US surgeon general warns of next public health priority: loneliness | Mental health

There’s an ailment linked to increased heart attacks, depression, diabetes, crime and premature death in the US, and it’s impacting people no matter where they live or who they are: loneliness.

US surgeon general Vivek Murthy released an advisory on loneliness and isolation on Tuesday and urged people and public officials to treat the matter with the same urgency as other serious conditions such as obesity or drug abuse as it continues to surge, affecting approximately half of the people living in the US.

“Right now, millions of people are telling us through their stories and statistics that their tank is running on empty when it comes to social connection,” he said.

“So bottom line is this has to be a public health priority that we consider on par with tobacco, with substance use disorders, with obesity and other issues that we know profoundly impacted people’s lives.”

Murthy, who has written about his own personal experience with loneliness and feeling isolated for several years, said the pandemic has brought the disruption of social cohesion to the forefront. But as the advisory points out, the issue had been ticking up since the 1970s for a myriad of reasons, including changes in social norms, built environments and, of course, technology.

The advisory cites polls from the 1970s in which 45% of Americans said they could reliably trust other Americans. That dropped to roughly 30% by 2016. Between 2003 and 2020, the time Americans spent alone increased by 24 hours a month, and time with friends in person decreased by 10 hours a month. Teenagers and adults reported being online “almost constantly” but across all ages had fewer friends and in-person interactions.

These changes, coupled with the influx of home delivery and other changes that limit personal interactions can leave people feeling disconnected.

“It’s a normal part of the human experience and loneliness, in many ways, is like hunger or thirst,” Murthy said. “It’s a signal our body sends us when we’re lacking something we need for survival.”

But without addressing the issue, the lack of connection contributes to increased hospital visits and dementia, but also a vicious cycle of anxiety and depression that one-third of US adults reported experiencing, according to the Kaiser Family Foundation.

During the Covid-19 pandemic, social isolation was exacerbated by school and workplace closures that were in place to stop the spread of the virus. Some public officials since then said schools may have stayed closed too long, prolonging the mental health and other impacts on students.

But Murthy, who was not surgeon general during the onset of the pandemic under Donald Trump, said policymakers had to “make tough decisions with little information” in that moment, when sometimes thousands of people were dying from the virus every day. He said that newer ideas like remote working are not always isolating either, often allowing people to spend more time with their children or elderly relatives.

Even so, he said there was a lesson to be learned from reflecting on the aftermath of some policies.

“The one thing I think that’s very relevant here, though, is I think it’s important to understand the kinds of consequences that can ensue from the decisions we make, and I think we often think about financial consequences. But I don’t think we think often enough about the social consequences of our decisions,” Murthy said.

Those consequences extend to the political and social divides that seem to only be widening in the US. With fewer people interacting in community settings such as churches, synagogues, recreational sports, or more spontaneously at the grocery store, there are fewer moments to see a person for more than their surface level qualities, Murthy said.

“There’s a very simple reason: it’s hard to hate people up close,” he said. “But when we don’t know one another, then we fall prey to the caricatures that people put out about groups that disagree with us.”

And he said social isolation can reach further, making people less civically engaged in their communities. “So when you look at it that way you start to realize that social connection is part of what fuels us, what allows us to show up in our lives and in our communities as whole people.”

Murthy’s advisory suggests ways that individuals, companies and public officials can start to bring people together and address the issue of loneliness. Those solutions include tracking social connection through research, making social connection a priority at work, and community programs that consistently bring people together.

Meanwhile, the surgeon general said he is using his own story about experiencing loneliness to combat the shame that people feel when they experience isolation. After he wrote a personal column about loneliness this weekend he said he has received countless letters from people sharing their own struggles.

“A lot of people that I encounter, all across the country and even around the world, are craving authenticity, they want to be able to be open with other people, they want other people to be open with them, but it can feel scary to do so,” he said.

“We have to recognize that part of that involves being able to show up as ourselves, being able to take a bit of a risk in sharing with other people, but also in listening to others and asking them how they’re doing and actually waiting, you know, for an answer.”

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