Former surgeon general Dr. Vivek Murthy says that underlying many of the most critical public health issues facing America today is an epidemic of loneliness. NPR’s Michel Martin speaks with Dr. Murthy about what that means, and what he thinks should be done about it.

MICHEL MARTIN, HOST:

Let’s talk about health and well-being for a few minutes. Often, when we talk about the issues that most concern the leading figures charged with addressing the nation’s health, we think about excess weight or smoking or violence. But the former surgeon general, Dr. Vivek Murthy, would like to add something else to that list – loneliness. That’s a subject of a new cover story in The Harvard Business Review. Some 40 percent of American adults say they feel lonely. And a rising number of people say they have no close confidant in their lives.

That’s one reason why Dr. Murthy argues that America is in the midst of a loneliness epidemic. And the consequences of that, he says, are significant enough that businesses, managers and workers should rethink the way they work to think about how to foster more meaningful relationships with colleagues, with whom many people spend more time than with family. To hear more about that, we’re joined now by Dr. Vivek Murthy in our studios in Washington, D.C. Dr. Murthy, thanks so much for speaking with us.

VIVEK MURTHY: Thank you for having me.

MARTIN: So I would imagine that a lot of people wouldn’t think about loneliness as a public health issue. So first of all, tell us why you think it is a public health issue, and then help us understand how you got to thinking that yourself.

MURTHY: Well, years ago, I wouldn’t have thought about loneliness as a public health issue either. But two big things happened in my life that changed that. Number one, I began practicing medicine and seeing patients and quickly realized that the greatest pathology that I saw was not heart disease or diabetes. It was, in fact, loneliness, and it was impacting the ability of my patients to live healthy and fulfilling lives.

But the second thing that happened is, when I began my tenure as surgeon general, I visited communities all across the country – big and small. And what I heard everywhere I went was that people were, in fact, struggling with loneliness. They used different words to describe that feeling and that experience, but the experience was often the same. Some people were struggling with loneliness in the face of illness.

You know, I met moms and dads, for example, who had lost children to drug overdoses and felt profoundly alone in part because of this terrible stigma that surrounds addiction. But even people who weren’t struggling with illness often felt that they were on their own. And this is quite striking despite the boom that we’ve had in technology, especially social technology.

So these two experiences really led me to see that loneliness is not only a profound problem. But when you look at the literature and you understand the science, there are powerful impacts that loneliness can have on our health. And that’s why I began to look at it as an important public health issue that we need to address.

MARTIN: Well, in fact, you used the language of health – like you said, it’s a pathology. I mean, I think when people think of an illness, they think of something that is something physical that has specific symptoms. I mean, does loneliness have those things?

MURTHY: When you look at the data, you find that loneliness is associated with shorter lifespan. And, in fact, the reduction in lifespan from loneliness is similar to the reduction associated with smoking, and it’s, in fact, greater than the impact of obesity. But if you delve even deeper, you see that there’s an association between loneliness and cardiovascular disease, dementia, anxiety and depression. And if you look at even more deeper at the physiology, it’s not too difficult to understand how this may, in fact, come about because loneliness, in fact, creates a stress state in our body.

As human beings, we evolved to be social creatures, and there was a very practical reason for that because, in ancient times, if we had other people that we were connected to, we had a stronger guarantee of a stable food supply. We also had a greater chance of being protected from predators at night. We could all take turns keeping watch around the fire instead of having one person stay up the entire night. And over hundreds and thousands of years, that need for social connection became baked into our nervous system. And so if we are in a lonely state, it actually places us in a state of stress, and chronic stress is associated with increases in cortisol, increases the inflammation in the body, which can damage tissues and ultimately increase our risk of heart disease, obesity and a number of other illnesses.

MARTIN: Why do you say that the work environment needs to address this? Why is that a business problem or work problem?

MURTHY: Well, the truth is that all of us have to think about how we can address the loneliness epidemic across all sectors. But in particular, we need to look at where people spend the bulk of their time, and people are spending the bulk of their time with families, in the workplace, in schools, in social organizations like faith-based organizations. And for many people, spend at least eight hours a day at work. Many spend many more than eight hours a day at work. And for this reason, the impact that the workplace has on our social connections becomes very, very important.

Now, one might think, OK, well, it’s not the job of an employer to really think about whether your employees are lonely or not. There are a couple of reasons you might be interested in doing that. Number one, you recognize that loneliness has an impact on your health. Then, you know that employees who are not healthy can contribute less to the actual business and to the bottom line. The second reason, though, is loneliness is not a phenomenon that occurs in isolation.

But in many ways, loneliness has network effects. When individuals are lonely, they can impact whether people around them feel lonely as well. And so that is, in part, why I think of it as an epidemic. But if you’re an employer, you want to make sure that people in your workplace are feeling connected, so that they can be happier, more productive, healthier and have reduced health care costs and, ultimately, so you have a community that’s thriving instead of a community that’s groaning under the yoke of stress.

MARTIN: That’s Dr. Vivek Murthy. He was the 19th surgeon general of the United States. He was appointed by former President Obama. And he was kind enough to join us in our studios in Washington, D.C. Dr. Murthy, thanks so much for speaking with us.

MURTHY: Thank you for having me.

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