[2023-09-27] Social connection
Today I had coffee with a friend. We've been meeting once a month since January with the exception of July, when I was recovering from my breast surgeries. Whenever I meet my friend, our time together flies by, as we catch up on each other's news and provide input on our respective challenges.
And yesterday, Chris and I had lunch with a former colleague of mine and his husband. My former colleague told me that it had been 17 years since we had seen each other. "Are you sure?" I asked, incredulous that it had been that long. He was sure since that's when he had retired from the department in which we were both working at the time. Part of our conversation yesterday was about the loneliness some people experience. I mentioned that the impact of loneliness is similar to smoking 15 cigarettes a day. I couldn't remember where I had read that, but I was pretty sure that my recollection was accurate.
This evening, I searched for the reference and found it in the U.S. Surgeon General’s 2023 Advisory called Our Epidemic of Loneliness and Isolation. I quoted that Advisory in my post Staying in the present and serving others, but I hadn't gone back to the Advisory since writing my article in August when I was still grappling with doubts about having opted for a prophylactic bilateral mastectomy. (Incidentally, I am much more convinced now than I was a month and a half ago of the soundness of my decision to remove my breast tissue and, with it, a significant risk of breast cancer. The reconstruction side of things will get resolved in time.)
In his 2023 Advisory, U.S. Surgeon General Dr. Vivek H. Murthy writes:
Loneliness is far more than just a bad feeling—it harms both individual and societal health. It is associated with a greater risk of cardiovascular disease, dementia, stroke, depression, anxiety, and premature death. The mortality impact of being socially disconnected is similar to that caused by smoking up to 15 cigarettes a day, and even greater than that associated with obesity and physical inactivity.
The Advisory defines loneliness as a distressing experience resulting from a mismatch between the level of meaningful connections we have and the level we'd like to have. It defines social isolation as insufficient relationships, group memberships and social interactions.
A lack of social connection not only increases the risk for heart disease and stroke, notes the Advisory, but is also associated with greater anxiety, depression and dementia, and may increase susceptibility to viruses and respiratory illness.
According to the Advisory, social connection is impacted by three factors:
- Structure – The number of relationships, variety of relationships (e.g., co-worker, friend, family, neighbor), and the frequency of interactions with others.
- Function – The degree to which others can be relied upon for various needs.
- Quality – The degree to which relationships and interactions with others are positive, helpful, or satisfying (vs. negative, unhelpful, or unsatisfying).
And social connection evolves over time. It can get better or worse for a variety of reasons, some at the personal level (e.g., illness, moves and job changes) and some at the community and society level (e.g., rise or demise of social programs and changes in the settings in which people build, maintain and grow their social networks).
Social connection also varies among different populations. Murthy's Advisory states that:
...studies find the highest prevalence for loneliness and isolation among people with poor physical or mental health, disabilities, financial insecurity, those who live alone, single parents, as well as younger and older populations. For example, while the highest rates of social isolation are found among older adults, young adults are almost twice as likely to report feeling lonely than those over 65. The rate of loneliness among young adults has increased every year between 1976 and 2019.
Murthy uses his Advisory to call for a National Strategy to Advance Social Connection. He notes that while the evidence about the consequences of social isolation, loneliness and social disconnection have been mounting for decades, the COVID pandemic accelerated the need for actions at the level of society and community. While Murthy's Advisory provides considerable detail about how to build a national strategy to support social connection, I was most interested in his guidance to individuals about how to enhance social connection and reduce loneliness in their own lives. I reproduce it here.
What Individuals Can Do
Understand the power of social connection and the consequences of social disconnection by learning how the vital components (structure, function, and quality) can impact your relationships, health, and well-being. |
Invest time in nurturing your relationships through consistent, frequent, and high-quality engagement with others. Take time each day to reach out to a friend or family member. |
Minimize distraction during conversation to increase the quality of the time you spend with others. For instance, don’t check your phone during meals with friends, important conversations, and family time. |
Seek out opportunities to serve and support others, either by helping your family, co-workers, friends, or strangers in your community or by participating in community service. |
Be responsive, supportive, and practice gratitude. As we practice these behaviors, others are more likely to reciprocate, strengthening our social bonds, improving relationship satisfaction, and building social capital. |
Actively engage with people of different backgrounds and experiences to expand your understanding of and relationships with others, given the benefits associated with diverse connections. |
Participate in social and community groups such as fitness, religious, hobby, professional, and community service organizations to foster a sense of belonging, meaning, and purpose. |
Reduce practices that lead to feelings of disconnection from others. These include harmful and excessive social media use, time spent in unhealthy relationships, and disproportionate time in front of screens instead of people. |
Seek help during times of struggle with loneliness or isolation by reaching out to a family member, friend, counselor, health care provider, or the 988 crisis line. |
Be open with your health care provider about significant social changes in your life, as this may help them understand potential health impacts and guide them to provide recommendations to mitigate health risks. |
Make time for civic engagement. This could include being a positive and constructive participant in political discourse and gatherings (e.g., town halls, school board meetings, local government hearings). |
Reflect the core values of connection in how you approach others in conversation and through the actions you take. Key questions to ask yourself when considering your interactions with others include: How might kindness change this situation? What would it look like to treat others with respect? How can I be of service? How can I reflect my concern for and commitment to others? |
Murthy also offers suggestions to parents and caregivers on how to promote social connection.
I took special note of the potential negative effects of illness on social connections. When a person is sick, they may not have the energy or physical capacity to meet with others face to face. They may be suddenly separated from colleagues if their illness results in a leave of absence from work. They may become immunocompromised and avoid social gatherings.
I experienced many changes after I was diagnosed with ovarian cancer. I stopped working very suddenly. I stopped going out while on chemotherapy because I was immunocompromised and a pandemic was raging. I stopped seeing my family regularly, especially during the colder months when a physically distanced visit on my deck was not possible.
But I did do one thing in particular that helped decrease the negative impacts of the disease on my social connections: I started this blog. My cancer might have made me feel isolated, lonely and disconnected. Instead, my blog allowed me to connect and reconnect with hundreds of people. I felt remembered, seen, loved, valued, appreciated and cared for.
When my friend and I had wrapped up today's coffee chat, she suggested that we put a recurring monthly event in our calendars to make sure that time doesn't slip away without our getting together. And when I said goodbye to my former colleague yesterday, he said, "Let's not wait another 17 years to see each other."
Today's inspiration is to nurture your relationships: social connection is good for you in so many ways.
