Dr. Murthy has issued a Surgeon General’s Advisory warning about the threat of the loneliness epidemic.
U.S. Surgeon General Vivek Murthy has warned about the growing problem of loneliness for years. Even before the pandemic separated us from our loved ones, Dr. Murthy viewed our growing sense of isolation as a grave public health threat — on par with smoking or substance abuse.
He has famously compared a lonely life to smoking 15 cigarettes a day, in that both have been shown to drastically reduce your lifespan. And that’s not all: Loneliness has been linked to depression, suicide, heart disease, and dementia, Dr. Murthy tells Katie in a new interview. Across his two stints as Surgeon General, he’s written extensively about the loneliness epidemic and how we can begin to heal, including in his 2020 book Together and in a new op-ed for the New York Times. But today, he’s going a step further by issuing a Surgeon General’s Advisory on the topic, along with a national strategy to help more of us feel more connected.
“I’m asking people to recognize that our disconnection from one another is one of the most important foundational issues we are dealing with in society today,” Dr. Murthy says.
Katie spoke to Dr. Murthy about how we can fix our country’s loneliness problem, the role technology plays in making our world feel more desolate than ever, and some simple tips to feel less isolated.
Katie Couric: You and I have had conversations about loneliness before — in fact, I think we first broached the topic five or six years ago. I’m curious, has the loneliness epidemic gotten better or worse since then?
Dr. Murthy: I worry that the loneliness epidemic has gotten worse over the last few years, because of the Covid 19 pandemic. I think it added fuel to a fire that was already burning long before Covid. But unfortunately, we’re seeing so many people who are struggling with a sense of isolation and separation from others. People went through what really can be described as trauma during the pandemic, where they lost loved ones and were separated from them during periods of extreme stress. They’re still recovering from that.
One of the reasons I’m issuing the Surgeon General’s advisory on loneliness and isolation for the first time is because I believe it’s more urgent than ever for us to let the entire country know how common loneliness is. Nearly one in two adults are reporting that they’re experiencing loneliness. We know that experiencing loneliness or feeling socially disconnected both impacts our mental health, increasing our risk for depression and anxiety and suicide, and also impacts our physical health, by raising our risk for heart disease, dementia, and stroke.
I know that you’ve often said being lonely is the equivalent of smoking two packs of cigarettes a day. That sounds hard to believe. Can you explain?
When you look at the increased risk of premature death associated with social disconnection, it’s on par with what you see with smoking daily. And it’s even greater than the mortality impact that we see associated with substance-use disorders or obesity. If you think about that for a moment, it’s staggering. That’s not to say that we should be thinking less about smoking or about obesity or substance-use disorders. It tells you that we should be thinking more about loneliness as a public-health concern.
In a recent op-ed, you wrote about your own experience with loneliness. Why was it important for you to share that, and why were you feeling so isolated?
I made a common mistake that I suspect other people may have made: I got into a new job and poured myself entirely into it, but told myself that I was too busy to keep up with my friends. And days and weeks and months went by, and I got deeper and deeper into work and my relationships frayed more and more. I didn’t realize the full impact that that would have on me. It turned out that it actually made it harder for me to do my work. I found that I was at greater risk of burnout because I didn’t have the social support that I was used. But I also found that when that job ended and I was left without the meaning and community that I had derived from work, I was suddenly really quite alone. That was really hard to deal with. I struggled for a long time and it was my wife Alice, who saw what was happening. She said, “I think you’re struggling with loneliness. I think you need to build a community again.” And so it took a long year of struggle to figure out how to get my footing back. I told that story because it felt cathartic to share. But I also wanted others who may be struggling with loneliness to know that they’re not alone. A lot of us are going through a similar experience.
I know that you’re not only issuing an advisory, but also issuing a framework to tackle this problem. Tell us more about that.
In our framework for a national strategy to address loneliness and isolation, we have six pillars that we lay out to tackle loneliness. And they require all of us — it’s not just what the government or community organizations can do, it’s also what individuals and families and workplaces and schools can all do together.
We know for example that faith organizations have a very powerful role in bringing people together. Recreational organizations and civic organizations can do the same, but participation in all of these groups has declined over the last several decades. And so we have to rebuild them. Schools also have a really powerful role to play in helping teach children about emotions and about how to build healthy relationships. Some of that happens through social emotional learning curricula, but we have to make this a priority within our schools and support teachers. There’s a lot individuals can do too. Simply taking 15 minutes a day to reach out to someone you care about, just to say, “Hey, I’m thinking of you,” can make a big difference.
I know that teenage girls, according to the CDC, are experiencing unprecedented levels of depression and anxiety. How can we address this?
