Loneliness and social isolation have reached crisis levels in the United States, with close to 60% of Americans reporting loneliness, according to a 2022 survey by the Cigna health insurance company. Although loneliness and social isolation are often seen as problems of older adults, they affect all age groups. In fact, survey respondents ages 18 to 24 were nearly twice as likely as adults ages 66 and older to report being lonely: 79% versus 41%. These are alarming statistics considering that loneliness and social isolation increase the risk of early death by 26% and 29%, respectively, regardless of other health factors, according to a 2015 review in Perspectives on Psychological Science.

Concerns about social isolation and loneliness are not new; reports of the health effects of loneliness can be found in the literature as far back as the 1950s. The noted nurse theorist, Hildegard Peplau, wrote about it in AJN in December 1955. But the tumult of recent years-polarized politics, predatory social media behavior, and the three-year COVID-19 pandemic-have combined to disrupt individual relationships and strain the overall social fabric. The U.S. surgeon general, Vivek Murthy, sounded the alarm last May in a report, Our Epidemic of Loneliness and Isolation, which warns of the mental and physical health consequences for individuals and communities and provides guidance on rebuilding supportive social connections.

Loss of person-to-person connection is evident in several areas highlighted in the surgeon general's report. Time spent alone increased by 24 hours a month between 2003 and 2020 while in-person social engagement significantly decreased. Individuals lacking in social connections are at higher risk for heart disease and stroke, and may also be more vulnerable to anxiety, depression, and dementia, as well as viral infections and respiratory illnesses. The report notes that the lack of social connections has the same impact on the likelihood of early death as more well-known risk factors, including smoking 15 cigarettes a day, having six alcoholic drinks a day, obesity, and physical inactivity.

Excessive social media use also contributes to loneliness and social isolation, according to the report. One in three adults report being online "almost constantly," and researchers consistently find that feelings of social isolation increase as social media use increases. The toxic form of social media use called cyberbullying is known to cause feelings of social disconnection and loneliness in both victims and perpetrators.

The report presents a national strategy with six action pillars to address loneliness and social isolation. Pillar 3-mobilizing the health sector-has important implications for nursing. It calls for health care providers to assess patients for social disconnection and, if present, educate them on the dangers of isolation and loneliness and link them to support and resources. To read the surgeon general's report, go to http://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisor.-Karen Roush, PhD, RN, FNP-BC, news director