A better way to address the US epidemics of loneliness and despair

Awareness of the risks stemming from our fraying social relationships is growing.

In May, Surgeon General Dr. Vivek Murthy released an advisory calling “our epidemic of loneliness and isolation” an “underappreciated public health crisis that has harmed individual and societal health.” 

Worsening social ties have also hurt early childhood development, contributed to an increase in drug overdoses and even played a role in spiraling mistrust and polarization. We often consider these disparate issues in silos, rather than as natural products of how the deinstitutionalization of our relationships is yielding fewer loving and supportive attachments, with great repercussions across American society.

What do I mean by the deinstitutionalization of our relationships?

The attachments that most satisfy our basic needs and build the trust, cooperation and mutual interdependence that helps everyone thrive are, as psychologists Roy Baumeister and Mark Leary describe, long-lasting. They involve frequent, positive reciprocal interactions, provide people with meaning and are structured in such a way as to encourage stability, care and concern among us. 

These are best fostered not through meetings with your network or sporadic social gatherings but through place-based institutions such as marriage, interfamily networks, community schools, neighborhoods, local associations, recurring voluntary activities and neighborhood markets and businesses.

The thinner the social ties, the more vulnerable the population. While a growing number of Americans have no close friends, in countries like Greece and Portugal, more than one-third of citizens say they see their friends daily. Whereas at one point, virtually every person mattered in an obvious way because their contribution to a place mattered, Americans today function as consumers with little connection to each other beyond our transactional value. Many social ills can be traced to this dramatic change in our social framework.

While other developed countries are experiencing similar trajectories, the problems are significantly worse in the United States. Other individualistic societies such as Canada and Sweden are also being impacted by rising drug overdose deaths, but the rate in the United States is much higher because the ties are weaker. More than 10 times more people per capita are dying of overdoses than in most European countries.

Researchers Anne Case and Angus Deaton have sounded the alarm on rising deaths of despair, and particularly, why these deaths persist in the U.S. and not in other rich countries. They conclude that “purely economic accounts … have rarely been successful in explaining the phenomenon.” Instead, they argue that the deterioration of traditional social structures such as marriage, church and unions and their impact on “family, on spiritual fulfillment and on how people perceive meaning and satisfaction in their lives” are chiefly responsible.

The typical government approach prioritizes treatment over prevention. Sen. Chris Murphy’s (D-Conn.) National Strategy for Social Connection Act, introduced in July, is a great example. It focuses on establishing a high-profile government office, developing a national plan, improving education and awareness and supporting more research. But its prescriptions aren’t based on how people form lasting relationships, with no mention of institutions or consideration of how important places are to social flourishing.

Similarly, efforts to reduce drug-related deaths aim for “harm reduction” instead of embedding people in relationships that can keep them clean. Efforts to help kids reduce adverse childhood experiences emphasize economic support, public education campaigns, child care, skills development, mentoring and treatment programs. These may lessen the impact of adverse childhood experiences but don’t prevent them in the first place.

How can we help each other connect and relearn place-based habits?

Public and private leaders should reenvision our urban, suburban and rural landscape around clearly demarcated neighborhoods. Neighborhoods with clear identities, institutions that lubricate social exchange and places where people regularly congregate are more likely to flourish socially.

While economic conditions do matter, they are not synonymous with these dynamics. Some materially well-off neighborhoods are socially impoverished — as well as the reverse.

We should also reenvision how government functions. Instead of dividing work into functional silos, which maximizes sector-specific expertise, state and local governments should be empowered to build teams of place-specific experts with a wide range of skills who work in a particular geography for an extended period of time. Public servants with intimate knowledge of businesses and residents in their specific neighborhoods would facilitate social vitality rather than simply distribute financial resources. This would shift accountability to be based on neighborhood-wide results rather than units disbursed. Metadata points — such as relative property values and transiency rates, family stability, crime statistics and school rankings — are especially important markers.

Neighborhoods are not a topic often discussed in Washington, but they are the best entry point to rebuild the social fabric that underpins everything else in our society. And the country will not flourish until all our neighborhoods do.

Seth D. Kaplan is a lecturer at the Paul H. Nitze School of Advanced International Studies at Johns Hopkins University. He is the author of a new book, “Fragile Neighborhoods: Repairing American Society, One Zip Code at a Time”