In 2023, then-U.S. Surgeon General Vivek Murthy released a bombshell report, “Our Epidemic of Loneliness and Isolation,” that painted a bleak picture of citizens feeling “isolated, invisible, and insignificant.” Most provocatively, it stated that perhaps half of Americans face a personal crisis of aloneness that poses health risks “similar to that caused by smoking up to 15 cigarettes a day.”
The report received wide attention as it resonated with myriad data points – including declining marriage and birth rates and the rise of remote work – showing Americans are spending less face time with one another. But a RealClearInvestigations inquiry has found that its warnings of a loneliness epidemic are unsupported and that its claims of severe health risks stem from a misreading of the data.
The University of Rochester’s Viji Kannan, whom Murthy partly relied on for his claims of a loneliness increase, told RCI her study focused on measurable declines in social connections and not more subjective feelings of loneliness. “YES!” she said in an email. “Loneliness is a different thing.”
Daniel Cox at the American Enterprise Institute, whose research on loneliness was also cited by the surgeon general, had a similar take. He told RCI, “The evidence more strongly supports an epidemic of ‘aloneness’ rather than loneliness. We are spending more time by ourselves.”
Hans IJzerman, who studies loneliness at the University of Oxford, concurred. “The biggest story may be how the surgeon general basically butchered the narrative by not relying on solid data,” he said.
Murthy, who now works outside of government, did not respond to request for comment. The Department of Health and Human Services, which still posts the loneliness report on its website, declined to comment, citing the government shutdown.
Critics say the former surgeon general’s questionable assertion of a loneliness epidemic – which has been amplified extensively in the media – reflects a larger pattern whereby science is invoked to make larger arguments about American culture. These include claims that systemic racism is a public health crisis or that technologies such as cell phones are increasing rates of depression, anxiety, and other mental health issues among teens. These assertions take kernels of truth – racism exists, mental health problems were on the rise until the last few years – and then attach them to specific causes to add a patina of scientific credibility.
The alleged loneliness epidemic seems to stem in part from concerns over how technology in particular may be enabling people to choose to spend more time by themselves – which can seem counter to democratic ideas of community – and from a conflation of two very different phenomena: loneliness and being alone. Being alone is not the same thing as being lonely, and research shows social obligations in heavy doses can be as stressful for many as they are supportive.
Research results have clarified that true feelings of loneliness only kick in at the extreme end of social isolation. Quality time with others is more important than simply time spent with others overall (sometimes other people are annoying!) Unsurprisingly, those who enjoy being alone are less likely to feel lonely when not around others.
More Time Alone
A wealth of data suggests that Americans are spending more time by themselves. The surgeon general’s advisory, for example, pointed to slow declines in family and friend engagement during the early 2000s, though the most serious drop-offs occurred after the COVID-19 pandemic due to lockdowns and social distancing.
Source: U.S. Surgeon General's Office
More people are forgoing marriage and parenthood. We have fewer close friends. More Americans live alone than ever before, partly because we’re living longer. 
Source: National Vital Statistics, US Census Bureau and American Community Survey, and previous work by John Loo
According to Gallup Data, U.S. church membership has been on a steady decline since the 1990s, though that decline may have slowed or leveled off as of 2018.
Source: RCI from Gallup
Remote work, already slowly increasing, skyrocketed after the pandemic. Whether this is bad or not is debatable, given people seem eager enough for it.
Source: Coworking Mag
While these trends are clear, their meaning and effect are harder to pinpoint. Even though people are alone more often, data for the period 2003-2019 shows a very small decline in social connection. Professor Kannan calculated that time spent with others declined by about 146 hours per year, or about 1.7% – a relatively slight decrease that hardly seems reflective of an epidemic.
That period was, of course, also marked by the rise of smartphones and social media, forcing researchers to ask new questions about connectivity: Is aloneness defined by physical proximity? If someone is playing Dungeons and Dragons online with friends all over the world, are they truly alone?
Source: RCI based on data from Kannan & Veazie
Loneliness By the Numbers
Loneliness is, of course, a common and universal human trait. It is a subjective feeling of unwanted aloneness that is accompanied by a sense of social emptiness. A connection is desired but missing. Feeling lonely from time to time is not a sign of a problem. Loneliness becomes a clinically relevant issue when it is chronic and becomes a precursor for persistent distress and dissatisfaction with life.
Tracking loneliness over time can be trickier than time spent alone, perhaps one reason why so many conversations about loneliness seem to subtly shift to time spent alone instead. There appear to be few high-quality datasets tracking subjective loneliness over time. Though some data suggests a very small, gradual trend upward in loneliness among young adults since the 1970s, the increase is remarkably small over a 40- to 50-year period, hardly an “epidemic.” Data from Gallup suggests that loneliness has decreased since a high during the pandemic, although their data does not appear to extend back earlier. As one recent summary of the evidence put it, “There is an epidemic of headlines that claim we are experiencing a loneliness epidemic, but there is no empirical support for the fact that loneliness is increasing, let alone spreading at epidemic rates.”
