A case study of how a CIHR-funded program of research built the surveillance backbone, policy infrastructure, and implementation tools needed to treat social connection as a serious public-health priority — spanning the Canadian Social Connection Survey, the Canadian Social Connection Guidelines, the Loneliness Policy Menu, the Tether app, and the Canadian Alliance for Social Connection and Health (CASCH).
By early 2020, the public-health community had decades of evidence that loneliness and social isolation harm physical and mental health on a scale comparable to smoking, obesity, and physical inactivity. What was missing was the operational infrastructure: a population-level surveillance system that could tell us who was disconnected and why; a set of evidence-based guidelines that practitioners and policymakers could act on; the policy levers and implementation tools to turn those guidelines into practice; and an alliance of researchers, practitioners, and community partners able to move the field together. COVID-19 made the absence of that infrastructure impossible to ignore.
This case study traces how that infrastructure got built. It begins with a partnership between the GenWell Project and our research team to launch the Canadian Social Connection Survey (CSCS) in 2021 — an open-cohort national survey that is now the most comprehensive longitudinal source of social-connection data in Canada. The survey’s evidence base anchored a 2024–2025 Delphi consensus process that produced the world’s first national public-health guidelines for social connection, accompanied by 50 evidence briefs and case studies. From there, the program turned to implementation: the Tether app translates the guidelines into a self-guided digital intervention for individuals, and the Loneliness Policy Menu equips governments and decision-makers with the policy levers to act on them at the community and population level. The Canadian Alliance for Social Connection and Health (CASCH) binds the program together as a research-to-practice alliance.
The aim is not to publish more papers about loneliness. It is to make social connection a normal, fundable, and accountable target of public-health practice in Canada and internationally — with the same operational scaffolding we expect for physical activity, healthy eating, and sleep.
A five-year arc: a pandemic-era survey partnership built the evidence base; a Delphi consensus and 50 evidence briefs translated it into national guidelines; and implementation tools then put those guidelines into practitioners’ and decision-makers’ hands.
Lockdowns, school closures, and physical distancing turned loneliness and social isolation into a population-level public-health emergency. The Canadian data landscape had no longitudinal, dedicated social-connection cohort to measure the impact, identify who was most affected, or evaluate response options. That gap became the founding case for what came next.
In partnership with Pete Bombaci and the GenWell Project, our team launched the Canadian Social Connection Survey (CSCS): an open-cohort, longitudinal, nationally distributed survey of social health behaviours, beliefs, and outcomes. The CSCS became the empirical backbone for everything that followed — characterising who was lonely, when, and why, and providing the population-level evidence base that the eventual guidelines would rest on.
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Launched at socialconnectionguidelines.org, the guidelines comprise 12 recommendations — six for individuals (prioritising connection, cultivating social confidence, building diverse networks, investing in meaningful interactions, deepening relationships, and using technology wisely) and six for communities (promoting awareness, fostering social-emotional development, prioritising social health in policy, designing connection-friendly environments, improving inclusion and accessibility, and measuring progress).
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The empirical foundation that makes the rest of the program possible.
Launched in 2021 in partnership with the GenWell Project, the CSCS is Canada’s most comprehensive dedicated source of social-connection data. It uses a serial cross-sectional design — with repeated nationally distributed survey waves that allow us to track population-level trends in loneliness, social network size, network diversity, perceived support, community belonging, time spent in face-to-face and digital interaction, and the determinants of all of the above. Nested within the cross-sectional waves is a longitudinal sub-cohort of participants who consent to be re-surveyed over time, supporting within-person analyses of how social connection changes and what drives those changes.
The CSCS provides the evidence base behind nearly every output in this program. It generates the prevalence estimates that justify treating social connection as a public-health priority; the within-person trajectories (from the longitudinal sub-cohort) that show how loneliness moves over time; the subgroup analyses that identify who is most affected (rural communities, men, older adults, racialised and 2SLGBTQ+ Canadians); and the predictive analyses that link social-health knowledge to behaviour change. It is the bridge between the lived experience of disconnection and the population-level recommendations in the Canadian Social Connection Guidelines.
Looking forward, the CSCS is being positioned as a model for ongoing population-level surveillance of social connection in Canada — with work underway, in partnership with the Public Health Agency of Canada, to assess how existing Canadian surveys can be extended to monitor the guidelines and where dedicated surveillance infrastructure is required.
The four projects that translate the surveillance evidence into individual- and community-level change.
Twelve evidence-based recommendations — six for individuals, six for communities — developed through an international Delphi consensus and Canada-wide community consultation. Supported by 50 evidence briefs and a growing library of Canadian case studies.
socialconnectionguidelines.orgAn interactive library of policy levers for reducing loneliness and strengthening social connection — from community-design choices to inclusion policy to social-prescribing infrastructure. Built so governments and community organizations can match a guideline domain to the policy options that operationalise it.
loneliness-policy-menu.vercel.appA self-guided digital intervention that translates the Social Connection Guidelines into concrete, daily practice. Built for individuals and as a low-cost adjunct to social-prescribing pathways, Tether is the front-line implementation arm of the guidelines.
addressing-loneliness.vercel.appThe convening infrastructure behind the program. CASCH binds researchers, link workers, practitioners, and community organizations into a shared research-to-practice agenda — producing evidence briefs, case studies, and the partnership architecture that gets the guidelines into the systems where they need to land.
casch.orgA growing body of work documenting the development, evaluation, and implementation of the Canadian Social Connection Guidelines and surrounding infrastructure.
“Social connection is no longer a private feeling we tolerate the absence of. It is a measurable, modifiable, and accountable target of public-health practice — and we now have the surveillance, the standards, and the tools to act on it.”— the guiding premise of the CIHR-funded Canadian Social Connection Guidelines.
This case study is one strand of a larger program of research that also includes social-prescribing implementation across British Columbia, Ontario, and Alberta; an evidence and gap map of social prescribing for older adults; and a portfolio of work on rural/urban disparities, male loneliness, and the social-connection mechanisms underlying climate-related distress. The Canadian Social Connection program described here is the policy-and-practice infrastructure that supports the rest of it.
