U.S. Surgeon General Cautions Against “Epidemic of Loneliness”

Loneliness has serious health consequences. Learn how it can affect your heart, brain, and risk for chronic disease.

lonely young man staring out at city at sunset

Updated on May 2, 2023.

In recent years, about one-in-two U.S. adults reports feeling lonely. The trend started even before the COVID pandemic cut people off from their loved ones, co-workers, and other support systems. The pandemic only worsened an existing problem with bona fide health consequences. Acknowledging the pervasive and dangerous trend, U.S. Surgeon General Vivek H. Murthy, MD, MBA, released an advisory warning Americans about the “epidemic of loneliness and isolation” across the country.

“Loneliness is far more than just a bad feeling—it harms both individual and societal health,” said Dr. Murthy in a May 2 statement, noting it’s tied to a higher risk for heart disease, dementia, stroke, depression, anxiety, and early death. In fact, Murthy says being socially disconnected is about as bad for your health as smoking up to 15 cigarettes per day—and even worse than the health risks linked to obesity and inactivity.

The Surgeon General is urging Americans to build more connected lives and a more connected society. “If we fail to do so, we will pay an ever-increasing price in the form of our individual and collective health and well-being,” he cautions. “And we will continue to splinter and divide until we can no longer stand as a community or a country. Instead of coming together to take on the great challenges before us, we will further retreat to our corners—angry, sick, and alone.”

What it means to be alone

To clarify, there are different kinds of being alone. Some people are objectively socially isolated, in contact with few or no others. They may be alone by circumstance, or simply prefer to remain solitary. Being alone is not the same as being lonely.

Some people feel lonely no matter where they find themselves—even in a crowded room.

“Loneliness is a subjective experience; you might feel cut off from people even though you’re surrounded by them,” says Stephen Pinals, MD, a geriatric psychiatrist and Chairman of Psychiatry with Saint Joseph Mercy Health System. “That’s different from objective social isolation,” he adds. Social isolation can contribute to loneliness but may not necessarily cause it.

Either way, both loneliness and social isolation can take a toll on your mental and physical well-being. Eventually, even the most introverted among us may experience health complications such as stress, heart disease, dementia, and more.

How loneliness affects health

"Humans are highly social mammals. We wouldn’t have survived without our evolving social function,” says Dr. Pinals. “We know that loneliness reduces survival.”

He notes that people who are lonely may have:

  • A less effective immune system
  • Higher risk of coronary artery disease
  • Higher risk of stroke
  • Higher risk of hypertension
  • Higher risk of dementia
  • More stress hormones

These health issues can contribute to an increased risk of early mortality. A 2020 report from the National Academies of Sciences, Engineering, and Medicine found that social isolation in adults aged 50 and older increased the risk of early death, comparing its effects to that of smoking, obesity, and a lack of physical activity. Loneliness was linked to higher risks of heart attack and stroke, as well as higher rates of depression, anxiety, and suicide.

At particular risk are older adults. More than a quarter of Americans ages 65 or older—or 14.7 million out of 54.1 million people—live alone, according to the Administration for Community Living. That figure jumps to 42 percent for women aged 75 and older.

Seniors who live alone tend to become lonely more than those who live with others. Why? “Older adults are less mobile,” says Pinals, “and they may not have as much contact with family and friends.” Often, people become isolated or lonely because they’re chronically ill, have limited mobility, or a low income.

Loneliness is associated with poorer health for a number of reasons:

  • People who are lonely generally have more unhealthy habits, such as smoking and alcohol use.
  • They may not eat a well-rounded diet or get enough physical activity.
  • Loneliness interferes with a good night’s sleep, which can compromise your immune system and put you at risk for heart disease, obesity, and diabetes.
  • Loneliness is a major stressor, a significant contributor to poor physical health.
  • Depression and loneliness often feed into one another.

Easing loneliness and feeling more connected

Though mental health plays a large role, loneliness is a combination of perspective and circumstance. “Individuals who are socially isolated often choose that lifestyle and resist getting out and being social,” says Pinals.

Whether people choose to isolate themselves or their social networks are limited, it’s important to go out and interact with others. The internet may be able to help; multiple studies and reviews have suggested that going online can decrease loneliness in older adults.

