Last updated 8/4/2023
Every so often, the United States Surgeon General puts forth an Advisory—a public statement that is meant to bring immediate attention to an urgent public health crisis. In the past 50 years, several advisories have led to dramatic shifts in our way of life.
Most notably, the 1964 Surgeon General’s Advisory on Smoking and Health documented the negative health consequences of smoking and concluded that smoking causes cancer. The advisory unleashed an anti-smoking campaign that required cigarette manufacturers to include a health warning on their packaging, banned cigarette advertising on TV, and called for ongoing public health and policy efforts to reduce cigarette use.
This year, the Surgeon General published an Advisory on an insidious problem that many of us have been affected by: the loneliness epidemic. In his report, he notes that millions of Americans lack meaningful social connection and draws from a large body of literature that has found myriad emotional and physical health consequences associated with this.
Loneliness is associated with an increased risk of anxiety, depression, and dementia. It increases our susceptibility to viral and respiratory infections and is associated with a 29% increased risk of heart disease and a 32% increased risk of stroke. It may even be a matter of life and death, with loneliness increasing the risk of premature death by 26%.
But what does this all mean? What does it mean to be lonely? Why are we lonely? Why are we talking about loneliness now? And what can we do about it?
When we—that is, health professionals like myself—talk about loneliness, we’re really talking about two related, yet distinct, concepts: social isolation and loneliness. Social isolation is defined as a lack of social contacts. Loneliness is defined as the feeling of being alone. And it’s this feeling of being alone, being disconnected, or not belonging that is so dangerous.
Human beings are, by nature, social creatures. Evolutionarily, banding together increased our chances of survival. Yet, in modern-day society, opportunities to build lasting, meaningful connections with others appear to be dwindling.
Due in part to the COVID-19 pandemic, we now spend less time with others. Fourteen percent (14%) of American adult employees work fully remotely, which often means limited face-to-face interaction with people outside our homes. And when we do spend time with others, we often find ourselves fiddling with our phones, checking our email, and scanning social media.
Social media itself is a paradox. It is meant to be a technology that enables us to create a sense of community by sharing content, news, personal messages, and more—yet large-scale studies have found that social media use is associated with increased feelings of loneliness. And it makes sense why. With many forms of social media, we aren’t meaningfully interacting with others. We are digesting snippets of their lives, comparing them to our own, and feeling inadequate or left out in the process.
The detrimental effects of loneliness have been studied for at least a decade. And the Surgeon General first sensed that loneliness was a national problem years ago. So, why are we only now making it a matter of public discourse?
The answer is likely that we’ve seen a dovetailing of events. The COVID-19 pandemic forced loneliness onto almost all of us. And even though we’ve emerged from the darkest days of the pandemic, our social behaviors, interpersonal connections, and physical communities have forever changed.
Mental health remains a nationwide concern, with 90% of adults believing that the country is facing a mental health crisis and more than 30% of adults experiencing symptoms of anxiety and/or depression. And the dangers of social media continue to make the news, with the Surgeon General recently issuing a separate advisory on the effects of social media on youth mental health.
So, what can we do about loneliness? The Surgeon General lays out several policy initiatives in his report, but I’m more focused on what we can do as individuals. Ideas include:
Investing in existing relationships by reaching out to our family, friends, loved ones, and others, having live conversations, and spending in-person time together.
Reconnecting with old acquaintances to check in and share memories and life updates.
Developing new relationships by leveraging our hobbies and interests to find people with whom we may share things in common.
Limiting our social media use so that we spend less time thinking about what we don’t have and have more time to focus on what we do have.
In addition to individual measures, the Surgeon General has created a Framework for a National Strategy to Advance Social Connection.15 It includes strategies for local communities, schools and workplaces, businesses, and many more impactful entities. It gives each of us opportunities to get involved on a broader scale. By working on our personal and community experiences of loneliness, I’m hopeful that we can tackle the epidemic and rebuild our sense of belongingness.