The Surgeon General Should Stop Telling People to Solve the Loneliness Crisis on Their Own

The Surgeon General, in recent comments about ‘Our epidemic of loneliness and isolation,’ gives individual solutions to a systemic problem that requires large-scale policy solutions.

We have all known the long loneliness and we have learned that the only solution is love and that love comes with community. 

Dorothy Day, anarchist and co-founder of the Catholic Worker Movement

I was reminded of Day’s words when I came across a recent tweet about loneliness by Surgeon General Vivek Murthy. Murthy tweeted:

NEW: Today, I released a Surgeon General’s Advisory on the epidemic of loneliness and isolation facing our country, the destructive impacts it has on our collective health, and the extraordinary healing power of our relationships. 

The tweet included a two-minute video of Murthy explaining why loneliness and social isolation are bad. One in two adults in the U.S. report experiencing loneliness, which can increase our risk of heart disease, stroke, dementia, anxiety, and premature death. Loneliness is even as bad for our health, Murthy tells us, as smoking daily. What can we do about this “widespread disconnection”? Murthy tells us there are “extraordinarily powerful” solutions: phone a friend, invite someone over for a meal, listen and be present when in conversation, and seek out opportunities to serve others.

I think Murthy is right to call attention to the problem of loneliness and isolation. For nearly two decades, I’ve lived in Houston, a large city that is known for its size and flood-prone endless sprawl. About seven years ago, I moved to the suburbs—about 25 miles from the urban core—and ever since then have felt increasingly disconnected not just from cultural things I used to do in the city (volunteering, going to museums, book readings) but from the possibility of making friends and maintaining friendships. Turns out it’s also a nightmare to do political organizing in a huge city because it takes forever to get anywhere, there’s no widespread rapid transit, there are few public places to do things like phone banking (local libraries, I learned, are not to be relied upon because they forbid “political” gatherings in their conference rooms), there are no public restrooms, and so on. Isolation, in my case, stems a lot from spatial problems related to city planning and infrastructure, as well as the privatization of all space, although simply being a working adult outside of a formal educational program (it’s much easier to make friends, I’ve realized, when you’re in a group of people who are working toward a common goal in the same place for years on end) and working from home make isolation even more likely. As just one example, recently, I had intended to go to a local meeting hosted by Workers Strike Back (the new independent group started by Socialist Alternative and socialist Seattle City Council member Kshama Sawant). But by the end of the workday I was too tired to make the dreaded highway commute into town to attend, so I didn’t go.

Murthy’s recommendations make a lot of sense, and I think they are all good suggestions. We have to start somewhere, often in very small moments or connections—such as chatting with a barista when getting a coffee or smiling and making eye contact with someone when crossing them in a hallway or on the street—in order to be more social. But Murthy is focused on individuals instead of systemic causes and solutions to the problem of loneliness. This is what Andrew Goldstein, a primary care physician, pointed out in a tweet about Murthy’s comments:

An important topic, but this report doesn’t get it. … This is a social and culture issue. Not a medical issue. This won’t be fixed by talking about social isolation worsening diabetes. … It’s great our Surgeon General is talking about this, but even “loneliness” and “social connection/disconnection” are such individualized lenses on these topics. This is about community.

Goldstein is right. To me, the Murthy video medicalizes the problem of isolation and makes it sound like “social connection” is a pill you can take to fix it. But also, the idea of “community” is what brought me back to the Day quote. Dorothy Day, whose work I read in medical school upon the recommendation of a Catholic classmate and friend, co-founded the Catholic Worker Movement, which created Catholic Worker Houses (where my friend worked) to serve those who are poor or marginalized. The Catholic Worker community here in town, Casa Juan Diego, says that they offer “hospitality and services for immigrant women, men, and children.” They also have a clinic and food distribution program. So they are meeting people’s basic needs in the community. For Day and others in the movement, working in these settings was not only a way to serve the community but to build community, which was fundamental to a person’s faith. Faith—and one’s practice of works grounded in faith—was a communal, not individual, experience:

Together with the Works of Mercy, feeding, clothing and sheltering our brothers and sisters, we must … “give reason for the faith that is in us.” Otherwise we are scattered members of the Body of Christ, we are not “all members one of another.” Otherwise our religion is an opiate, for ourselves alone, for our comfort or for our individual safety or indifferent custom. We cannot live alone. We cannot go to Heaven alone.

“Community is good” seems obvious, but Day’s words always struck me as rather profound, as I grew up in a Catholic family but always felt that no one in the Church (priests, Sunday catechism teachers) ever talked about the social responsibilities of Catholics or about how faith ought to be expressed in social, or communal, and not individual, ways. (My Catholic friend also introduced me to liberation theology, which, with its emphasis on political liberation of oppressed people, was, I discovered, more my speed.)

