An epidemic of Americans alone in a crowd
When I heard in May that Surgeon General Vivek Murthy had declared that our country was having a loneliness epidemic, my first thought was, No kidding. And then I felt grateful that he was using his national platform to shine a light on a problem that has dire consequences for the elderly.
Even before the onset of the COVID19 pandemic, approximately half of US adults reported experiencing measurable levels of loneliness. According to the Centers for Disease Control and Prevention, social isolation — like other health risks such as smoking, obesity, and physical inactivity — increases the risk of premature death from all causes. Loneliness leads to a 29 percent higher risk of developing heart disease, a 32 percent higher risk of having a stroke, and a 50 percent higher risk of developing dementia. According to some experts, loneliness is as harmful as smoking 15 cigarettes a day.
When I was a first-time mother, what made me lonely was missing my work and colleagues, especially during 2 a.m. feedings of the beautiful creature in my arms. (I also fantasized that my coworkers probably had trouble carrying on without me.) Decades later, losing my husband of 55 years produced a different kind of loneliness, an unfillable void that I am still working hard to process.
For example, I sometimes find myself listening for the sound of Peter’s key in the lock. When he was alive, that sound always heralded an evening with a delicious meal, often prepared by him, listening to some Mozart, watching an episode of “Friday Night Lights,” and some serious cuddling. Over our decades together, we often kidded about how lucky we were to have each other because no one else would have wanted either of us. Now, the quiet of my apartment can be deafening, and I still can’t listen to Mozart without tearing up.
My experience reminds me of my mother’s. She lived for 14 years after my father died, and she told me how she especially missed him after a social event that they would have attended together. “There’s nobody to gossip with on the way home,” she lamented.
I can relate. A widow for almost two years now, I still hate coming home to an empty apartment. I also miss the post-party gossiping and the reporting of how our days went. The hardest part for me is not being able to share the things we so enjoyed doing together. I find that I want to tell my husband so many things. Sometimes I do anyway.
So what works, in my experience, to stem loneliness? I find it helpful to check in on friends and to make plans to see them regularly. Being there for them has the benefit of taking me outside myself. It also helps me to remind myself that my friends are there for me, too.
Even small interactions with strangers improve my days. Walking home from an errand on a very hot day recently, I spotted two women struggling to pay a parking meter with a credit card. (Remember paying for parking with pennies and nickels?) By the time I reached them, they had figured it out. Relating to their struggle, I said, “That sure looked like fun!” One of the women nodded and gave me a huge smile. Just that little exchange made my hot walk home so much better.
More recently, a huge piece of bark fell from a sycamore tree along Memorial Drive and hit me on the head. I wasn’t hurt, but I was startled, and it prompted me to tell a young man walking in the other direction to look up as he walked. As we chatted, we were joined by another man who suggested that it was this summer’s unusual heat causing excessive bark shedding. Shortterm friends, but it was fun.
I also make sure I have a cause that I am passionate about and that engages me and gets me out into the world. Lately, that cause has been championing death with dignity, a movement that seeks to ensure that people have the right to choose to end their life if their suffering is unbearable. Since writing in these pages about my husband’s decision to end his own life for that reason, I have had an outpouring of interest in my point of view. I have testified on Beacon Hill and sat for television interviews. (I want so much to show Peter my appearance on the local NBC affiliate’s evening news.) I never anticipated that sharing our story would spark this kind of response, but I’m so glad it did. These days, I have blessedly less time to be lonely.
Loneliness isn’t just a problem in America. There are ministers for loneliness in Japan and Great Britain. In England, Every Mind Matters, a campaign to end loneliness, encourages young people aged 18 to 24 to “lift someone out of loneliness” by carrying out small acts of kindness to help a person who may be feeling lonely. Mail carriers are encouraged to check in on postal customers they know to live alone.
Our doctors should notice, too. Dr. John Rowe, a pioneer in geriatrics, told me in an email exchange that he advises his medical students, “When you examine that old man in the next room and you want to get a sense of his likelihood to be well or sick going forward, you are better off asking him how often he interacts with family or friends than if he smokes cigarettes.” He also encouraged his trainees always to include this information on the list of vital signs — blood pressure, pulse, respiratory rate, body temperature, and social engagement. I hope more doctors do the same.
Loneliness is a problem we must address if we want our world’s longerliving inhabitants to flourish. And we, the longer-lived, must take responsibility for our own flourishing. We can volunteer, take classes, and make regular dates with friends. Some organizations, such as Hebrew Senior Life Intergenerational Programs, Volunteer Match, and Catholic Charities, pair older adults with younger people in ways that make both generations feel needed.
There is strength in numbers, and as our older population mushrooms, we can be a force for engagement. Our surgeon general noticing is a good start. Perhaps next, we can force presidential candidates to notice, too. We might start by asking them “What is your plan for easing the loneliness of our aging population?”