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Social Isolation Epidemic Must Be Confronted Head-On
We have known for some time that social isolation has very deleterious effects on both our mental and physical well-being. In fact, the adverse health effects of being socially isolated are sometimes seen as equivalent to those of smoking almost a pack of cigarettes a day. That is why the Grand Challenges for Social Work national initiative included eradicating social isolation as one of the 12 fundamental challenges we are facing in American society today.
Just 2 weeks ago, US Surgeon General, Vivek Murthy, MD, issued an advisory on the epidemic of loneliness and isolation. The feeling of loneliness is a primary psychological effect of being socially isolated. The surgeon general noted that, prior to COVID-19, about 1 in 2 adult Americans reported experiencing loneliness. COVID-19 undoubtedly has increased this number dramatically.
Dr Murthy went on to add: “Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health. Our relationships are a source of healing and well-being hiding in plain sight—one that can help us live healthier, more fulfilled, and more productive lives. … Given the significant health consequences of loneliness and isolation, we must prioritize building social connection the same way we have prioritized other critical public health issues such as tobacco, obesity, and substance use disorders. Together, we can build a country that’s healthier, more resilient, less lonely, and more connected.”
Recently, we have learned that teens are even more likely to suffer the effects of loneliness than adults. This is because teens today frequently are engaged in social media for many hours each day rather than in actual interpersonal interaction, as well as the fact that teens experience loneliness more intensely than adults due to their developing brains.
Good social connectedness with family, friends, and colleagues is essential for healthy development and for wellbeing as an adult. Our self-concept develops through interaction with others, and our self-esteem depends on how others respond to us. Lack of such important connections is a very potent negative social determinant that can lead to loneliness, trauma, and serious behavioral health conditions. In fact, the process of recovery from behavioral health conditions essentially involves regaining one’s voice and connections with one’s social support network.
One experiences loneliness when these essential positive social connections are not present. One who is lonely lacks needed interactions with family and friends to share recent experiences, confide problems and successes, seek advice, or just receive personal affirmation and support. If one also currently has or develops a behavioral health condition, then one also will be more likely to call a crisis line for social support or to seek such support from a behavioral health provider or peer.
The behavioral health conditions most likely to be associated with social isolation and loneliness are depression, anxiety, and substance use. For example, people who are lonely are 3 times as likely to experience depression as those who are not lonely. This can even include suicide attempts. Similarly, the health consequences of social isolation and loneliness are also pervasive: Those with these social deficits are much more likely to die prematurely, irrespective of cause.
To address this public health crisis, the surgeon general has proposed a National Strategy to Advance Social Connection. This strategy has 6 foundational pillars:
- Strengthen Social Infrastructure. Communities must design environments that promote connection, develop community connection programs, and invest in institutions that bring people together.
- Enact Pro-Connection Public Policies. All levels of government can play a role in establishing policies like accessible public transportation or paid family leave that can support and enable more connection among community or family members.
- Mobilize the Health Sector. Healthcare providers can assess patients for risk of loneliness and intervene.
- Reform Digital Environments. We must critically evaluate our relationship with technology and ensure that it does not detract from meaningful and healing connection with others.
- Deepen Our Knowledge. We must develop a more robust research agenda to further our understanding of the causes and consequences of social disconnection, populations at risk, and the effectiveness of efforts to boost connection.
- Cultivate a Culture of Connection. Our norms and culture of how we engage one another significantly influence the relationships we have in our lives. We must promote a culture that values connection.
I think that we have known intuitively for some time that our communities have not been functioning very well. These deficits, combined with information technology that promotes isolation and the centrifugal social effects of COVID-19, have led us to a public health crisis of loneliness and lack of social connection. Collectively, we must do better. individually, we can start today on our own social network.
Ron Manderscheid, PhD, is the former president and CEO of NACBHDD and NARMH, as well as an adjunct professor at the Johns Hopkins Bloomberg School of Public Health and the USC School of Social Work.
The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.
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