slip sliding away

social interaction is a budget item, whether we see it or not

I’m going to annoy you. Not because I want to annoy you, but because my role entails making information about our collective wellbeing legible, and with that come truths that take energy to metabolize. Just know that you’re being annoyed for a good cause.

In 2023, the last functioning Surgeon General’s office issued an Advisory on Social Connection: 82 pages of peer-reviewed evidence making a case that loneliness and social isolation are killing us at rates we’ve only ever associated with smoking, obesity, and heart disease. I’m just doing my job: this is a public health announcement.

Here are five numbers worth sitting with:

Lacking social connection carries the same mortality risk as smoking up to 15 cigarettes a day. More than obesity. More than physical inactivity. This isn’t a wellness blog statistic. It comes from a synthesis of 148 independent studies tracking people over an average of 7.5 years. The finding has been replicated so many times that researchers now consider social disconnection an independent risk factor for death from all causes—the same category as high blood pressure and high cholesterol.

Please pay attention.

Half of American adults report feeling lonely. That was before COVID. The pandemic didn’t create the problem—it revealed infrastructure that was already failing. The trend lines go back decades.

This is important.

Young adults between 15 and 24 spend 70% less time with friends in person than they did twenty years ago. In 2003, that age group averaged about 150 minutes a day (2 1/2 hours) with friends. By 2020 it was 40 minutes (2/3 of an hour). This is not a screen time lecture. It’s a structural observation about what’s been quietly disappearing while we were looking at other things.

I hope you’re noticing.

Social isolation among older adults costs Medicare an estimated $6.7 Billion annually—mostly in increased hospitalizations and nursing facility stays. Loneliness isn’t just a feeling. It shows up in the body as inflammation, elevated stress hormones, weakened immune response, accelerated cognitive decline. People who are lonely get sicker, heal more slowly, and die sooner. The biology is not subtle.

Thinking of you…

A 10% increase in community trust is associated with an 8% decline in overall mortality. Read that again. Trust—the felt sense that your neighbors are basically on your side—predicts survival at the population level. Not as a metaphor. As a measurable, replicable finding across multiple studies.

The details paint a clearer picture

Loneliness and isolation are distinct—but both are at work here. Isolation is objective: time spent alone, network size. Loneliness is subjective: the gap between the connection you have and the connection you feel. You don’t need one to have the other. Since 1976, loneliness among young adults has increased every year. Between 2003 and 2020, time spent alone increased by 24 hours per month (the numbers are probably an undercount). The important point here is that the health risks cut both ways.

The study is also careful about technology. The evidence isn’t simply that screens are bad. It’s more specific and more troubling: passive consumption increases isolation. Active, reciprocal contact—even in the online space—can help people feel connected. But phone use during in-person time degrades the quality of that time measurably. The people in the room with you notice, even when they don’t say so; (and you notice, too, if you make the effort).

What the report calls “social infrastructure”—the recurring gatherings, the third places, the community organizations, the classes and courts and congregations that give people somewhere to show up—turns out to be public health infrastructure. Not a nice amenity, or a leisure category—a determinant of how long people live and how well.

We’ve spent decades building policy around tobacco and obesity and heart disease. We have guidelines, interventions, reimbursement codes, awareness campaigns. We treat those as health issues because we decided to. The evidence for social connection is at least as strong. We just haven’t made it a public health priority yet.

I’m not a clinician. I’m a community music facilitator who has spent a quarter century watching what happens when people of different ages, backgrounds, and neurologies share a room and make sounds together without any pressure to perform. I’ve watched it work on other people—I’ve also come to see this social time as an accommodation for my neurodivergence: a type of socializing that refreshes, rather than drains, my social battery. I didn’t have language for the mechanism until recently. Now that I do, I feel obliged to share it.

I’m not actually marketing to you (though you’re welcome to join one of our community music environments).

Here’s the call-to-action:

Call a friend you’ve been meaning to call. Not a text. A phone or FaceTime call. The reciprocal, real-time, slightly inefficient kind where you walk in circles and forget where you were a second ago.

Show up somewhere regularly. A class, a court, a congregation, a cafe. The recurring part matters more than the activity. Consistency is the mechanism. Showing up once is nice. Showing up every week is medicine.

Share a meal with someone. Settle in, taste the food, share something about your day. Phones down. The social connection is the point.

Notice who in your orbit is isolated. Not lonely in a way they’d advertise—just not showing up anywhere. The person you used to see semi-regularly, but you haven’t thought about in a minute. Reaching out is working a muscle, and to someone, it might be the only exercise of care they’ve received in a while. That’s money.

Let yourself be shown up for. This one is harder for a lot of folks than the others. Receiving care, accepting an invitation, admitting you’d like company—these are also skills. They atrophy when unused. Practice them.

It counts. It’s a healthcare subsidy—for real.

imeetswe is a community nonprofit in the East Bay serving the musical and social needs of people of all ages, but especially children birth through age 7.

imeetswe.com