Widespread loneliness in the U.S. poses health risks as deadly as smoking a dozen cigarettes daily, costing the health industry billions of dollars annually, the U.S. surgeon general said Tuesday in declaring the latest public health epidemic.
About half of U.S. adults say they’ve experienced loneliness, Dr. Vivek Murthy said in a report from his office.
“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,” Murthy told The Associated Press in an interview. “Millions of people in America are struggling in the shadows, and that’s not right. That’s why I issued this advisory to pull back the curtain on a struggle that too many people are experiencing.”
The declaration is intended to raise awareness around loneliness but won’t unlock federal funding or programming devoted to combatting the issue.
Research shows that Americans, who have become less engaged with worship houses, community organizations and even their own family members in recent decades, have steadily reported an increase in feelings of loneliness. The number of single households has also doubled over the last 60 years.
But the crisis deeply worsened when COVID-19 spread, prompting schools and workplaces to shut their doors and sending millions of Americans to isolate at home away from relatives or friends.
People culled their friend groups during the coronavirus pandemic and reduced time spent with those friends, the surgeon general’s report finds. Americans spent about 20 minutes a day in person with friends in 2020, down from 60 minutes daily nearly two decades earlier.
The loneliness epidemic is hitting young people, ages 15 to 24, especially hard. The age group reported a 70% drop in time spent with friends during the same period.
Loneliness increases the risk of premature death by nearly 30%, with the report revealing that those with poor social relationships also had a greater risk of stroke and heart disease. Isolation also elevates a person’s likelihood for experiencing depression, anxiety and dementia.
The surgeon general is calling on workplaces, schools, technology companies, community organizations, parents and other people to make changes that will boost the country’s connectedness. He advises people to join community groups and put down their phones when they’re catching up with friends; employers to think carefully about their remote work policies; and health systems to provide training for doctors to recognize the health risks of loneliness.
Technology has rapidly exacerbated the loneliness problem, with one study cited in the report finding that people who used social media for two hours or more daily were more than twice as likely to report feeling socially isolated than those who were on such apps for less than 30 minutes a day.
Murthy said social media is driving the increase in loneliness in particular. His report suggests that technology companies roll out protections for children especially around their social media behavior.
“There’s really no substitute for in-person interaction,” Murthy said. “As we shifted to use technology more and more for our communication, we lost out on a lot of that in-person interaction. How do we design technology that strengthens our relationships as opposed to weaken them?”
BY AMANDA SEITZ / AP MAY 2, 2023
How to Make Friends as an Adult
— and Why It’s Important
Anyone who’s ever made room for a big milestone of adult life–a job, a marriage, a move–has likely shoved a friendship to the side. After all, there is no contract locking us to the other person, as in marriage, and there are no blood bonds, as in family. Friendships are flexible. “We choose our friends, and our friends choose us,” says William K. Rawlins, Stocker Professor of Communication Studies at Ohio University. “That’s a really distinctive attribute of friendships.”
But modern life can become so busy that people forget to keep choosing each other. That’s when friendships fade, and there’s reason to believe it’s happening more than ever. Loneliness is on the rise, and feeling lonely has been found to increase a person’s risk of dying early by 26%–and to be even worse for the body than obesity and air pollution. Loneliness wreaks health havoc in many ways, particularly because it removes the safety net of social support. “When we perceive our world as threatening, that can be associated with an increase in heart rate and blood pressure,” says Julianne Holt-Lunstad, professor of psychology and neuroscience at Brigham Young University and author of the recent study linking loneliness to mortality. Over time, she says, these effects can lead to hypertension, which increases risk for cardiovascular disease.
The antidote is simple: friendship. It helps protect the brain and body from stress, anxiety and depression. “Being around trusted others, in essence, signals safety and security,” says Holt-Lunstad. A study last year found that friendships are especially beneficial later in life. Having supportive friends in old age was a stronger predictor of well-being than family ties–suggesting that the friends you pick may be at least as important as the family you’re born into.
Easy as the fix may sound, it can be difficult to keep and make friends as an adult. But research suggests that you only need between four and five close pals. If you’ve ever had a good one, you know what you’re looking for. “The expectations of friends, once you have a mature understanding of friendship, don’t really change across the life course,” Rawlins says. “People want their close friends to be someone they can talk to, someone they can depend upon and someone they enjoy.”
If you’re trying to replenish a dried-up friendship pool, start by looking inward. Think back to how you met some of your very favorite friends. Volunteering on a political campaign or in a favorite spin class? Playing in a band? “Friendships are always about something,” says Rawlins. Common passions help people bond at a personal level, and they bridge people of different ages and life experiences.
Whatever you’re into, someone else is too. Let your passion guide you toward people. Volunteer, for example, take a new course or join a committee at your local religious center. If you like yoga, start going to classes regularly. Fellow dog lovers tend to congregate at dog runs. Using apps and social media–like Facebook to find a local book club–is also a good way to find simpatico folks.
Once you meet a potential future friend, then comes the scary part: inviting them to do something. “You do have to put yourself out there,” says Janice McCabe, associate professor of sociology at Dartmouth College and a friendship researcher. “There’s a chance that the person will say no. But there’s also the chance they’ll say yes, and something really great could happen.”
The process takes time, and you may experience false starts. Not everyone will want to put in the effort necessary to be a good friend.
Which is reason enough to nurture the friendships you already have–even those than span many miles. Start by scheduling a weekly phone call. “It seems kind of funny to do that, because we often think about scheduling as tasks or work,” says McCabe. “But it’s easy, especially as an adult, to lose track of making time for a phone call.” When a friend reaches out to you, don’t forget to tell them how much it means to you.
It’s never too late to start being a better pal. The work you put into friendships–both new and old–will be well worth it for your health and happiness.
BY MANDY OAKLANDER FEBRUARY 15, 2018
This appears in the February 26, 2018 issue of TIME.