SEATTLE — Loneliness isn't just a feeling. It's a public health concern, U.S. Surgeon General Vivek Murthy said Wednesday in Seattle.
Murthy declared loneliness and isolation a national epidemic in May 2023, issuing an 81-page report outlining the problem and potential solutions. Even before the COVID-19 pandemic, about half of American adults said they'd experienced loneliness.
Isolation has significant effects on physical health: It increases heart disease risk by 29%, stroke risk by 32% and dementia risk by 50%, according to the Surgeon General's office. A lack of social connection increases the risk of premature death by more than 60% — the equivalent of smoking 15 cigarettes per day.
"As somebody who sits in an office that for generations has focused on issues like tobacco and obesity, it made me realize that this issue of loneliness is a public health concern," Murthy said.
Murthy joined Washington State Secretary of Health Umair Shah for a discussion on social connection and loneliness, part of a state health department speaker series. Here are five key points from the conversation.
For thousands of years, humans lived as hunters and gatherers who formed small groups with people they trusted, Murthy said. They shared food, took care of children together and looked out for one another's safety.
"We learned to live together and recognized that when we are connected with one another in trusted relationships, we actually do better. We have a much greater likelihood of survival," he said.
Not all of those elements still exist in our current society, he said. More people feel disconnected from community or don't feel like they're a part of others' lives in meaningful ways.
"We have become, in the grand scheme of human existence, quite lonely and isolated, despite the fact that we live in more densely populated parts of the world and despite the fact that we are connected through our devices and technology," Murthy said.
Three different types of relationships are important in human connection, Murthy said: Intimate connections like a spouse or best friend; relational connections like close friends and extended family members; and collective connections like people we share a workplace or organization with.
After Murthy's first term as surgeon general from 2014-17, he wrote a commencement speech examining his loneliness, even though his wife had been "his rock" during that time.
"I found myself in a place where I was blessed to have these intimate connections, but I had utterly lost my friendships and my sense of community," he said. "If you don't understand that, then you might think if your loved one is struggling with loneliness, it's your fault, or it's an indictment of your marriage, for example, but that's not at all the case."
We need to rebuild these collective connections in modern social infrastructure, Murthy said.
Fewer people today participate in community organizations like places of worship, recreational sports leagues or service groups. People move around from place to place more often. And while technology has created "extraordinary conveniences," it's replaced some personal interactions.
Loneliness and isolation have adverse health effects, but on the flip side, community and relationships are natural buffers to stress, Murthy said. Communities that are more connected to one another generally have higher levels of economic prosperity, lower levels of violence, and more resilience in the face of adversity or natural disasters.
"Whether you care about health, education, the economy or issues like division and polarization in society, all of these, it turns out, are impacted by social connection," Murthy said.
Murthy issued an advisory about youth mental health in 2021, writing that "the challenges today's generation of young people face are unprecedented and uniquely hard to navigate."
Social media is contributing to this "major crisis," he said Wednesday. Adolescents spend an average of 4.8 hours per day on social media, and he's concerned that time replaces healthy activities like in-person connection, physical activity and sleep.
Murthy's 2023 advisory on loneliness and isolation called for data transparency from technology companies and national safety standards for social media platforms, like stronger age restrictions for young people.
"My worry is that we have lost control of social media, and we have essentially no effective guardrails in place right now, in terms of the technology itself, or in terms of policy and regulation," Murthy said. "To me, this is morally unacceptable."
Murthy said he feels more hopeful than he did before he served as surgeon general, even though he's seen more challenges. We can all contribute to social connection at the community and individual level.
"While we do need good policy and good programs in place, fundamentally, health and well-being has to do with how each of us show up in our families and our communities," Murthy said.
Calling a friend to check in, taking care of your child's classmate, stopping by a co-worker's office: these small moments all help us stay connected to each other and combat isolation.
"This is how we evolved to be over thousands of years," Murthy said. "If we can rebuild that connection with one another, if we can call upon that compassion, generosity, and love that is our birthright and our nature, I have no doubt that we can help each other."
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