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  • Family helped the U.S. Surgeon General when he was lonely. But for some reason his new anti-loneliness campaign omits family as a solution.  Tweet This
  • In the crusade against loneliness, why not include policies meant to bolster fatherhood? Tweet This
  • The Surgeon General's advisory fails to take a position on which lifestyles are likely to result in more or less loneliness. Tweet This

Last week, U.S. Surgeon General Vivek H. Murthy rolled out a new advisory on “our epidemic of loneliness.” The document argues that “Americans appear to be becoming less socially connected over time,” states that this trend has negative consequences for individuals and communities, and offers a number of solutions meant to boost connectedness.

To announce the advisory, Murthy wrote in the New York Times about his own struggles with loneliness. He recounted, for example, how he let his relationships languish as he focused on his job, and then how he later felt ashamed to rekindle those relationships when the job ended. Murthy then went on to explain what ultimately pulled him out of isolation:

For me, it took more than a year of struggling with the pain and shame of loneliness, but I eventually found my footing. I didn’t do it on my own. My mother, Myetraie; father, Hallegere; and sister, Rashmi, called me every day to remind me that they loved me for who I was. My wife, Alice, reminded me that the light she had seen in me when we first met was still there, even if I couldn’t see it at times. And my friends Sunny and Dave committed to doing video conferences once a month and texting and talking weekly about the issues that weighed on our hearts and minds.

So, the antidote to Murthy’s loneliness was first and foremost family, with whom he communicated every day. I thought this was a brave admission because Murthy didn’t claim, for example, to have an unrealistically huge friend group or to be heading out for guy’s night every other evening. He mentioned six close relationships, four of which were with family members, that “patched me up with their acts of love and connection.”

Murthy’s description of the social circle that helped him deal with loneliness also brings to mind the research of Oxford anthropologist and evolutionary psychologist Robin Dunbar,1 who found that people typically have a small circle of intimate relationships. That circle usually includes about five people—almost the same number Murthy mentions.

I appreciate that Murthy is highlighting the problem of loneliness. It’s a serious and widespread problem that doesn’t get as much attention as it should. But I also found his set of solutions inexplicable: He announced his anti-loneliness campaign by emphasizing the role family played in his own life, then goes on to almost entirely leave family out of his set of recommendations. In fact, the new advisory explicitly states that it’s trying to “cultivate ways to foster sufficient social connection outside of chosen traditional means and structures.”2

In other words, the advisory’s omission of family is apparently intentional.

Murthy’s policy recommendations are broken down into “six pillars to advance social connection.”3 The pillars include good ideas, like improving our relationship with technology and building more socially-oriented infrastructure in cities. The advisory also includes recommendations for specific stakeholders, such as local governments, healthcare providers, and employers.

Murthy’s New York Times piece additionally mentions a focus on “school-based programs,” “workplace design,” and “community programs.” Significantly, though, Murthy didn’t mention any of these ideas as being instrumental in helping him overcome his own loneliness.

Instead, he mentioned that, among other things, his dad helped him out. That’s significant because today nearly a third of boys are living apart from their biological dads. That’s a huge jump from 1960, when only 17% of boys weren’t living with their fathers. There’s a mountain of research on why this trend is a problem, and why we should want fathers to be present in their sons’ lives. But Murthy’s own experience suggests that one benefit of having a present father is less isolation.

So, in the crusade against loneliness, why not include policies meant to bolster fatherhood and reverse the ongoing trend in which fewer boys live with their dads?

Murthy also mentions his wife. But the marriage rate in the U.S. has dropped almost 60% over the last five decades. So, fewer and fewer people have a spouse like Murthy’s to help pull them out of funks.

The first chapter of the advisory actually discusses the decline of marriage, the rise of people living alone, and shrinking household sizes. It’s a useful overview of the basic research on these trends.

But these topics are completely absent from the policy recommendations at the end of the advisory. There are some suggestions for parents, but they’re geared to people who already have kids. Ultimately, there’s nothing about making marriage and family more available to more people—even though the advisory’s first pages correctly point out that the decline of these institutions is a major contributor to loneliness.

It’s a strange omission because the research is compelling. A widely cited 1998 study, for example, found that both marriage and parenthood were associated with lower levels of loneliness. Significantly, the study found that simply cohabitating didn’t offer the same benefits. There’s something unique about marriage. It’s not just about companionship.

