Amrit Kahlon, M.D., Adil Khan, M.D., Steven Lippmann, M.D.                                                                                                                                                          

Social connection is as crucial to humans as water, food, and shelter. We have evolved to depend on each other for survival. Hillary Clinton once noted that child raising is best done by a group effort. Our emotions require contact and being isolated worsens life’s challenges. Even with modern conveniences, we still have a biological need for connection. Our relationships impact our health, well-being, and safety.

On May 23, 2023, Surgeon General Dr. Vivek Murthy warned about a public health crisis: loneliness due to isolation. Loneliness predated COVID-19, and became much worse during the pandemic, affecting people’s emotional, physical, and social health. Loneliness impacts mental well-being as well as increasing premature death rates from physical illnesses. He suggested that the risk is similar to the danger of smoking 15 cigarettes daily.             

Loneliness is a personal condition, causing distress due to unfulfilled social needs. Lack of human connection includes too few community relationships, societal roles, social interactions, and also diminished self-esteem.

Loneliness raises the rate of premature death, stroke, and heart disease by nearly one-third. Patients with congestive heart failure comorbid with isolation exhibit more hospitalizations, medical emergency contacts, and outpatient clinic appointments. Mortality greatly increases and compares to that of obesity, hypertension, hypercholesterolemia, smoking, and/or alcohol abuse. Developing type 2 diabetes and its complications have also escalated.

Mental health also is compromised with a greater rate of becoming anxious, depressed, and/or demented. Suicide rates, already at dangerous levels are rising. It is a strong, reliable promoter of suicidal thoughts, suicide attempts, and fatal outcomes. The same applies to substance abuse; interpersonal connection is the strongest protection against addictions. Viral and respiratory illness vulnerabilities are also heightened. Antibody response to COVID-19 vaccines is also attenuated.

Isolation with loneliness affects people of all ages or backgrounds. It is more common among older individuals; yet, young adults recently are more likely to experience loneliness, with prevalence having risen every year from 1976 to 2019. The internet, smartphones, social media, and “screen time” have diminished socialization. Since the pandemic, the same applies to remote work, less classroom attendance, virtual meetings, artificial intelligence, etc. These technologies have replaced face-to-face interactions and damaged well-being.

Based on these findings, society and physicians need to address this issue. The separations spawned during the pandemic are better done through physical distancing rather than social distancing. Improving interpersonal connection is the goal. We need more togetherness.