Loneliness poses a public-health threat, prompting a rare advisory from the surgeon general, with a plan to rebuild social connections

By Melissa Patrick

Kentucky Health News

The physical and societal harms that come from loneliness are so bad that America's top public-health official has issued a rare advisory with a framework to rebuild social connection and community in the U.S. 

"Loneliness is more than just a bad feeling," Surgeon General Vivek H. Murthy writes in an opinion piece for The New York Times. "When people are socially disconnected, their risk of anxiety and depression increases. So does their risk of heart disease (29%), dementia (50%), and stroke (32%). The increased risk of premature death associated with social disconnection is comparable to smoking daily — and may be even greater than the risk associated with obesity."

Social disconnection was worsened by the pandemic. 

“What Covid did is really pour fuel on a fire that was already burning,” Murthy told Fenit Nirappil of The Washington Post. “I want the entire country to understand how profound a public-health threat loneliness and isolation pose.”

Murthy's opening letter in the public-health advisory, titled Our Epidemic of Loneliness and Isolation, adds, "The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day . . .  And the harmful consequences of a society that lacks social connection can be felt in our schools, workplaces, and civic organizations, where performance, productivity, and engagement are diminished." 

To further this point, the advisory says, "Data across 148 studies, with an average of 7.5 years of follow-up, suggest that social connection increases the odds of survival by 50%." 

In the Times, Murthy tells the story of his own experience with loneliness after his first term as surgeon general and how, with the help of others, he found his way out of it. Research shows he was not alone in this feeling, he reports: "About one out of every two Americans is experiencing measurable levels of loneliness. . . . Its invisibility is part of what makes it so insidious." 

Murthy goes on to say that loneliness and isolation have led us to a place where we "are less invested in one another, we are more susceptible to polarization and less able to pull together to face the challenges that we cannot solve alone." And this, he says, "has fueled other problems that are killing us and threaten to rip our country apart." 

For all of these reasons, Murthy writes, "rebuilding social connection must be a top public-health priority in our nation." To do this, he offers three key suggestions in the op-ed, which are outlined in greater depth in the 68-page advisory. 

First, Murthy says we must strengthen our social infrastructure, such as school-based programs that teach children about building healthy relationships and workplace design that fosters social connection.

Second, we must figure out how to create space in our lives without our electronic devices so that we can be more present with each other, with a commitment to promote conversation that amplifies understanding. 

Third, we need to take steps to rebuild our connections to each other, reaching out to people we care about, talking to our neighbors, checking in with co-workers who may be having a hard time, and seeking opportunities to serve.

Murthy has long advocated treating loneliness as a public-health issue wrote a 2020 book, Together: The Healing Power of Human Connection in a Sometimes Lonely World.

Research cited in the advisory shows that nationally, social connection decreased between 2003 and 2020 as time alone increased: Isolation increased by 24 hours per month and social engagement with friends dropped 20 hours per month.

Research also shows that loneliness and isolation are most prevalent in people with poor physical or mental health, disabilities, struggling financially or living alone, says the advisory. It adds that younger and older populations struggle the most. 

"For example, while the highest rates of social isolation are found among older adults, young adults are almost twice as likely to report feeling lonely than those over 65," it says. 

The advisory provides a national strategy to advance social connection that involves six pillars and the report goes on to lay out a detailed plan for how to support them. They include: strengthening social infrastructure in local communities; enacting pro-connection public policies; mobilizing the health sector; reforming digital environments; deepening our knowledge; and building a culture of connection. 

Graphic from Our Epidemic of Loneliness and Isolation public health advisory 

The report says, "We can choose, in short, to take the core values that make us strong—love, kindness, respect, service, and commitment to one another—and reflect them in the world we build for ourselves and our children. This strategy shows us how to create the connected lives and the connected world we need."

Murthy talked to Christina Caron of the Times about how to build meaningful social connections in an increasingly lonely world. He offered five tips: 

• Reconnect with people: "To get started, take 15 minutes each day to contact a friend or a relative. Put a reminder in your calendar, if needed, so that it remains a priority. Your relationships cannot thrive unless they are nurtured," she writes
• Minimize distractions: For a more satisfying quality time, put the devices down and give your full attention.“Focus on the conversation,” Murthy told Caron. “Listening is as important as what we say.”
• When people call, pick up the phone: Even if you are busy, he said. Pick it up, make a time to talk later, and do it. "That 10 seconds feels so much better than going back and forth on text," he said. 
• Serve others: Studies show that volunteering can ease feelings of loneliness and broaden our social networks, she writes. “When we help other people we establish an experience or a connection with them — but we also remind ourselves of the value that we bring to the world,” he told her. 
• Get help: Murthy said to tell someone if you are struggling with loneliness, whether that be a relative, a friend, a counselor or a health care provider. And, if you are having thoughts of harming yourself, call the 988 crisis hotline.