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A monthly exploration of the many benefits available to you through your TRICARE health plan.

The Doctor Is In offers tools, information and resources focused on topics that are trending and may be affecting you and your family. Your TRICARE health benefit is robust – and we want to make sure you take advantage of everything your benefit has to offer. 

April 2023

Written by Dr. Joyce Grissom, HNFS Chief Medical Officer


The Beatles warned us that “One is the loneliest number.” 

I recently had an opportunity to attend a presentation by the U.S. Surgeon General, PHS Vice Admiral Vivek Murthy. His central message: Loneliness – the “tobacco of our time” – is the greatest health threat facing Americans today. Loneliness can be described as the feeling when our need for social contact and relationships is not met. 

Human beings are social beings by nature. Yet, with the COVID-19 pandemic, the pendulum swung hard in the direction of social isolation, especially in our workplaces, shopping habits, and in the lives of people with health risks. Today, it has yet to fully return to normal. 

From a medical perspective, we can associate loneliness with bad outcomes, including:

  • Depression,
  • Anxiety,
  • Suicide,
  • Cardiovascular illness,
  • Dementia, and 
  • Sleep disturbance.  

In fact, social isolation rivals smoking, obesity, and physical inactivity for risk of premature death. In patients with heart failure, loneliness was associated with increased emergency room use, hospitalization, and an almost quadrupled risk of death. 

In a presentation to the Leaders Forum at the Yale School of Medicine Surgeon General Murthy stated, “People all across America know that something is not right…it’s a symptom of a deeper pain and unrest that people are feeling inside. Our charge is to ask ourselves how we can address that deeper pain and make people feel more connected and understood.”

Loneliness by age

A report from the National Academies of Sciences, Engineering, and Medicine (NASEM) points out that more than one-third of adults aged 45 and older feel lonely, and nearly one-fourth of adults aged 65 and older are considered to be socially isolated. Yet, loneliness is not limited to older Americans.

  • Elementary and middle school: Social isolation affects millions of elementary and middle school students and has been linked to bullying, self-harm and community violence. It’s one of the reasons why Health Net Federal Services’ parent company, Centene Corporation, has partnered with Beyond Differences to sponsor the annual ‘No One Eats Alone’ day in schools. Started in 2017, this program supports interaction and engagement with students in school lunchrooms. Consider extending this idea! Take a friend or coworker to lunch or ask someone you know who could benefit from some human interaction.  
  • Older teens and young adults have been hit particularly hard by the loneliness epidemic. Loneliness peaks between the ages of 18 and 29, according to a new research review conducted by the Newport Institute. In a national survey conducted by the Harvard “Making Caring Common” project, out of approximately 950 respondents, 36% reported feeling lonely “frequently” or “almost all the time or all the time” in the prior four weeks, compared to 25% when asked about the two months prior to the COVID-19 pandemic. Specifically, of those aged 18 to 25:
    • 61% reported high levels of loneliness
    • 63% reported experiencing substantial symptoms of anxiety and depression 

Social media

While smartphones and social media apps may be viewed as ways to cope with loneliness, many researchers believe technology is actually a primary cause of loneliness. Direct messaging and commenting on social media posts are replacing face-to-face human interactions. This can make virtual connection feel like actual isolation. 

  • Social media use can increase one’s FOMO (Fear of Missing Out). Scrolling through images of peers having an apparently great time with friends can leave young adults feeling even more isolated and lonely. 
  • The effort to appear perfect and attractive on social media can leave us feeling disconnected from not only other people, but also ourselves. As Robert Waldinger M.D. and Marc Schultze, PhD, the authors of The Good Life put it, we are constantly “…comparing our insides to other people’s outsides.” 

Consider this: Try limiting use of social media use to 10 minutes per platform, per day for three weeks. Researchers found that young adults who limited their social media use demonstrated significant reductions in loneliness and depression compared to a control group of their peers who didn’t.  

But do we have to be lonely?

  • Volunteer. Helping others can form connections with other volunteers and with the people you are serving, creating positive infusions of neurotransmitters such as dopamine that increase our sense of happiness and well-being. 

  • Get more sleep. Not getting adequate sleep can be both a consequence and a cause of loneliness. 

  • Bring your family along for the ride. Make time to nurture family relationships and friendships. 

  • In school or the workplace, scheduling regular meetings (even if via telephone or video calls) with supervisors/coworkers/teachers/classmates. Aside from getting development and mentorship advice, frequent meetings can also help us make and maintain personal relationships.  

We are encouraged to start where we are, even with small steps. Richard Weissbourd, psychologist, senior lecturer at the Harvard Graduate School of Education said, “If every person…can make a commitment to reaching out to one person they are concerned might be lonely once a week, that would be a good thing.” 


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