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Why the Former Surgeon General Worries About Loneliness and Older Adults

A conversation with the author of the new book, 'Together'


While traveling across America during the final two years of the Obama administration, Surgeon General Dr. Vivek Murthy discovered many people were experiencing something he struggled with as a child: loneliness.

Murthy became concerned that loneliness and social isolation run deep in our country, especially among older adults (although not all older adults feel lonely or socially isolated, of course).  A study from the University of California/San Francisco found that 43% of adults over 65 feel lonely, which can put them at a greater risk for poor health.

Murthy has a new book on the subject, Together: The Healing Power of Human Connection in a Sometimes Lonely World, which was written before the pandemic. But the current stay-at-home orders only make his observations that much more timely.

I just interviewed Murthy about loneliness and isolation of older adults and how the coronavirus has affected this. Highlights:

Next Avenue: You never brought up loneliness or social isolation as a public health issue during your confirmation hearings. So how did it emerge as a signature issue during your time as Surgeon General?

I began my tenure with a listening tour of big cities and small towns all across America. And what I kept hearing again and again were threads of loneliness in the stories that people would tell me. The stories were often about substance-use disorders, about suicide and depression, violence in communities, about diseases like diabetes and heart disease and obesity. Behind so many of these stories were themes of loneliness.

I worry that we don’t sufficiently value the wisdom and the experience that comes with age.

I would hear people say, ‘I feel like I have to deal with all of these problems by myself’ or ‘I feel if I disappeared tomorrow, no one would even notice or I feel invisible.’ And hearing that again and again. I started to realize that there was something much broader and deeper happening in America.

I remember even sitting with members of Congress individually who would tell me behind closed doors and in hushed tones that loneliness was a problem for them.

In a recent Next Avenue opinion piece, thought leaders Marc Freedman and John Gomperts described older people as the “canaries in the loneliness coal mine” who are most at risk for poor health. What makes them so vulnerable?  

As people get older, sometimes they can experience more chronic illness. And as they limit one’s mobility, that can make it harder to go out and engage more broadly in society.

The second factor: As we get older, many people experience difficulty hearing and they may also have trouble with their vision. And that can also limit the extent to which they proactively socialize with others.

There’s a third factor as well: Our modern society really values youth. And I worry that we don’t sufficiently value the wisdom and the experience that comes with age.

As a result, I think as they get older, people often feel like they’re less useful in society. So, I think that has contributed to a sense of isolation.

The pandemic has prompted some doctors to come out of retirement and head to the front lines in the hospitals. It’s perhaps the most visible example of older people being valued for their experience. How can we do a better job of encouraging older Americans to use their accumulated skills and wisdom to help society? 

Good question. When you reach out and serve others, that can be a very powerful antidote to loneliness. What happens when we serve other people is that we shift the focus from ourselves to someone else.

"Together" by Vivek H. Murthy, MD

Society needs the older generation to help nurture children, to provide wisdom when society makes big decisions around threats — whether it’s national security or health or climate change. And often the perspective and support of somebody who has been there before can be incredibly valuable.

I think about volunteer programs like the [AARP] Experience Corps, which places older Americans into classrooms. We need more intergenerational learning and support. And it can be good for both kids and the adults.

Now studies are showing the connection between loneliness and poor health, is it time for medical schools to train doctors in spotting patients suffering from loneliness or social isolation?

I do think it’s important for doctors to try to learn how to assess loneliness in their patients as well as how to address it. But I don’t think it should be the responsibility of the health care system alone.

It’s important for us to make social connection a clear priority in government.

I do think that doctors and nurses can, and must, be partners and identify and address the loneliness. But that only can happen if they are trained to think about it, even have permission to raise it and address it with their patients.

The truth is that many doctors themselves struggle with loneliness at some point in their lives.

One of the most important medicines we have is the ability to listen with an open heart, simply acknowledging the challenge of loneliness and giving someone the opportunity to talk about it without judgment. It can be a very, powerful thing to do and a valuable service to render to a patient.

Several years ago, the UK appointed a Minister of Loneliness. For some, it might sound a little touchy feely, but I gather you’re an advocate of creating a similar cabinet-level position in the United States. Why?

It’s important for us to make social connection a clear priority in government, because it can inform how we design policy, inform what we discover in research. It can help us set goals about what direction we want to move in and target what we want to accomplish.

I can’t think of a more important time for us to have real conversations with each other than at a such a polarized time like this, when we are so divided by the issues.

If the next president is able to nominate the first Secretary of Loneliness, is that something you’d be interested in?  

Nobody asked me that question before. Yes, I’d consider it.

Richard Harris
By Richard Harris
Richard Harris is a freelance writer, consultant to the nonprofit iCivics and former senior producer of ABC News NIGHTLINE with Ted Koppel. Follow him on Twitter @redsox54.

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