my body, or even worse, call my mother to inform her of my passing, feels particularly repugnant.

As society’s views on singleness evolved over time, it certainly wasn’t anyone’s intention to saddle strangers with all of these costs and responsibilities. But it doesn’t seem like anyone has developed a good alternative.

How did we get here?

The stigma surrounding singleness has fluctuated considerably over time. For a large chunk of the last millennium, marriage was mostly transactional: It was a means of transferring property from one generation to the next, as a tool of social cohesion, as a means of perpetuating family lineages, and as a panacea against all kinds of loneliness.

Single people stood outside of this order, and thus threatened it. And the social stigma of singleness was designed to nudge them back in line.

By the 19th century, this orthodoxy was disrupted in parts of America when the reputation of an unmarried woman in the wealthier classes was somewhat neutralized. This was brought about primarily by women’s tepid introduction to the market economy, mostly necessitated by the deaths of so many men in the Civil War.

In her book Marriage, a History, historian Stephanie Coontz explains the etymology of the word “spinster,” pointing out that the term was originally used to refer to women who supported themselves financially by spinning wool.

As such, these women were regarded as being “highly moral and fully womanly creatures,” according to sociologist Zsuzsa Berend, writing in the Journal of Social History. Berend analyzed the journals of 40 single women and found that these women “remained unmarried not because of individual shortcomings but because they didn’t find the one ‘who could be all things to the heart.’”

The socioeconomics of singleness

Patricia Palmieri, author of In Adamless Eden and the forthcoming book Single in America, situates this period on a kind of stigma timeline. She argues that singleness can be thought of in three distinct eras in the last two centuries: The pre-Freudian (1875-1920), Freudian (1920-1960), and post-Freudian (1960-present).

The conversation on remaining single in the first era was defined by economics and demography. The loss of human lives in the Civil War led to the belief that there were too many women. Consequently, many were encouraged to move West to find husbands. It was during this time that women in urban areas could respectably be unmarried in cities, given that they could work to sustain themselves.

Many men similarly abstained from marriage for longer and began living in bachelor apartments. On the whole, marriage was put off as the economics of the times made it difficult to professionalize and marry early.

Then came Freud, whose writings vastly expanded what people considered to be normal sexuality.

“It was left to others to say, ‘Guess what is abnormal?’” Palmieri explained to me in a telephone interview. A flurry of writers emerged who extrapolated from Freud’s work, arguing that being unmarried was indeed abnormal. These views were widely publicized and became immensely popular, to the extent that a 1957 survey revealed that 80% of Americans believed people who did not marry were sick, neurotic, and immoral. Unmarried women in particular were treated with suspicion. Similarly, unmarried men were deemed narcissistic, deviant, and pathological.

In the post-Freudian era beyond the 1960s, there was a proliferation of commodities tailored to singles: clubs, trips, apartment housing, and—much, much later on—dating apps.

Demography becomes important again as single women began to outnumber the available men in professional cohorts. Urbanization accelerated. Divorce became more acceptable, and homosexuality destigmatized in an increasing number of countries.

By the 21st century, polyamory entered the mainstream lexicon and a social narrative emphasizing freedom and unencumbered relationships became firmly established in the collective consciousness.

These developments have made it possible for me to live my atomized life without raising any eyebrows. And for that I am grateful. Perhaps I, like many people, thought that these societal shifts did not come at any cost.

That was naive. As I enter my mid-thirties and many of my relationships evolve, I am continuously reminded of both the virtue and difficulty of friendship. On the one hand, unlike other major relationships such as marriage, parenthood, or employment, friendship is an institution that has no legal component.

If a wife wants to divorce her husband, the state gets involved. If an employee is fired without due cause, a lawyer can step in to help address grievances. Severing a friendship, on the other hand—or establishing a friendship, for that matter—has no bureaucratic red tape. If we decide it, it is so.

This precariousness is precisely what makes friendship so beautiful. Since no one is in a friend relationship due to stipulations in a contract, exercise of the free will endows the bond with special meaning. The fact that you could leave at any time makes it all the more meaningful that you haven’t.

This has always been true of friendship. But what is new is that the precariousness seems to be getting worse as we are becoming less comfortable with the idea of commitment as societies.

