Loneliness leads to early death, Surgeon General warns. Health systems can help.

U.S. Surgeon General Vivek Murthy has issued an advisory on the health risks of loneliness and social isolation. (Photo: Surgeon General's office)

On a listening tour that took him around the country, Surgeon General Vivek Murthy said he heard a recurring problem over and over.

People are lonely. Even if they don’t describe it precisely that way, Murthy said it’s clear that many feel isolated and are longing for more connection. And he said there's evidence the rising prevalence of isolation began before the COVID-19 pandemic.

On Tuesday, Murthy issued an advisory outlining what he described as the epidemic of loneliness, its toll on public health, and recommendations for helping foster more social connection. The report states that loneliness and social isolation increase the risk of early death by 26% and 29% respectively, and social isolation leads to greater risks of heart attack and stroke.

The surgeon general said in the report that the increased risk of mortality due to loneliness is comparable to smoking 15 cigarettes a day.

There are many reasons for a growing sense of isolation, and one driving factor is more people are living alone. In 2022, roughly 3 in 10 Americans (29%) live by themselves, up from 13% in 1960. Seniors, those who struggle with financial problems, individuals with disabilities, and those with mental and physical health problems all can grapple with loneliness and isolation.

The surgeon general has also expressed concerns about the mental health of healthcare workers. A year ago, Murthy issued an advisory on burnout among health workers.

Murthy’s new report includes a host of recommendations to improve social connections, and he describes loneliness as a public health issue. His advisory includes suggestions for healthcare providers and public health agencies, along with recommendations for all sectors.

Providers

Health systems and healthcare workers need to acknowledge that social connection is a priority for health.

Systems must provide health professionals with training and continuing education on health risks of social isolation, including training on prevention and interventions.

Integrate social connection into patient care by assessing patients for risk of isolation or loneliness, educate patients about the benefits of social connection, and utilize interventions to help patients, such as involving family or utilizing group therapy options.

Electronic health records should include information on assessments for social isolation.

Partner with community organizations to offer support for people who are dealing with loneliness and isolation.

Providers and insurers can educate patients on the risks of social isolation. The report also urges insurers to provide adequate reimbursement to providers for assessing and addressing loneliness and a lack of social connection.

Public health

Public health agencies should view social connection as a social determinant of health, and view it as a primary health indicator. They should view social connection as a way to improve well-being.

Launch public education campaigns focused on the health risks of loneliness and isolation, and promote social connection as a primary element of wellness programs, including those focused on suicide, substance use and burnout at the workplace.

Develop sustainable programs to promote social connection and prevent isolation.

• Read more: Surgeon General urges health leaders to tackle gun violence

Six pillars

Murthy outlined six pillars to improve social connection among Americans. They are:

Strengthen social infrastructure in communities: Establish programs to connect communities and invest in local institutions that bring people together.

Enact policies to promote connection: Federal, state and local government should adopt a “Connection-in-all-policies” approach, recognizing all sectors of society are relevant to social connection.

Mobilize the health sector: View connection as a key factor in health and develop policies to address loneliness, including partnering with community organizations.

Reform digital environments: Support pro-connection technologies, establish safety standards and require more data transparency from technology companies.

Deepen knowledge: Invest more in research on social connection and increase public awareness.

Cultivate a “culture of connection”: Expand conversations on social connection in communities, workplaces, and schools, and leaders should model the values of connection.