Surgeon General Vivek Murthy fights America's loneliness epidemic

• Loneliness can increase the risk of heart disease, dementia, stroke and premature death.
• It's also expensive, with social isolation among older adults accounting for $6.7 billion in excess Medicare spending annually. That's largely due to increased hospital and nursing facility spending, the advisory notes.

"It was only when I started traveling the country as surgeon general back in 2014 when I was confirmed for my first stint [during the Obama administration] that I really came to understand how pervasive loneliness was," Murthy told Axios.

• "I also came to see during that time that people were often quite ashamed to talk about it, and they wouldn't use the word lonely to describe how they were feeling. They would use words like 'invisible.'"

Below is an excerpt from a conversation between Axios and Murthy about what the U.S. needs to do about the problem of loneliness. The conversation has been edited and condensed for clarity.

On why loneliness is such a pervasive problem:

• "COVID most recently exacerbated the loneliness that's been building for decades. In the last half-century we've seen the pace of change has dramatically increased. We communicate differently with people in part because of technology. We change jobs more often. We move more often. That has a profound impact on our relationships with one another.
• "What I worry about with technology is we've seen more of a shift to online interaction in place of in-person interaction. There really is no substitute for in-person."

On how young people, in particular, are affected by loneliness:

• "For too many of our children, we're seeing the impact of that has been particularly profound. In the last two decades, there's been about a 50% decline in the amount of face time young people have with other people. That's pretty profound. Across the board, we're seeing these kinds of measures that tell us our relationships with one another, our interaction with one another have diminished over time.

On his advisory's framework for solutions, such as "fixing our built environment":

• "We tend to think about financial costs whenever we design policy and implement policy. One cost I worry we don't think about as much is the social cost...

• "When we think about housing in ways that integrate housing and retail spaces and walkable spaces, it tends to ensure people will engage with or encounter people more in the space they live. Our policies have a profound impact, whether we recognize it or not, on our likelihood of connecting with one another."

On what he does personally to combat social isolation:

• "I create sacred spaces in my life where I'm spending time with people and not with technology. That is at dinnertime with my family, it's when I'm getting my kids ready for bed, and it's when I'm having dinner with friends.
• "The second thing I do is I now make it a point to actually pick up my phone when my friends call. It sounds like a simple thing but so often when we're busy or we only have a few minutes, we may silence the call and figure we'll text them later, and catch up at some future point.
• "But I've been finding that even if I just pick up the phone for 10 seconds and say — 'Hey, I can't talk now but can I call you later?' — just hearing their voice and their hearing my voice makes us both feel so much better than taking that same time to send a text message."