Source: Gallup
As Bad as Smoking?
One of the surgeon general’s more dramatic claims was that “lacking social connection is as deadly as smoking up to 15 cigarettes a day.”
This comparison appears to come straight from the research of Professor Julianne Holt-Lunstad at Brigham Young University, who was the lead science editor on the surgeon general’s report. However, this comparison appears to be for light smoking (defined as 15 cigarettes or less per day). Had comparisons been made with medium (15-25 cigarettes) or heavy smoking (25+ cigarettes), smoking would clearly come out far more dangerous.
Further, the impact of smoking is pretty direct … lung cancer, heart attacks, strokes. Loneliness’s impact on mortality is clear. It could involve everything from more stress to fewer people around to help with medical issues. Causal claims are also tricky, given the degree to which the evidence relies on self-report correlational studies of subjective loneliness, associating it with mortality. In some cases, prolonged illness could prompt social abandonment, which would cause loneliness. Using correlational data to suggest that loneliness is causing illness is fraught, but that did not stop the surgeon general.
While Holt-Lunstad declined to address RCI’s questions about the surgeon general’s use of her study, her co-author, University of Arizona Professor David Sbarra, expressed some unease with the epidemic framing. “In terms of a loneliness epidemic, I think I am more skeptical than most…demographic changes that would establish an epidemic are really challenging,” he told RCI. “I think loneliness can spread through social networks…but what are the best data that loneliness and social disconnection are increasing? It's quite equivocal, in my opinion.”
There is little disagreement that loneliness is bad and can be associated with declining health. This may be because the distress of loneliness can cause stress and related health problems such as high blood pressure. But also because close social connections can help people with their medications and medical complications.
It’s less clear that, if the prevalence of loneliness has risen, it’s risen dramatically or that simple interpretations of loneliness = health risk are warranted.
IJzerman, who is also CEO of Annecy Behavioral Science Lab and an expert on loneliness, has been critical of the way Kannan’s data was used by the surgeon general. IJzerman noted that trends regarding time spent alone don’t tap into subjective loneliness and may be due to changes in how questions are asked over time. Further, they may simply reflect more people using technology for social interaction, which isn’t necessarily bad. IJzerman suggested we tend to get distracted by vanishingly small time trends and a tendency to look for technology to blame, such as social media or smartphones. Instead, we should be more concerned with the structural barriers some people face regarding social connection, for example, older adults and lower-income individuals.
Children and Loneliness
Much attention has focused on the world of teens. Buffeted by COVID-19 lockdowns, with increasingly structured lives, and navigating new technology worlds, legitimate concerns have been raised about teen loneliness. Though some studies have suggested an increasing loneliness trend among youth, IJzerman has said they are seriously flawed. He has critiqued these studies as “mining noise,” saying, “We cannot afford to base our understanding of loneliness on the psychological equivalent of wetted fingers in the wind.”
IJzerman also noted the difficulties of measuring loneliness across various cultures, as some studies have done. “While measuring loneliness across different societies might seem as simple as translating a questionnaire, the reality is far more complex. A Dutch student's understanding of loneliness may differ fundamentally from their British peer's interpretation, shaped by distinct cultural norms and social expectations. Even within the same country, temporal shifts in social attitudes can dramatically affect responses - as stigma around loneliness waxes and wanes, respondents' willingness to acknowledge these feelings may change accordingly.”
While arguing that our difficulty in measuring loneliness should give society pause – especially when it comes to advancing specific policies as a response – he also noted that our current concerns around technology have a long lineage. “Socrates warned that writing would erode memory and authentic dialogue; the printing press faced condemnation for encouraging solitary reading over community gatherings; early telephones were criticized for disrupting social norms; television was blamed for isolating families. Even mundane innovations like heating stoves faced resistance for disrupting traditional communal practices. Time has generally proven these fears exaggerated, suggesting we should approach current concerns about social media with similar careful skepticism.”
This doesn’t mean we should dismiss all concerns about loneliness. Whether subjective loneliness has declined or people have simply changed how they interact with others remains something of an open question. Whatever is occurring, it does not appear that changes in technology are central, so we might look to the breakdowns in institutions, reduced marriages, problems with schools, etc.
Our difficulty seems to be that our national conversation can occur in only two modes. Either something is a crisis, or it is not worth talking about at all. Perhaps in having a more nuanced understanding of loneliness concerns, we could begin to appreciate that some issues are still worthy of consideration even if they are not a 5-alarm fire.
Christopher J. Ferguson is a professor of psychology at Stetson University in Florida and author of "Catastrophe! The Psychology of Why Good People Make Bad Situations Worse."
