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November 9, 2023 50 mins

It is widely known that smoking and obesity can lead to chronic disease and death, but do you know that loneliness can be equally detrimental to your health? Dr. Vivek Murthy, Surgeon General of the United States, is here to talk about the epidemic he is most concerned about right now - the epidemic of loneliness and isolation. As technology increasingly enables us to work, shop, socialize and live online, people are reporting higher feelings of loneliness than ever before. Dr. Murthy shares important information surrounding these issues and what can be done to protect your physical health and well-being.

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Speaker 1 (00:00):
I have turned much of my focus to mental health
and well being because I believe this is the foundation
on which we build everything else. Like our mental health
is like the fuel that allows us to show up
at work, for our families and our communities, in our schools.
Our mental health is not good, it's hard to really
thrive in the rest of our lives, and rebuilding that
foundation is really what I want to dedicate my time

(00:20):
and effort to.

Speaker 2 (00:24):
Doctor Barbaik Murphy is a physician. He's a Vice admiral
and the current Surgeon General of the United States. He
was the nineteen surgeon general and now he is again
a surgeon General the twenty first, and he has served
under Presidents Obama, Trump, and Biden. We've all heard about

(00:44):
the surgeon general the warning labels on alcohol, for example,
But what does the nation's top doctor actually do, How
does one become surgeon general, and what are his most
pressing concerns. Doctor Murphy joins me today to discuss these
topics and others. And I must tell you I really
didn't know that you are part of the armed forces

(01:06):
of the United States.

Speaker 1 (01:08):
Yea, So many people don't realize that the surgeon channel
is actually the head of one of our eight uniform
services in the US government, and the service that I
have the privilege of leading is called the US Public
Health Service, right, and we have about six thousand nurses
and doctors and pharmacists and physical therapists all over the country.
We deploy them million times of emergency, one of the
hurricanes and tornadoes and other natural disasters to help support

(01:30):
local health care and public health.

Speaker 2 (01:32):
So you must have been very busy with all the
fires in not only Hawaii, but on the West coast
and in the northeast. You've been very, very busy. And
you are a young man. Vivek is how old?

Speaker 3 (01:46):
I'm forty six now forty.

Speaker 2 (01:47):
Six years old and very handsome by the way, and
dress in his beautiful uniform. I hear you even walked
in the morning in your uniform.

Speaker 3 (01:57):
Well, yeah, I walk miles.

Speaker 2 (01:59):
Do you walk to work?

Speaker 3 (02:00):
Oh it's not far. It's like a little over a mile,
not far at all.

Speaker 2 (02:03):
But you look very dapper and very nice. And doctor
Murphy's come with some of his colleagues. What should they do?

Speaker 1 (02:11):
Oh, my gosh, I have an incredibly talented team, and
I've been bussed to have folks who help with communications
with our engagements with outside organizations. They also help with
the design of our products and our website, and with
running our operation, which is, while it's small and nimble,
we operate in a fairly large bureaucracy of the United
States government, and so the team helps me navigate all

(02:32):
of that as we build out, you know, our initiatives
on mental health and in other areas, and as we
design projects and collaborations. The Public Health Service which I
run is much smaller. It's six thousand officers who function
across medical and health disciplines.

Speaker 2 (02:47):
Yeah, I mean it's and do you do you actually
tell people where to go? So, I mean it's it
must be very complicated. Well, it is complicated, but many
people that you have to send to Hawaii.

Speaker 1 (03:00):
Set for several dozen people to Hawaii to help specifically
actually with the mental health challenges there, because, as you know,
when natural disasters happen, a lot of times we rightly
focus on the immediate destruction, but the mental health challenges
they last for a long time. Even after the last
house is rebuilt, last piece of debris cleaned up, people
will struggle, and in fact, sometimes those mental health challenges

(03:22):
increase after all the public attention has gone away.

Speaker 3 (03:26):
People are left in dwelling.

Speaker 2 (03:27):
Just to clarify for the audience, what are the different
divisions of the United States Armed Forces?

Speaker 1 (03:34):
There are eight, So there are eight I would say
the uniform services. Some of them are armed and some
are not. So the United States Public Health Service, for example,
this is a uniform service that's focused on health. It's
the only one that's solely focused on advancing the health
of the country. Many people are familiar with the Army
and the Navy, and the Coast Guard, with Space Force,
with other services. Air Force, yes, Air Force as well,

(03:55):
and there's no other national Oceanic and Atmospheric administration, So
you put all them together in different ways. They serve
to help protect our country, whether it's from outside threats,
from health challenges we may face, or other situations.

