An ‘Epidemic’ of Loneliness Threatens Health of Americans, Surgeon General Says

Being socially disconnected can have health impacts akin to smoking 15 cigarettes per day, according to a new report

Man looks out the window
Even before the Covid-19 pandemic, about half of all American adults reported experiencing loneliness. Milamai via Getty Images

Americans are facing an epidemic of loneliness, an “underappreciated public health crisis” that needs to be brought to light, said Surgeon General Vivek Murthy in a statement last week. Even before the Covid-19 pandemic, about half of adults in the country reported measurable levels of loneliness, which can affect mental, physical and societal health.

In response, Murthy has issued a new public advisory to call attention to the mounting problem.

“Millions of people in America are struggling in the shadows, and that’s not right,” Murthy tells Amanda Seitz of the Associated Press. “We now know that loneliness is a common feeling that many people experience. It’s like hunger or thirst. It’s a feeling the body sends us when something we need for survival is missing.”

The health risks associated with prolonged loneliness are dramatic—akin to smoking up to 15 cigarettes a day, per Murthy’s 81-page advisory. Loneliness can increase the risk of premature death by 26 percent and raise the likelihood of heart disease, stroke, anxiety, depression and dementia.

“Part of this is recognizing that there are real health consequences. This is medically relevant,” says Julianne Holt-Lunstad, a psychologist at Brigham Young University and the lead scientific author on the report, to USA Today’s Nada Hassanein. “This is far more than just affecting our emotional well-being, but truly affecting our health.”

Feelings of isolation and loneliness may be rising because Americans’ social networks and interactions are in decline. In 2021, 49 percent of adults reported having three or fewer friends, compared to about 27 percent in 1990, per the report. For young people ages 15 to 24, time spent in-person with friends fell from about 150 minutes per day in 2003 to 40 minutes per day in 2020—an almost 70 percent drop.

At the same time, technology has changed how people interact with others. For some, it has created a community online—internet-based groups can provide emotional support, especially for individuals in marginalized communities. But extensive social media use can also displace in-person interactions, lower the quality of interactions or even diminish self-esteem, according to the advisory report. Among teens ages 13 to 17, time spent online has increased since 2015, and more than half reported it would be hard to give up social media. 

Social disconnect can also carry an enormous economic cost—among older adults alone, isolation accounts for an estimated $6.7 billion in excess Medicare spending. It’s also linked to poorer academic achievement and work performance. 

Eric Liu, the CEO of Citizen University, a Seattle-based nonprofit that aims to build civic awareness across the country, tells NPR’s All Things Considered that loneliness can influence the way we see our community. People who feel isolated for long periods of time might grow to believe that others, in general, do not have their best interests in mind.

Murthy writes in a New York Times opinion piece that loneliness can lead to more polarization and lessen our ability to come together to address issues like climate change and economic inequality. Per the report, trust in each other and major institutions is now at “near historic lows.” 

“So much of the challenge that we have right now is far upstream of electoral politics and policy, it is a culture problem,” Liu tells NPR.

To address this issue and increase social cohesion, Murthy outlines several strategies in the advisory. He writes that Americans should create a “culture of connection” based on “kindness, respect, service and commitment to one another.” His other strategies include implementing a national research agenda on loneliness and raising public awareness about it; strengthening volunteer organizations, sports teams, religious groups, libraries, parks and other infrastructure in local communities—and ensuring equal access to them; and educating doctors on the health impacts of feeling disconnected.

Parents can encourage individual and group social interactions, promote quality time without screens and have conversations about loneliness to decrease the stigma around it, per the report.

“We must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity and substance use disorders,” Murthy says in the statement. “Together, we can build a country that’s healthier, more resilient, less lonely and more connected.”

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