More than three in five Americans are lonely, with more and more people reporting feeling like they are left out, poorly understood and lacking companionship, according to a new survey released Thursday. Workplace culture and conditions may contribute to Americans’ loneliness.

And loneliness may be on the rise. The report, led by the health insurer Cigna, found a 7% rise in loneliness since 2018, when the survey was first conducted. (Cigna is a provider of health insurance for NPR employees.)

The report surveyed over 10,000 adult workers in July and August 2019, relying on a measure of loneliness called the UCLA Loneliness Scale, used as a standard within psychology research. Respondents rated their reactions to statements such as “How often do you feel outgoing and friendly?” and “How often do you feel alone?” which were used to calculate a loneliness score on an 80-point scale.

Pervasive loneliness “has widespread effects,” says Bert Uchino, a professor at the University of Utah who studies relationships and health. It’s strongly linked to mental health issues such as anxiety and depression.

Most Americans Are Lonely, And Our Workplace Culture May Not Be Helping

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