Subsequent research has repeatedly confirmed, to quote economist and policy advisor Christos A. Makridis, that “the unmarried are substantially more likely to feel lonely,” while “married Americans have much lower rates of loneliness.” 

Another study, published just this year, looked specifically at women and pointed out that marriage leads to an array of benefits including better mental health and, again, less loneliness. Significantly in the context of the Surgeon General’s efforts, the study notes also that “marriage arguably remains one of the strongest social ties that shape individuals' lives.” Two of the  study’s authors, Harvard’s Tyler VanderWeele and Brendan W. Case, further speculated that marriage is so common and important for human societies “because it promotes human flourishing in many ways at once, both meeting and harmonizing the distinctive needs and desires of men, women, and children.” 

The list of research linking marriage to a higher sense of life satisfaction and better mental health could go on. But again, in addition to all of this research, Murthy’s own account highlights the fact that marriage has a significant role to play in abating isolation.

All of which is to say it would make a lot of sense to include policies that promote marriage and family formation as part of any anti-loneliness crusade. For instance, more robust parental leave policies have been found to promote fertility. Ergo, an effective anti-loneliness campaign might include efforts to improve access to parental leave in order to expand family-based social networks. The same goes with policies on flexible child care and tax credits. 

Choices about family have a profound impact on individual experiences with loneliness.

We also know that successful adults tend to complete major life milestones in a particular sequence. They finish their education, get a job, and get married—all before having kids. Researchers have dubbed this concept the “success sequence” and found that whether or not someone completes all the steps has a major impact on their chances of ending up in poverty. A family-based campaign against loneliness would look for ways—via schools, religious institutions, etc. — to distribute this information and promote its benefits.  

I was also struck by the intergenerational component of Murthy’s experience. In his moment of loneliness, he leaned on his parents. 

Intergenerational support is a massive boon for families who have access to it. And it has been the norm across numerous societies and in numerous historical eras. But it’s difficult to pull off in modern America, in part, because most communities make it nearly impossible to build flexible housing—duplexes, basement apartments, cottage courtyards, etc.—that’s well-suited for intergenerational families. Anti-loneliness policies should consequently aim to change housing regulations so that it becomes easier for family members to live in close proximity to each other. 

None of this means individuals need be forced into getting married or having a family. Obviously. But it seems only fair to at least tell people what Murthy discovered himself: That choices about family have a profound impact on individual experiences with loneliness.

Instead, the Surgeon General's new advisory fails to take a position on which lifestyles are likely to result in more or less loneliness. It’s like an anti-drug campaign that equally validates the choices of people who avoid drugs and people who abuse drugs. In the end, not every lifestyle leads to equally fruitful outcomes, and when it comes to loneliness, the research is unambiguous about the benefits of family.4

Ultimately, I’m grateful that Murthy is bringing attention to a serious problem. My professional life is nothing like his, but I’ve experienced some of the same things he describes regarding his relationships. My solution was similar as well: Leaning into family relationships dramatically reduced my feelings of isolation.

Unfortunately, not everyone has that same support network. I suspect that’s why Murthy omitted family from his recommendations. But just because some people lack a healthy family doesn’t mean we should throw up our hands and abandon a concept that has a proven track record as one of the best antidotes to loneliness. Doing so is neither fair nor compassionate. In the end, the goal of policy should be to extend the best opportunities—in this case the kind of family support network both Murthy and I enjoyed—to more people. 

Jim Dalrymple II is a journalist and author of the Nuclear Meltdown newsletter about families. He also covers housing for Inman and has previously worked at BuzzFeed News and the Salt Lake Tribune.

1. Friends: Understanding the Power of our Most Important Relationships. Robin Dunbar. 2021.

2. Page 15

3. Page 47

4. Imagine an anti-drug abuse campaign that didn’t involve telling people to stop taking drugs. It wouldn’t work. Beating addiction is a complicated process, but at the end of the day the goal is to change behavior. You can’t beat the opioid epidemic with more opioids, or without the recognition that when it comes to drugs not every lifestyle is equally fruitful. Loneliness strikes me as analogous; solving it will involve telling people to avoid lifestyles that lead to a high risk of isolation.