Loneliness without an epidemic: gendered pathways, health consequences, and intervention gaps among men in the United States.

Introduction: Male loneliness has become one of the most significant public health concerns in recent years, also referred to as an "epidemic." Research demonstrates that men are at greater risk than women for severe health impacts resulting from loneliness; therefore, a gender-informed synthesis of patterns, mechanisms, and intervention gaps is needed to provide clarity. Purpose: This systematic review evaluates the current literature on loneliness among men in the United States. Specifically, this evaluation examines prevalence and temporal trends, gendered and life-course risk factors, health consequences, and the effectiveness of extant interventions addressing loneliness. Methodology: Following PRISMA recommendations, we searched PubMed/MEDLINE, CINAHL, PsycINFO, SCOPUS, and Google Scholar for peer-reviewed empirical studies and systematic reviews that included male-specific data. We identified 485 potential references through initial screening, then screened titles and abstracts, reviewed 262 full texts, and ultimately identified 30 core studies that met the inclusion criteria. To assess the quality of each article, we used the Newcastle-Ottawa Scale, the Cochrane Risk of Bias Tool, and AMSTAR-2. Results: Evidence indicates that a widespread epidemic of male loneliness is absent, although specific groups are at higher risk. Younger males (ages 18-29) appear to be experiencing a sharp increase in loneliness, while older males (ages 60+) show more stable patterns. However, this trend is accompanied by a notable imbalance in the evidence base, with younger men underrepresented relative to older populations. Traditional masculine norms, relationship loss, unemployment, disabilities, and veteran status have all been identified as risk factors for male loneliness. Our research demonstrated that male loneliness is associated with serious health problems, including depression, cardiovascular disease, cognitive decline, risk of suicide, and increased mortality. While community-based programs targeted toward males show high participation, they are almost entirely under-evaluated. Conclusion: Male loneliness is a patterned, life-course-related experience and should therefore be viewed as an ongoing process rather than a single "epidemic" event. Existing intervention strategies do not sufficiently consider how socialized gender processes influence men's social withdrawal or disengagement. Future research may include conducting male-only randomized controlled clinical trials and longitudinal studies. Systematic review registration: https://osf.io/q97yv/, The review protocol was developed a priori and has been made publicly available through the Open Science Framework (OSF) to enhance transparency and reproducibility.