Speaker 2 (04:10):
One of your biggest initiatives, and I know what you
really want to talk about, and I do too because
I have godchild who in England who started a company
called Hillo Tomo. Do you know about that?

Speaker 3 (04:22):
No, I don't know.

Speaker 2 (04:23):
It's all about exactly your initiative, which is combating the
epidemic of loneliness and isolation that is growing in all
over the world actually right now. So I'm very happy
to talk to you about what you are doing to
help combat this loneliness and this sense of isolation that's occurring.

(04:44):
What is this a direct result basically, well.

Speaker 1 (04:47):
I think to really understand that, we have to recognize
that loneliness has been building for years. It's not something
that happened overnight. The pandemic made it worse, but it
was a crisis even before the pandemic, as silent crisis,
if you will. And there's several things that happening over
the last several decades that have led to that. So
one is that over the last half century, our participation
in the organizations that used to bring us together, like

(05:10):
recreational leagues, service organizations, faith organizations, has steadily declined. The
other thing that's happened is that as we've come to
use technology more, which has been really wonderful and efficiency producing,
it's also made it unnecessary for us to see people
as much. So, for example, I don't need to go
to the grocery store or to a retail store to
buy things. I can just buy things online. Now that

(05:32):
can save me some time. One of the consequences we've
realized is we have less interaction with one another. We
also move around a lot more, we change jobs, we
leave home for school. Those are communities we leave behind. Again,
some benefits there, but there's a cost. And finally, I
think that the phenomenon of social media for many people
has actually led to an antisocial effect, which is that

(05:53):
many of them have found that they're substituting what used
to be in person connections for online connections, where there
are less known, they have less of a strong, you know,
sort of I think, personal connection with other people, and
that has left many people lonelier and more isolated than before.
The thing that concerns me most, Martha, is when you
look across the age spectrum at who's most affected. We

(06:15):
find that one in two adults are living with measurable
levels of loneliness in America, but the numbers are even
greater among young people. And depending on the study you
look at, somewhere between seventy to seventy five percent of
young people say that they are in fact struggling with loneliness.

Speaker 2 (06:28):
And it makes me very unhappy to hear that. I
remember when I was just out of college, starting a
good job on Wall Street, I would get about one
hundred phone calls a day from different people. And I
really liked that because I got to talk to people
in a job but also at home, and that verbal

(06:51):
communication was so important to me. Now, if I count,
if I count ten phone calls a day, that's a lot.
I hate it. And my colleagues here at the office,
they text from one desk to another. Huh, that's what
they do. They text, And that's what's happening everywhere. I mean,

(07:12):
my granddaughter texts me instead of picking up the phone.
I always write, please call me. I get a text.
Busy right now, I'll text you later, you know. And
she's twelve. Yeah, and I know that she's I know
she's not with anybody, but she's gotten into this bad
I think it's a horrible habit. By the way, because
I might be very old fashioned, but text, how much

(07:33):
do you text versus call?

Speaker 1 (07:35):
Well, so I'll tell you I've changed in the last
couple of years, in part because of a lot of
this work we've been doing on loneliness. I used to
primarily send people texts. I wasn't leaving people voicemails either.
I had to call them out with. If I couldn't
reach them, I just text them or email them. But
I had his friend actually who whenever we used to

(07:56):
play phone tag and he didn't reach me, he would
actually leave me along voicemail, and I actually realized I
really enjoyed just hearing his voice. And I also started
to pick up the phone more often when people called,
even if it was busy, because I would just say, hey,
can I call you back, like I'm about to walk
into a meeting, And even that five seconds or ten
seconds of hearing their voice made a difference.

Speaker 2 (08:16):
Well, not only does it help you, and also I
mean help them to get a voice, but you know
that you're going to call back, You're making a note
to yourself that you're going to actually correspond with that person.
That's right and words.

Speaker 1 (08:31):
And the thing is that there's a whole evolutionary scientific
basis to the fact that you and I feel better
with phone calls, which is that, like you know, thousands
of years ago, when we were as we were evolving,
we came to not just process the words that somebody
was saying, but their facial expression, the tone of their voice,
their body language, all of that went into us understanding
who they were are connection.