Whereas my parents were expected to stay in the same jobs for 20 to 40 years, my generation gets itchy feet after just one or two. Fewer and fewer young people are buying property. Our aversion to commitment is perhaps most apparent in the ubiquitous marketing copy of streaming and subscription services that constantly entices us with the salvific phrase: “cancel anytime.”

In many ways, I am the personification of this opting out, this side-stepping of commitment.

I live in a rented apartment. I have mostly worked on a freelance basis throughout my life. And I have only one mouth to feed. At any point, if I wanted to, I could pack up my apartment and go live anywhere, do anything—and have to answer to no one.

So, with all this freedom and power of choice, why do I feel so vulnerable?

Cancel anytime

I don’t like the word “lonely.” Or even the word “alone.” In fact, when people ask whether I live alone, I quickly correct them: “I have my own place.” I say it like someone admonishing a bigot.

Because, honestly, I don’t feel lonely. The term, according to Amelia S. Worsley, an assistant professor of English at Amherst College, has referred to “the danger created by being too far from other people” since about the 16th century. My urban life, on the other hand, is very close to people, both in proximity and intimacy. I have many great friends who I speak to regularly about my joys, fears, and dreams. These people really do love me. If I ever got cancer, I know many of them would sit at my bedside, lovingly  keeping me company, probably read this very article aloud to me.

I must admit, however, that since I turned 30, I’ve experienced a growing amount of negative space in my life. Many of those great friends are now partnered, which means that, even though some of them were at one point a best friend, they now have someone else in their life with whom they have built their primary relationship.

That is to say, if my cancer ever conflicted with their partner’s work schedule, or their children’s kindergarten routine, maybe my cancer would win for a few days, but eventually the gravity of their family responsibilities would pull them back to where they belong.

As a single person, I am aware that nearly everyone in my life has someone else in their life more important to them than I am.

The loneliness-industrial complex

And in that regard I am not alone—for lack of a better word.

An ever-growing proportion of the world’s population is experiencing a sense of disconnectedness, or communitylessness. According to Matthew Brashears, a social network researcher from the University of South Carolina, “The problem isn’t ‘are you socially isolated?’ i.e., you have no social contact. The question is, are you experiencing social poverty, inadequate social support?”

A recent loneliness survey conducted by the BBC asked 55,000 people to think about the quality of their relationships. It emerged that adults between the ages of 16 and 24 were the loneliest, with 40% stating that they felt lonely “often” or “very often.” Just under a third of those over age 75 gave the same reply.

The trend cuts across cultures, too: The Kaiser Family Foundation surveyed rich countries with the Economist in 2018 and found that 9% of adults in Japan, 22% in America, and 23% in Britain always or often felt lonely.

This feeling has a dramatic impact on actual life expectancy. A review of 148 studies with 308,849 participants published by Holt-Lunstad in 2010 found that people who had weaker social ties had a 50% higher chance of dying early than those with stronger ties. The researchers commented that being disconnected “posed a danger comparable to smoking 15 cigarettes a day,” and was more predictive of early death than the effects of air pollution or physical inactivity.

In that sense, for all its freedoms, living life as a single person has great risks and costs that we do not often acknowledge publicly. And since, like me, many single, urban professions live far away from family, many of us don’t have a plan for what we will do when things get bumpy.

I know that marriage is no miracle cure. Indeed, in many cases it can serve to isolate people socially even more. But for all its problems, marriage (or any long-term partnership) does at least offer a default community of two.

In times of crisis, a partner would have to actively opt out of the role of caregiver, whereas a single person in peril requires friends to opt in to their pain.

My generation needs to think long and hard about what that could look like.

I’ve come across one viable example in the story of a blogger named Wesley Hill, who wrote about attending the baptism of his new little goddaughter, Felicity. Wesley lives with Felicity’s parents, Aiden and Mel. Together, they form an informal community.

In his blog post the next day, Wesley recounted how Aiden asked Mel and Felicity to stand, and announced to the church and to the world: “This is my family.”

“Mel is my wife, and Felicity is my daughter,” he said. And then he asked Wesley to stand, and said with similar pride: “And this is our friend Wes. We live in Christian community. Wes shares our home and is Felicity’s godfather.”

Wesley went on to reflect on how grateful he is for this public declaration that he belonged to this particular group, this family. In his other posts, he has advocated for a new culture of committed friendship, calling for public expressions—even rituals—that could solidify friendship in the way that a wedding ceremony might. Something that says, “We are committed to each other.”

