How to solve America’s loneliness crisis

Social isolation and loneliness have the same effect on human health as smoking 15 cigarettes a day, i.e. they can shorten life span by up to 15 years. Getty Images

A National Health Advisory issued by United States Surgeon General Vivek Murthy on May 3, 2023, sheds light on the pressing public health problems of loneliness and isolation.

The report reflects Dr. Murthy’s personal and professional experience with the detrimental health effects of loneliness. As surprising as it may seem, social isolation and loneliness have the same effect on human health as smoking 15 cigarettes a day, i.e. they can shorten life span by up to 15 years.

I am a leader in academic and clinical medicine and have served as COVID-19 czar for the state of West Virginia, so I have experience thinking about public health emergencies and how to resolve them.

Let’s look at the problem first and then look at some solutions and what the nation would gain by implementing them.

Define the problem

Loneliness and social isolation are widespread. A 2021 survey by Cigna shows that nearly 1 in 6 Americans reported feeling lonely or isolated. This means that these conditions likely affect you or someone you know.

In the same survey, young adults were nearly twice as likely as those over the age of 65 to report feeling lonely or isolated. Additionally, 75% of Hispanics and 68% of Black or African Americans reported these conditions, as did a majority of low-income and single-parent respondents.

While there are no definitive explanations for these high numbers, experts have suggested several possible drivers: population mobility, the shift from in-person work and learning to remote work and learning since the start of the pandemic, and the profound divisions in society caused by irresponsible social media and news sites. To get viewers’ attention, some advertisers and media leaders understand that humans are biased towards messages that activate fear and loss. In fact, the scientific term aversion bias demonstrates that people are twice as afraid of loss as they are of happiness at gain.

When we feel socially isolated and alone, our vigilance for threat activates our basic survival instincts, which are rooted in evolutionary times. For early humans, being accepted and belonging to a group or community were key factors for survival. Being separated or driven out of one’s tribe meant almost certain death.

Thriving relationships have become central to human feelings of security and well-being. In fact, longevity studies consistently find that the strength of one’s lifelong relationships is the single most important driver of a long, healthy life.

Stress and loneliness are connected

The human nervous system is balanced in two modes: the fight or flight of the sympathetic system and the rest and digest of the parasympathetic system.

Loneliness and isolation drive unbalanced activation of the sympathetic nervous system, leading to hypervigilance or scanning of the environment for threats. Once this threat response is activated, people view their environment as unsafe, leading to the release of hormones that interfere with our responses of trust and pleasure. As this stress response increases, people experience surges in hormones that increase heart rate and blood pressure.

Over time, the release of these hormones damages our blood vessels, heart, brain, blood and liver, and our metabolic and musculoskeletal systems. Much like a car engine that is continually revved, our body’s systems begin to break down and our perceived experience of pain is heightened.

Feelings of worthlessness and fear increase the risk of substance use, mental health problems, a variety of chronic diseases and obesity which can contribute to shortened lifespan.

In other words, loneliness and isolation drive disease and shorten lifespan through deranged activation of the sympathetic nervous system induced by threat perception and chronic stress.

Of course, stress can also lead people to isolate themselves, so the effects go both ways.

Find relief

A primary solution to loneliness and social isolation is meaningful social connection.

Social connections increase our perceptions of psychological and physical safety, value, and worth, and enhance feelings of belonging and contribution.

These critical relationships branch out from our families to our friends to form networks of trust and communities. These networks of relationships are called social capital.

Princeton University economists Anne Case and Angus Deaton speculate that the reduction in social capital and hope resulting from job losses in the Appalachian and Ohio River Valley from 1999 to 2013 was a key cause of overdose deaths, suicide and liver disease in these areas .

So what can be done to address the loneliness epidemic?

In his Framework for a National Strategy to Advance Social Connection, Murthy provides a practical call to action to address the public health issue of social disconnection and to strengthen social connection and community. These strategies include being open to new relationships, reconnecting with distant friends and family, and serving others by volunteering. The framework includes sharable tools and resources for individuals and organizations to invest in community-based social relationships and improve the mental health of their community.

One of the reasons I’m answering this call is that my home state of West Virginia is the only one located entirely in Appalachia.

Appalachia is the central location of deaths of despair, which means that the people who live here are disproportionately affected by the loss of jobs, social capital, purpose and relationships resulting in the experience of loneliness and social isolation.

This may explain why West Virginians have the second lowest life expectancy in the country and some of the poorest health metrics.

But I would argue that West Virginia also has resilient people who care for each other. There is a real goodness and kindness in our people. To better serve our state, staff at the flagship university academic medical center are building more sophisticated and better access to health care. My colleagues in business and government are focusing on reversing loneliness and social isolation through jobs that provide income, social capital, and caring relationships.

Like the COVID-19 pandemic, the pandemic of isolation and loneliness requires us to work together in community to make a positive difference.

Clay Marsh, Chancellor and Executive Dean for Health Sciences, West Virginia University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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