US Surgeon General declares national loneliness epidemic

SAN FRANCISCO - U.S. Surgeon General Dr. Vivek Murthy released an 81-page report Tuesday, saying loneliness is an epidemic that has turned into a nationwide public health problem.

The report cited research that shows loneliness and social isolation increases the risk for premature death by 26-29% and is similar to smoking up to 15 cigarettes a day.

"Loneliness and isolation are associated with a greater risk of heart disease, dementia, stroke, depression, anxiety and premature death," said Dr. Murthy.

The report referenced a 2013 study by UCSF researchers who investigated connections between loneliness and patients' physical ailments.

"We found that those adults that were more socially isolated, had an increased likelihood of dying over the follow-up period compared to those that were not socially isolated. And something that we also found was that there was what we call a social gradient in what we observed, and that it's not just that you're either dichotomously isolated or connected," said Dr. Matt Pantell, who was part of the UCSF research team.

"When we talk about loneliness, we're usually thinking about it being concerning if it's been chronic," said Dr. Pantell, "Studies have shown that people that are more socially isolated have higher levels of this biomarker of inflammation called C-reactive protein which has been associated with a lot of adverse health outcomes."

Psychiatrists say while there are ways to measure social isolation, such as whether one lives alone or how many times one sees other people, loneliness is different.

"Loneliness is a more subjective feeling, so I could be with people and still feel lonely. So how connected am I, the lack of companionship...if I don't feel in tune with people," said Dr. Kalpana Nathan, Chief Medical Director of Mental Health Services at El Camino Hospital in Mountain View.

The report says in recent years studies have shown half of all adults in America reported feeling loneliness.

The report states some of the reasons include an increase in the number of people living alone, which has increased to 29% of American households.

Also, the report cites a decrease in participation in traditional clubs and community groups, as well as a decline in attendance at churches, synagogues or mosques from 70% in 1999 to 47% in 2020.

Dr. Pantell says it is important for medical professionals to recognize the importance of addressing loneliness and social isolation as they treat their patients. In one UCSF study, only 13% of patients surveyed said doctors had asked them about loneliness.

"A lot of clinicians are not trained about one, how related to health outcomes social isolation and loneliness are, but two, what to do about it when you uncover it," said Dr. Pantell.

Dr. Nathan says finding spaces for people to connect with others is important for health care providers. Her team at El Camino Hospital is launching a new free seminar next week to help parents and youth in the community better communicate and feel connected.

"Understanding to some degree what are the things I want and how do I express that to someone else? My interpersonal connections, my communication my boundaries," said Dr. Nathan.

Dr. Nathan says social media can be both a powerful way to connect people, but also can take people away from face-to-face interactions.

The Surgeon General's report showed that hours of face-to-face interactions decreased in many areas.

"This decline is starkest for young people ages 15 to 24. For this age group, time spent in-person with friends has reduced by nearly 70% over almost two decades, from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020," the report stated. 

The Surgeon General called for six areas where Americans can take action to advance social connection. For key takeaways from the advisory and the full U.S. Surgeon General's report, click here.