I don’t think Day’s ideas only apply to Catholics or to matters of how to practice one’s faith. I’ve always interpreted Day’s quote about “the long loneliness” not just as a metaphor for her journey toward Catholicism (she converted as an adult) but as a metaphor for the loneliness each of us experiences in our lives—the physical and emotional and existential loneliness of modern life, or even the search for meaning and purpose in life. The solution, according to Day—love—must come about through active engagement in community, not just being an individual actor alongside other actors in an increasingly impersonal society. The Catholic Worker movement was also about the concept of personalism, which “emphasized the freedom and dignity of each person” and moved “away from a self-centered individualism toward the good of the other.” This is such an important concept for people who live in hyper-individualistic societies like the U.S.

All of which is to say, again, that Murthy is right to talk about loneliness as an important issue and social bonds as critical for our health and well-being—humans are social creatures, and we all need human support systems to thrive. But ultimately, calls that emphasize individual actions don’t quite work to solve the problem, and we need to promote a culture centered around the individual and the collective well-being.

For people to truly not be lonely or isolated, and to live meaningful lives in which their potentials can be realized, it’ll take more than atomized actors making small-scale connections; we need an entirely new social fabric which fosters social connection, and that has to come about through systemic changes, such as what Goldstein says in the rest of his tweet:

The indirect policy solutions on these things are one that centrist/neoliberals will never call for. Ones that give us time, basic needs met as guarantees. A basic income, a 30 (or 20) hour work week, guarantee health care and paid leave, reducing the scale of corporate power in tech, entertainment, advertising by immensely taxing corporate wealth/revenue (not just profits) and by limiting their ability to take over our public spaces and airwaves, fighting for union power, fighting automakers/car culture, fighting suburban developers, and so many more policies that actually foster and enable genuine social infrastructure.

How can you join a political group when you are working one, two, or three jobs to make ends meet? (Even one full-time job is exhausting enough.) How can you take a break to meet someone for coffee or join a reading group when you don’t have child care? How can you seek out new social connections when social media and streaming services are designed to be addictive and take up a lot of your free time? How can you make a social connection without having to consume something (say, buying food or drinks to get a place to sit) because public spaces for recreation are so limited? How can you meet up with a friend or family member who lives 20 miles away or multiple bus rides away? Or when your loneliness complicates depression or other mental health needs and you don’t have healthcare? 

I’m not saying people never get to socialize. The point is that social and economic realities make it too difficult for the vast majority of people to develop healthy social lives. There’s also something cruel about telling people, “These are the solutions,” but they’re things that many people can’t actually do. This makes it easier for people to then blame themselves when they don’t fix their loneliness—after all, the “solutions” were available!

The government website that Murthy links to does give suggestions for institutions (i.e., non-individuals). But these are purely vague “recommendations” such as “make social connection a public health priority” (governments) or “ensure safe digital environments” (tech companies) and are no substitute for the kinds of structural and regulatory changes we need to make it easy for people to socialize.

We need to organize for changes that will help us get our basic needs met (Medicare for All, Green New Deal, universal child care, $25 minimum wage, and so forth) and create the infrastructure to help us all be more socially connected. I also happen to believe that many of us may benefit from political organizing as one way to stem loneliness and isolation. (This falls under the “service to others” category in Murthy’s advice.) Some of the most satisfying social experiences I remember from the last few years involve canvassing for the 2020 Bernie campaign and meeting people from a variety of backgrounds who all believed in progressive policy as a way to make our lives better. Canvassing also helps you connect with people who don’t agree with you, and you learn something from them and about how to try to convince them of your ideas. All of these experiences are important and meaningful and give one a sense of purpose.

The larger point here is that whenever we are told to “do more of something,” we should ask whether society is creating the conditions for us to do that thing (assuming that thing is indeed good). So, it could be anything from exercising more to eating right to self-care to sex. For example, an op-ed in February of this year in the New York Times by Magdalene J. Taylor encouraged readers to “Have More Sex, Please!” Aside from the fact that exhortations in the Times opinion page are unlikely to change the sexual behaviors of the masses—and regardless of whether you agree with her assertions that lack of sex contributes to loneliness or that having more sex is a part of the solution to loneliness—it’s not too hard to see that our society is definitely not creating the conditions for people to have more sex if they want to. That would require us to commit to all people’s sexual freedom. For that, we need a lot of things that we simply don’t have now: more free time and less work, comprehensive sexuality education, healthcare for all (including free pre-exposure prophylaxis for HIV and contraception), free abortion on demand, equality of gender and of relationship forms (an end to patriarchal “family values”), and an end to moral panics which stigmatize and essentially criminalize people for being LGBTQ.

There are usually systemic changes that need to be made in order for us to fulfill our own individual duties to better our lives and the lives of those around us. Murthy’s comments should make us think not just about individual efforts to socialize but about the systemic solutions to loneliness that need to be put into place—and also about how we as individuals might contribute to a political movement that would bring about those solutions.

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