Isolation and loneliness are an epidemic that is as damaging to the individual and public health of Americans as smoking and obesity, the United States surgeon general said in a stark advisory issued Tuesday.
Nearly half of US adults report feeling lonely in recent years, according to research cited in the advisory. A 2021 study commissioned by health care company Cigna found that 79% of people ages 18 to 24 reported feeling lonely, nearly twice as many as seniors 66 and older.
Although the problem has been exacerbated by the COVID-19 pandemic, it has been growing for a long time. From 1976 to 2019, the rate of loneliness among young adults increased every year, noted Surgeon General Vivek H. Murthy.
Being socially withdrawn can have both mental and physical consequences. It puts people at greater risk of anxiety and depression, and increases the risk of dementia by 50%, stroke by 32% and heart disease by 29%. According to the report, the risk of early death from increased isolation is comparable to smoking 15 cigarettes a day and may even be greater than the risk associated with obesity and physical inactivity.
However, studies show that 20% of people who feel lonely or isolated do not see it as a major problem, the advice says. Murthy laid out a national strategy to combat what he called “profound threats to our health and well-being,” saying the U.S. must address the epidemic with the same energy and intent as it does the opioid addiction crisis or tobacco use.
“If we fail to do this, we will pay an ever-increasing price in the form of our individual and collective health and well-being,” Murthy said. “And we will continue to be divided and divided until we can no longer stand as a community or as a country.”
The report describes social isolation as objectively having few social connections or interactions, while loneliness is a subjective and internal feeling that occurs between people’s actual connections and the desired connections they seek.
Research shows that people are spending less time with friends and family or participating in clubs or organizations, in part due to technology intruding into our social interactions. Some people leave their communities. many others focus on their careers at the expense of their personal relationships. Studies cited in the advisory found that between 2003 and 2020, time spent with friends decreased by 20 hours per month, while time spent alone increased by about 24 hours per month.
And that increased isolation can erode our trust in each other. Polls conducted in 1972 showed that 45% of Americans believed they could confidently trust other Americans; In 2016, that number dropped to roughly 30%, the consultation paper said.
It’s a trend that goes against human nature and has adverse effects on individual and societal health, says Juliana Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University and editor-in-chief of Counseling Science.
“Humans are a social species,” Holt-Lunstad said. “Throughout human history we’ve needed to rely on others to survive, so it makes sense that our bodies are adapted for survival.”
Because of the way humans have evolved and adapted, feeling disconnected, especially from those we trust, becomes a “very threatening state,” Holt-Lunstad said. “It requires more energy, and our bodies respond accordingly.”
Isolation causes our brains to become more active and signal various physiological responses that essentially throw our bodies out of rhythm, he said. One example is inflammation. evidence suggests that being isolated and lonely is associated with chronic inflammation, which increases the risk of cardiovascular disease, cancer, diabetes, depression, and Alzheimer’s disease.
“There are many cascading biological responses that occur when these physiological changes are dysregulated on a chronic basis; it can increase the risk of developing various chronic diseases,” said Holt-Lunstad.
It can also impact community outcomes, from population health to community safety, civic engagement and prosperity. “This is both an individual and societal health issue,” he said.
The pandemic has compounded the decline in social connections as well as isolation and loneliness, cutting people off from their support networks. But it also made people realize how important connection is, Holt-Lunstad said, because they saw how little time with friends or family took a toll on their well-being and the well-being of those around them.
The 82-page Surgeon General’s advice issues a public call to action to promote greater social connectivity and provides a national plan to achieve it.
Its six pillars include strengthening social infrastructure in local communities and mobilizing the health sector, offering recommendations that government agencies, workplaces and others can adopt to bring people together in a meaningful way.
In an essay published in the New York Times days before Tuesday’s report, Murthy described his struggles with loneliness and highlighted the risks America faces.
“Addressing the crisis of loneliness and isolation is one of the greatest challenges of our generation,” Murthy wrote. “By building more connected lives and more connected communities, we can strengthen the foundation of our individual and collective well-being and be better prepared to respond to the threats we face as a nation.”