I was immediately inspired by Wesley’s story. In my gut, I know that the vulnerability I feel can only be addressed through the very thing that I have tacitly been avoiding.

It’s the other c-word: commitment.

The commitment

I know I need commitment. So, I decide to seek a similar arrangement in my own life.

I send my good friend Magriet a WhatsApp message asking her to meet up. As with most of my friendships, the earliest we can find time in our calendars is in two weeks.

When we eventually do get together, the conversation is familiar and light, buoyed by our 10 years of friendship—two of which we spent sharing an apartment. All of this history floats between us as she sips a ginger ale, and I’m strangely nervous because I don’t really know what I want to say, because all I have is a vague feeling that I hope she can relate to.

Then I blurt it out: “I would like to make our friendship slightly more committed.”

She looks at me attentively, inviting me to explain what I mean.

“I want to commit—really commit—to being there for you,” I say. “If you get sick, I want you to call me, I want to bring you soup.”

I explain that this model of “wild oats singleness” we are living is not sustainable. It’s like taking up full-time residence in a tent: i.e., treating as permanent something that was designed to be temporary.

If we are going to survive our entire lives like this, something needs to change. I throw more similes at her, arguing that because modern singleness has no emergency plan, we’re like motorcyclists riding down the highway without helmets. Sure, the freedom feels good, but it would only take a single pothole to usher in a cataclysmic crash.

Even as I say these words, the objections are blaring in my mind. What if I pledge to be part of this ultra-friendship and then things change? What if one of us falls in love with someone else, gets married, and then forsakes our friendship vows? Where would that leave the other person? What if one of us gets a job somewhere else—would the other one move? I don’t want to move. She doesn’t want to move. Does she?

I voice my hesitations. She says she appreciates it, and that she feels them, too.

The emotional knot we find ourselves in actually has a name. It’s called waithood—a term coined by Diane Singerman, associate professor in the department of government at American University. It refers to people who are seeking long-term romantic relationships but who have, for various reasons, not found them yet, so they end up delaying other life decisions, presumably until “the one” arrives.

The result can be a reluctance to entertain big life changes, especially those that make one less available for meeting a romantic interest. After all, who wants to be stuck committed to a plan B when plan A finally comes into the picture?

This, of course, assumes that plan A—finding “the one”—will eventually happen. The reality is it just might not happen for me or for Magriet—or for any of us single folk. If more and more people are single for their entire lives, then why not us?

But while I want to be prepared for that scenario, I also don’t want to necessarily plan for it. That feels like giving up. And I’m not ready to give up.

I’m self-aware enough to know that the hesitation I feel is at odds with the very nature of commitment.

I’m also someone with the type of personality who, ideally, would like to have all of life’s eventualities mapped out before I commit. Which I know, in reality, is just not possible. Commitments are intrinsically based on trusting some form of incomplete information. Most people only get a few job interviews at most before signing on to commit to a position. After just a few short hours (or maybe a few days) of visiting a college, you have to commit to spending four years there before you know what life is really like at a given institution, or how it will impact your future. Only once you show up and move onto campus can you get the full picture. Just like after spending six months to a year in a new company, you might realize the charm and promises your boss displayed in the interview have faded away to reveal that she can be quite a jerk.

This is as it should be. None of us would ever commit to anything if we knew its true cost. Maybe no one would get married if we could be fully aware of how many gray hairs, heated arguments, and debt snares the institution can entail. A lot of people might not get pregnant if we were magically able to fully comprehend all the challenges that the birthing process and parenthood can entail.

So on that level, I know I just need to grow up. But I also feel a deeper fear: I’m worried that by asking for this commitment, I’m jeopardizing the fragile beauty of a friendship.

Am I being a fool, like someone who tries to capture a butterfly’s grandeur and subsequently crushes it in my hands? If this feels contractual, will we lose the joy of the voluntariness of our bond?

Magriet and I discuss all these issues frankly, ultimately acknowledging that there are no easy answers. We resolve to keep talking about it.

Before we say goodbye, I tell her that there is a system in place in Berlin whereby I can register someone as my emergency contact should I ever have a medical problem. The status that a spouse would have by default, I can confer on her. I would like to start this arrangement, whatever it is, by naming her as my person.

No matter what we do from here, that seems like a good place to start.