"Medicine and technology may fail us at times, but human connection grounded in love and compassion always heals."
Those words from the 21st and current U.S. Surgeon General Dr. Vivek Murthy resonate with many of us in the medical community who increasingly encounter individuals suffering from the damaging effects of loneliness. Almost half of adults reported experiencing feelings of loneliness, and that was before COVID-19 exacerbated our sense of disconnection.
But it's the end of the quote—"always heals"—that is most prescient to me, as a lifestyle medicine expert, coach, and educator. There are many complex factors driving loneliness, but it is clear that positive social connections do in fact "heal," and in ways far beyond simply reducing feelings of estrangement. These connections can work wonders on our physical and mental health, even prolong our lifespans.
The surgeon general's 2023 advisory on the epidemic of loneliness compared the health consequences to those of smoking cigarettes. A lack of positive social connection puts individuals at 29 percent higher risk of heart disease, 32 percent higher risk of stroke, and 50 percent increased risk of dementia. Lack of good social connections increase the risk of premature death by an astounding 60 percent, the advisory stated. Social support can even help people maintain a healthy body mass and control blood sugars.
Simply put, we long to belong. From our births, when the so-called bonding hormone oxytocin creates our first social bond with a parent, we depend on connections for survival. But if the evidence shows that social connections are a human need vital to our health, why are they so rarely incorporated into health care? How often does your social support system come up during a rushed 15-minute office visit so common in primary care today? I suspect not often, if ever.
A rapidly growing number of clinicians certified to practice lifestyle medicine recognize that it should come up often. Lifestyle medicine is the application of evidence-based, whole-person, prescriptive lifestyle changes focused on six pillars: optimal nutrition, physical activity, restorative sleep, stress management, positive social connections, and avoidance of risky substances. While every individual's treatment should be personalized to the unique aspects of their life, these pillars are interconnected, with social connections receiving attention just as nutrition does.
Here are several actions—simple, modest, and deep—you can take to improve your social connections and support your health.
Simple
Even short, positive interactions may positively impact our health. When shopping, make a point to smile at someone passing. Ask a sales associate how they are doing, and look the worker at the cash register in the eye and say, "thank you." Ask a work colleague about a pin or piece of jewelry they're wearing, or about a detail in their Zoom background. Take a walk and ask someone their dog's name, and if it's friendly, if you can pet them. Ask someone what the slogan on their T-shirt means. Simple and easy opportunities to engage abound in our everyday routines when we keep an eye out for them.
Modest
Examples of modest social connections are participation in an event or activity comprised of people with similar interests. Community and senior centers often host a wide range of activities with opportunities for social connection, such as pottery, woodworking, dancing, scrapbooking or painting classes. Social media platforms like Facebook are a good resource to find private groups for people interested in walking, birdwatching, or cars. Libraries often host book signings and lectures that encourage engagement. To connect with people with similar passions, volunteer at a food bank or other nonprofit organization. Call a friend or relative you have not spoken to in a while. Any of the above have the ability to increase your sense of belonging.
Deep
Our deepest social connections are provided by those closest to us. It can be helpful to intentionally cultivate these relationships because they provide the greatest social support. Asking open-ended questions that invite engaging interactions is helpful in building deep relationships. "What is the best thing going on in your world?" or "If you could change one thing in your daily routine, what would it be?" are conversations starters. Most people reciprocate these questions, so put some thought into your own answers. Write a note to someone you love and express the reasons why. Deep social connections can involve direct, even difficult, conversations. Be mindful of the right time and space for those discussions and frame that as opportunities to learn together, not blame one another.
There may be no quick fixes to an overwhelming state of loneliness. But by taking steps now to start to build a foundation for strong positive social connections in our future, we can make ourselves and our country as a whole healthier.
Beth Frates, MD, is a faculty member of Harvard Medical School and president of the American College of Lifestyle Medicine.
The views expressed in this article are the writer's own.
Uncommon Knowledge
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