More people are struggling with loneliness than diabetes, US surgeon general says
The link between loneliness and public health may not be readily apparent to many, but it is to U.S. Surgeon General Vivek Murthy, who visited his Miami hometown Friday with a broad agenda—meeting with health care workers about pandemic-related burnout, speaking with LGBTQ students about mental health concerns, and preparing to deliver the commencement address to graduating students of Miami Dade College on Saturday.
Murthy, a 1994 graduate of Miami Palmetto Senior High School, said in his roles as a private physician and the country's top doctor he had come to realize, through conversations with patients and everyday Americans, that loneliness and isolation are pervasive among kids, young parents and others whose lives appear to be filled with the presence of others.
"That opened up my mind to the fact that this is a broader crisis," Murthy said in a meeting with the Miami Herald's editorial board at Miami Dade College Medical Campus. "As I dug into the research and the data on it, I came to realize that we have more people who struggle with loneliness in our country than have diabetes."
Murthy, 44, said research has shown that loneliness is associated with an increased risk of both physical and mental health illnesses, from anxiety and depression to premature death, dementia and heart disease.
"Yet we don't really think of it as a public health concern," he said. "We think about loneliness as just a bad feeling we've got to figure out or put up with. The reality is it's much more than that. It's a warning signal that's similar to hunger or thirst that tells us when something we need that's critical for our survival is missing, and in this case it's social connection."
In between his time as the 19th and 21st surgeon general of the United States under President Barack Obama and President Joe Biden, Murthy wrote a book called "Together: The Healing Power of Human Connection in a Sometimes Lonely World," which was published in 2021.
Speaking softly and at times sounding more like a spiritual counselor than a doctor, Murthy said social connections and trusted relationships are the bedrock of societies and imperative for public health efforts to succeed.
"We can have the best science. We can have the best policy. We can have the best resources to invest in programs," Murthy said. "But if we don't have a community where people feel connected to one another, where they trust one another, then all of those resources will have limited impact."
As an example, Murthy pointed to COVID-19 vaccines, which have been proven to reduce the severity of the disease, keep infected people out of the hospital and save lives.
"But there's so much misinformation that has flowed throughout society, often on social media platforms, that many people are confused and they don't know who to trust any more. ... This is where the breakdown of relationships and community starts to hurt us," he said.
Murthy's connection to Miami is strong. He grew up in the Pinecrest area, and his father and sister are both practicing physicians in South Florida. Murthy said he and his wife and chlidren spent 18 months of the pandemic in South Florida after coming to visit his grandmother, who was recovering from an injury, on what was supposed to be a five-day trip.
Murthy began his day with a visit to Jackson Memorial Hospital, where he held a roundtable meeting with nurses, doctors and other workers about their experiences working through the pandemic. Murthy said his office was working on "a blueprint" to address health care worker burnout, which he has yet to make public, but that he wanted people to understand the consequences of so many doctors, nurses, therapists and others quitting the profession.
"Now what is starting to happen, as more and more nurses and doctor are dropping out of the workforce, more and more people are finding it harder and harder to get care ... not just for COVID but for routine medical appointments," he said. "That shouldn't be the case."
Murthy acknowledged that burnout in the health care profession is a longstanding problem that preceded the pandemic, and that it's happening against a backdrop of other crises, such as climate change, racism and violence, which taken together have made many question whether the future will be better than the past.
But he emphasized that for the future to appear brighter, building community and connectedness will be as important as addressing the burnout crisis among health care workers or disinformation around vaccines and COVID-19.
"We need to have a conversation as a country about what we build our lives around," Murthy said. "For too long we, and by that I mean me as well, have built our lives around work, and we fit people in where we can, where it's convenient, based on what work dictates. But I think it's actually been hurting us. I think that what we need to do is what we have done frankly for thousands of years from an evolutionary perspective, which is we have built our lives around relationships with people.
"Those relationships were critical to our survival, so we prioritized them," he said. "They're still critical to our survival, but we haven't prioritized them in the same way."
Building trusted relationships and social connections, he said, could also help many people recognize and accept that face masks do not just protect the wearers but also those around them—particularly on airplanes, trains or other public transportation settings where groups of strangers come together and many may not have a choice but to travel due to work or to visit a sick relative.
Murthy said COVID-19 cases and hospitalizations are rising now in many states, including in Florida, and that the decision whether or not to wear a mask is not only an individual choice but an action that can also impact others.
"To me, this is the difference between being 330 million people who are just out there on their own versus being a country, being one community of people who recognize that we have got to look out for one another," he said. "These decisions about masks, they may be up to us at this point, they may be our option, our choice. But my hope is that people will recognize that our choices have consequences for others, and wearing a mask is an effective strategy to reduce spread."
Not everyone may get that message, Murthy said, but he stressed that the recent decision by a Tampa federal judge to strike down the Centers for Disease Control and Prevention's mask mandate for airplanes is "a judicial decision."
"That's not the same as public health guidance," he said, noting that the CDC still recommends that people wear face masks on airplanes at this time.
Despite the deep politicization of the pandemic and face masks, Murthy said he still sees an opportunity for the nation to get stronger. But that will require reflection, he said, and investment in mental health services, and building social connection and community.
"If we do that," he said, "I actually feel optimistic that we can come out of the pandemic even stronger than before it began."
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