Our Epidemic of Loneliness and Social Isolation is a 2023 advisory report by U.S. Surgeon General Vivek Murthy. It highlights the widespread issue of loneliness and social isolation in the U.S. and its severe health consequences. 

Scope of the Problem

The report highlights that loneliness and social isolation have become widespread in the U.S., affecting millions of people across all demographics.

• About one in two adults reports experiencing loneliness. Social isolation has increased due to shifts in how people interact, including greater reliance on technology and remote work.
• Young adults, older adults, and marginalized communities are particularly vulnerable.

Causes and Contributing Factors

• Decline in community participation (e.g., fewer people engaging in religious or civic groups).  
• Remote work and digital communication reducing in-person interactions. 
• Changes in family structures leading to fewer social connections.  
• COVID-19 has had a substantial impact.
• Americans spend less time with friends and family than in previous decades.

Health Impacts

The report emphasizes that loneliness and social isolation are not just emotional struggles—they have serious consequences for physical and mental health, comparable to other well-known public health risks.

• Chronic loneliness increases the risk of heart disease, stroke, dementia, depression, and anxiety.
• The health impact of lacking social connection is comparable to smoking 15 cigarettes per day.
• Social isolation raises the risk of premature death by 26-29%.

Solutions and Recommendations

The report outlines a six-pillar strategy to rebuild social connections and address the loneliness crisis:  

  1. Strengthen Social Infrastructure

• Invest in public spaces, community centers, and social programs that encourage connection.

  2. Promote Pro-Social Public Policies

• Encourage workplace policies that support social well-being. Integrate social connection efforts into healthcare systems, such as screenings for loneliness.  

  3. Reduce Harmful Aspects of Technology

• Develop healthy digital habits.

  4. Deepen Community Engagement 

• Increase participation in local organizations, religious groups, and volunteer work**.  

  5. Equip the Public with Social Skills

• Teach social connection skills in schools and workplaces. Educate people about the importance of maintaining relationships for their well-being.  

  6. Make Social Connection a Public Health Priority

• Recognize loneliness as a public health crisis and fund research and initiatives. 

Quotes from the Study

Social connection is a fundamental human need, as essential to survival as food, water, and shelter. (9)

Despite current advancements that now allow us to live without engaging with others (e.g., food delivery, automation, remote entertainment), our biological need to connect remains. (9)

The lack of social connection poses a significant risk for individual health and longevity. Loneliness and social isolation increase the risk for premature death by 26% and 29% respectively. More broadly, lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day.* In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke. Furthermore, it is associated with increased risk for anxiety, depression, and dementia. Additionally, the lack of social connection may increase susceptibility to viruses and respiratory illness. (8)

Social connection is a significant predictor of longevity and better physical, cognitive, and mental health, while social isolation and loneliness are significant predictors of premature death and poor health. (23)

Substantial evidence also links social isolation and loneliness with accelerated cognitive decline and an increased risk of dementia in older adults, 10.41 including Alzheimer’s disease 63 Chronic loneliness and social isolation can increase the risk of developing dementia by approximately 50% in older adults, even after controlling for demographics and health status.41 A study that followed older adults over 12 years found that cognitive abilities declined 20% faster among those who reported loneliness. (28)

Evidence shows that being objectively isolated, or even the perception of isolation, can increase inflammation to the same degree as physical inactivity. (32)

Increased levels of social connection can improve various biomarkers of cardiovascular functioning, including blood pressure, cardiovascular reactivity, and oxidative stress. (32)

Loneliness… is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day. (4)

Photo by Toa Heftiba