This is really alarming. And if you look at the trends, particularly around sadness and hopelessness, you see that those numbers among high school students have been increasing for years now. In fact, there was a 57 percent increase in the suicide rate among young people from 2007 to 2018. What can we do? Well, to address the mental health crisis, rebuilding connection is absolutely essential, because our connections with one another are the buffers that help reduce the impact of stressors in our life. And young people in the last few years have experienced a lot of stressors: disruption from the pandemic, gun violence in their communities, and they also worry a lot about climate change. They look at the polarization and division that exists in the country, and that also sometimes makes them feel less confident that we’re actually gonna be able to create a better future.
We’ve also gotta make sure help is there for kids who are in crisis. It’s one of the reasons that we worked very hard to set up 988, the new mental health crisis line that anyone can call or text at any hour of the day. And we’ve put in billions of dollars in the last two years toward expanding opportunities for people to get care. The bottom line is, we’ve gotta work on multiple fronts to get care to where people are, and address the root causes of what’s causing this crisis among young people.
You mentioned connecting people through technology, but as you well know, technology can be a big problem, too. We’re all addicted to our phones, and comparing our lives to manufactured images that are being projected to us, 24/7. Teens are particularly susceptible to that. But I, too, am addicted to my phone. So how can we break this very deep relationship so many people have with their digital devices?
I’m a believer in technology. I spent seven years building a technology company, and I use technology all the time. We use technology to get public health messages out to the public. But tech can help or hurt, depending on how it’s designed and it’s used. Particularly for our kids, I think technology has in some cases had a harmful effect — stealing time away from sleep and other activities that are important for their development. In some cases, it also reduces the quality of their relationships with other people, and reduces their own sense of self-esteem, which is what kids tell me all the time. They constantly compare themselves to other people online. I do think that technology is a double-edged sword.
I think what we have to do as a society is make sure that we have safety standards in place to ensure that technology helps and doesn’t hurt our kids. We also have to ensure that we’re getting the data from social media companies about the impact on mental health, so that independent scientists can assess who’s most at risk and what interventions are working to mitigate or reduce that risk. And scientists right now say that they just do not have access to the data that they need.
I’m so glad you’re making people aware of this and giving some ideas for how to cope with loneliness. But the cynical side of me can’t help but wonder if this will truly have any impact: How are you going to make people aware that technology is having extremely dangerous health consequences and that they need to change their lifestyles?
It is a hard thing to do. But I’ll tell you why I feel hopeful, Katie: Because in all the time that I’ve served as Surgeon General, over two stints, there’s no issue that I have found has resonated more deeply with people than the issue of loneliness and social connection. Because so many people are actually experiencing it right now. The second thing that’s really important is that when people hear about public health challenges, they normally figure, These are so big, somebody else has to do something about them. There’s nothing I can do. But we now know very clearly that the individual steps we take in our lives, whether it’s the 15 minutes we spend with somebody once a day or the small acts of help and service we extend to others, we know that these make a material difference in how we feel.
So that means that we have agency and that’s a really important part: We can do something about this. My hope is through the advisory, more people will know that this is a common struggle. The goal is to be able to talk about it more. And if we can talk about it more, we can work together more. Because some of the community solutions that we need — having places where we can gather and support one another and get to know each other — these are things where we have to work together. And when we make a commitment together, then we can create change. And that’s what I’m asking people to do — to recognize that our disconnection from one another is one of the most important foundational issues we are dealing with in society.
Can you recommend some simple steps that’ll reduce loneliness?
Absolutely. I’ll give you four, which if you practice, will help you feel less lonely every day. First, spend 15 minutes reaching out to somebody you care about. It could be a text to a friend, or a call to your mother. Number two, when you’re spending time with someone — having dinner with them, having breakfast, talking to them on the phone — don’t check your devices, or your inbox, or the news. Just allow yourself to focus entirely on them. You will feel jittery initially, but you will feel better at the end. The third thing is to extend kindness to people around you. That could be somebody next to you, or in line at the grocery store, or a neighbor. Smile at them, ask them how they’re doing, and you’ll find that even that brief moment of interaction in your neighborhood or in an elevator will make you feel better.
And finally, the fourth one is acts of service. Finding small ways to help people you encounter goes a long way to helping. And here’s why: When you help somebody else, you forge a connection with them that feels very meaningful. But you also remind yourself that you have value to bring to the world. And this is critical because a lot of time, loneliness can chip away at our sense of self-worth. And we start to believe that we’re lonely because we’re not likable or lovable. And when you help somebody else in that moment, you break that cycle of loneliness and help remind yourself that you do have value to bring to the world. These are small steps that can just take seconds or minutes in your day, but they can go a long way to helping you feel more connected to other people.
