Dr. Vivek Murthy, who served as surgeon general under Presidents Barack Obama and Joe Biden, released the first U.S. Surgeon General's Advisory on loneliness as a public health issue in 2023—backed by more than 300 supporting citations—and is now touring the country with a simple but profound message: social connection is a frontier in suicide prevention that we've largely overlooked.
The shift marks a departure from how the United States has traditionally approached suicide prevention. For decades, treatment of serious mental illnesses like major depressive disorder has centered on medication and talk therapy, with little or no consideration of factors such as social isolation or financial duress. But research tells a clearer story than those siloed approaches allow. Among the various complex issues that contribute to suicide, loneliness is a major one—a particularly strong predictor for older adults, who have the highest rates of suicide, and for youths, for whom suicide is the second-leading cause of death.
The evidence goes deeper still. Humans are social animals, and when we feel cut off from one another, our stress levels increase, our immune systems are disrupted, and we're likely to die earlier by suicide or other causes. One oft-cited study concluded that being socially disconnected is as harmful to one's health as smoking up to 15 cigarettes a day. Yet loneliness is rising across America, fueled by rapid growth of technology like smartphones and artificial intelligence, increased political polarization, the shift to remote work since the COVID pandemic, and decreased participation in religious institutions.
With suicide rates remaining stubbornly high—ranking among the top 10 causes of death in America—a growing movement of advocates, clinicians, and people who have lost loved ones to suicide are proposing a new approach: shift focus from stopping harm in moments of crisis to efforts that give people reasons to live well before they make fateful choices.
Murthy has been clear that this work isn't just the responsibility of families and neighbors. Elected officials have a role to play, he argues. They can use their platforms to turn this into a mainstream issue, create microgrants to support grassroots ideas from community entrepreneurs, and invest in what Murthy calls "social infrastructure"—the physical spaces, policies, and programs that support genuine connection. This includes libraries and parks, public transportation systems, and volunteer groups.
What's striking is how communities are already experimenting with creative solutions that don't require massive budgets. In Charlotte, a health system and a museum have teamed up to provide "prescriptions" for people to attend art classes or live performances together. Chattanooga is working on community ideas to increase connection and time in nature, including benches where people can speak with volunteer listeners. Across the country, men's sheds have popped up as spaces where men can work on projects side by side and discuss their mental health.
"To help someone else feel less alone, to help them feel seen and understood and valued," Murthy told KFF Health News, "That can be one of the most powerful interventions that we make." As suicide rates refuse to budge despite decades of crisis-focused prevention efforts, the case for fostering social connection as a public health priority has never been clearer.