Other ways that you can feel more socially connected and ease the effects of loneliness:

Practice self-care. Take steps to help ensure that you get regular physical activity and eat a healthy diet that emphasizes fruits, vegetables, whole grains, and lean protein. It’s also important to sleep at least seven hours each night and engage in activities that you enjoy. Each of these lifestyle adjustments will help manage your stress level and protect your health.

Volunteer for a cause that matters to you. Connecting with a group in this way can not only help you feel less lonely but also give you a sense of purpose, which is tied to better health.

Find activities that give you joy. Learn a new skill, pick up an old hobby you once enjoyed, or sign up for a class. This can help you meet people who share common interests.

Schedule time for connection. Busy days can turn into hectic weeks or months, but relationships should be nurtured—not neglected. It’s important to carve out the time to stay in touch with your family, friends, or neighbors. Reach out routinely by calling, texting, e-mailing, or meeting in person.

Find a furry friend. Pets have been shown to provide comfort, help ease stress, and lower blood pressure. A four-legged companion may not only be good company but also a reason to get outside and walk or meet up with other pet owners.

Pinals recommends real human contact as an antidote to loneliness. “Whether it’s going to church, the senior center or walking around the shopping mall, try to just be outside and away from home," he says. "Those who choose to stay in are at higher risk for all those poor outcomes.”

Article sources open article sources

U.S. Department of Health and Human Services. Our Epidemic of Loneliness and Isolation. May 2, 2023.
NIH/National Institute on Aging. Loneliness and Social Isolation — Tips for Staying Connected. January 14, 2021. Accessed May 10, 2022.
McMaster University. Understanding loneliness and social isolation. July 31, 2018. Accessed May 10, 2022.
American Psychological Association. The risks of social isolation. May 2019. Accessed May 10, 2022.
Cole SW, Capitanio JP, et al. Myeloid differentiation architecture of leukocyte transcriptome dynamics in perceived social isolation. PNAS. November 23, 2015. 112 (49) 15142-15147.
Angus Chen. Loneliness May Warp Our Genes, And Our Immune Systems. NPR.org. November 29, 2015.
Valtorta NK, Kanaan M, et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart. 2016;102:1009-1016.
Hawkley LC, Thisted RA, Masi, et al. Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and Aging. 2010. 25(1), 132–141.
Jaremka LM, Fagundes CP, et al. Loneliness promotes inflammation during acute stress. Psychological Science. 2013 Jul 1;24(7):1089-97.
Doane LD & Adam EK. Loneliness and cortisol: momentary, day-to-day, and trait associations. Psychoneuroendocrinology. 2010. 35(3), 430–441.
Zhou Z, Wang P, Fang Y. Loneliness and the risk of dementia among older Chinese adults: gender differences. Aging and Mental Health. 2018 Apr;22(4):519-525. 
Holt-Lunstad J, Smith TB, et al. Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science. 2015;10(2):227-237.
Ong AD, Uchino BN, Wethington E. Loneliness and Health in Older Adults: A Mini-Review and Synthesis. Gerontology. 2016;62:443–449.
Cotten SR, Anderson WA, & McCullough BM. Impact of internet use on loneliness and contact with others among older adults: cross-sectional analysis. Journal of Medical Internet Research. February 2013. 15(2), e39.
Centers for Disease Control and Prevention. Loneliness and Social Isolation Linked to Serious Health Conditions. April 29, 2021. Accessed May 210, 2022.
National Academies of Sciences, Engineering, and Medicine. 2020. Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. Washington, DC: The National Academies Press.
Administration for Community Living (HHS). 2020 Profile of Older Americans. May 2021. Accessed May 10, 2022.
Chen YR, Schulz PJ. The Effect of Information Communication Technology Interventions on Reducing Social Isolation in the Elderly: A Systematic Review. Journal of Medical Internet Research. 2016 Jan 28;18(1):e18.
Todd E, Bidstrup B, Mutch A. Using information and communication technology learnings to alleviate social isolation for older people during periods of mandated isolation: A review. Australian Journal on Ageing. 2022 Feb 9.
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