Recently the U.S. Department of Health and Human Services released a report on a surprising, yet intriguing subject: loneliness. According to various studies and surveys, isolation and a lack of social connectivity has become epidemic. The COVID-19 pandemic may have exacerbated what was already problematic for millions of Americans.
“Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health,” declared U.S. Surgeon General Dr. Vivek Murthy. “Our relationships are a source of healing and well-being hiding in plain sight – one that can help us live healthier, more fulfilled, and more productive lives. Given the significant health consequences of loneliness and isolation, 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. Together, we can build a country that’s healthier, more resilient, less lonely, and more connected.”
The physical health consequences of poor or insufficient connections are dire. They include a 29% increased risk of heart disease; a 32% increased risk of stroke; and a 50% increased risk of developing dementia for older adults. Lack of social connections is estimated to increase the risk of premature death by more than 60%.
In addition to our physical health, loneliness and isolation contribute substantially to mental health challenges. In adults, the risk of developing depression among people who report feeling lonely often is more than double that of people who rarely or never feel lonely. Loneliness and social isolation in childhood increase the risk of depression and anxiety both immediately and well into the future. And with an estimated one in five adults living with a mental illness in the U.S., addressing loneliness and isolation has become critical in fully addressing the mental health crisis in America.
For better or worse, the COVID-19 pandemic exposed the loneliness dilemma. It also seems to have amplified it. As businesses either switched to remote work or shut down altogether, people found themselves isolated in the name of good health. I think much of this was foretold by the obsession with social media in the preceding two decades; where people would establish cyber relationships and call each other “friends”.
As an only child and a confirmed introvert, I’ve dealt with loneliness my entire life. Sometimes I really do get lonely; other times I’m just alone. I’ve always been a loner – something my parents never seemed to understand – and I’ve rarely done well in groups. I get bored easily and quickly grow tired of dealing with people’s attitudes and personality quirks. I put up with a lot of people’s disrespectful behavior towards me most of my life, which is the primary reason I don’t consider myself a people person.
But I have to admit I do get lonely sometimes. I’m glad my parents had each other and me (and even my dog, Wolfgang to some extent) as they aged. One of my uncles lives alone in a dingy apartment with a cat. (An older cat died a few months ago, which devastated him.) He can’t drive anymore, so he either takes a bus or has someone transport him somewhere. I’ve taken him to a variety of doctor appointments over the past few years and grocery shopping almost every weekend for months now. His stepdaughter lives closer, but she has her own health problems.
I have an aunt who also lives alone. Her son, like me, is an only child, but he’s married and resides several miles from his mother. She’s fortunate, though, in that a neighbor has access to her house and keeps an eye on her. My aunt frightened me a few years ago, when she recounted how she fell in the bathroom one night and had to drag herself into her bedroom. It took her hours just to get there. But she was able to call her neighbor who contacted the fire department. I stay in touch with my uncle and aunt, as well as other relatives and friends – even if it’s just via text message.
I only know a few of my neighbors and have little contact with most relatives. I’ve never been married and I never had children, so I don’t know how life will be for me if I grow much older. Loneliness will be just one factor in my later life.
Some years ago a friend expressed concern that I was becoming a hermit. “Why should I go out?” I responded. I lived with my parents, so I certainly couldn’t bring anyone home. Then again, I hadn’t brought anyone home who I didn’t know since before the turn of the century.
A close friend keeps urging me to get a dog, as he did a couple of years ago. Aside from two household plants that languish nondescriptly on a kitchen counter, I’m the only living being in this house. (That doesn’t include the occasional insect that invades my quiet abode.) I’d love to get a dog, but I’m just not in the right situation now to get one.
Dr. Murthy has established a six-point plan to help the U.S. deal with its loneliness epidemic:
- Strengthen Social Infrastructure: Connections are not just influenced by individual interactions, but by the physical elements of a community (parks, libraries, playgrounds) and the programs and policies in place. To strengthen social infrastructure, communities must design environments that promote connection, establish and scale community connection programs, and invest in institutions that bring people together.
- Enact Pro-Connection Public Policies: National, state, local, and tribal governments play a role in establishing policies like accessible public transportation or paid family leave that can support and enable more connection among a community or a family.
- Mobilize the Health Sector: Because loneliness and isolation are risk factors for several major health conditions (including heart disease, dementia, depression) as well as for premature death, health care providers are well-positioned to assess patients for risk of loneliness and intervene.
- Reform Digital Environments: We must critically evaluate our relationship with technology and ensure that how we interact digitally does not detract from meaningful and healing connection with others.
- Deepen Our Knowledge: A more robust research agenda, beyond the evidence outlined in the advisory, must be established to further our understanding of the causes and consequences of social disconnection, populations at risk, and the effectiveness of efforts to boost connection.
- Cultivate a Culture of Connection: The informal practices of everyday life (the norms and culture of how we engage one another) significantly influence the relationships we have in our lives. We cannot be successful in the other pillars without a culture of connection.
All of this is easier said than done, and every plan looks good on paper. But I know something has to be done, if the nation’s overall health is to improve. I only have a small collection of friends, but that’s all I personally need. As with most everything else, it’s quality, not quantity, that matters. And quality of life is always important.
Image: Seher Bilgin