Speaker 2 (08:52):
And now you don't some people you just don't see them. Yeah,
you're definitely onto a major problem here, and I congratulate
you on doing that, because I think people have to
know this, And as you say, especially children. I mean
eleven and twelve, the two grandchildren that I care most about.
Luckily they have school. Luckily they have a school to

(09:13):
go to. During COVID, the girl did not like being alone.
She wanted to see her friends. The boy, I'm so happy,
he said, I can get all my homework done by
eight thirty in the morning, and then I can do
whatever I want to do, which is kick a soccer
ball and read. And he's okay with that, uh huh.
But she's not. And she needs that social life, that

(09:34):
correspondence with others in physical ways. You know.

Speaker 1 (09:37):
The truth is every kid needs that at some level,
some many more than others, but they all need it.
And I think that's one of the reasons the pandemic
was so tough for them. But it's also one of
the reasons I worry, Martha that even when many kids
are in school today, they are on their phones and
they're not actually interacting as much with each other. I've
had so many young people when I do roundtables around
the country tell me, hey, I want to talk to

(09:58):
other people. That lunchtime everyone's on their phone, and I
mean new classes are on their phone.

Speaker 2 (10:03):
But why do schools allow phones? Well, during class, they
shouldn't allow them.

Speaker 1 (10:10):
So I do believe that there need to be stronger
limitations and restrictions on phones in school. I think many
schools have not necessarily known what the right policies are.
Some of them have policies, but they're not sure how
to enforce them. I think many teachers, rightly, I think,
have felt like, hey, I don't want to be the
enforcer on top of everything else I'm doing, so then

(10:30):
the question of how to enforce it comes to play.
But I think that these are issues that we have
to find solutions to because one of the challenges is
that with having your cell phone on you all the time,
is not only that you don't connect with other people,
but it's also that it impairs your attention and in
a learning environment. And so I think about a few
key areas that we need to protect in our lives

(10:53):
from our phones and technology. One of them is our sleep,
and too often our phones invade our bedrooms and they're
taking stealing out hours away from sleep. The second is
in person interaction, where they often distract us and impair
and I think we can our connections with others. So
when you're talking to friends, when you're having dinner and
catching up with the family, do that without your phones.
The third is where we learn, and that's where I

(11:14):
think keeping schools in particularly to be an area where
the use of technology is limited, specifically your phones, is important.
The final area is actually physical activity. You know, one
of the consequences of spending three and a half hours
a day on your devices, which is the average amount
that adolescents spend each day. Yeah, but there's certain things
you're not doing, and one of those, you know, I

(11:35):
worry is that the cost comes from your time to
be physically active. These are as, I think of it
pillars for health and well being.

Speaker 2 (11:42):
Can you have an effect on this? You can you
impose some rules or encourage schools to clamp down on
the use of phones and put your phone in a
cubby hole in the morning and you'll get it back
in the afternoon. Yeah.

Speaker 3 (11:55):
So it's a great question.

Speaker 1 (11:56):
So we while most of the rules around schools are
made locally in the United States by local school districts.
What thing our office can do and what we have
done is to push forward strong recommendations to schools of
what they can do. And already since we issued our
advisory on Social media and Youth mental health in May
of this year, we've actually seen more schools taking actions.

(12:19):
I was actually just said at when school in Indiana,
for example, that they told me when I went to
visit that after advisory came out, they finally put in
strong rules around not using your phone during schools. And
what they said, it's very interesting. They've found that the
volume has gone up in a good way. They hear
more kids talking to each other in school. The second
thing they've noticed is they see more kids playing with

(12:41):
one another, playing Jenga, they mentioned, than other games with
one another. This is what childhood should be about. Should
be about playing, about connecting with one another, about discovering
their relationships. And I think to do that we need
to protect some of our time without our devices in school.

Speaker 2 (12:56):
Well, you were the nineteenth US Surgeon General and now
the twenty first search in general. Your role has how
did it change from nineteenth to twenty.

Speaker 1 (13:05):
First COVID was happening when I took office the second
time around, it was in March of twenty twenty one.
We were about a year into the COVID pandemic. The
other thing that was different, and this in a in
this saddening way, is that the mental health crisis in
our country was worse. The polarization that we were experiencing
in division was worse than even it was when I
was searching general the first time. So all of this

(13:27):
was deeply worrisome to me, and it was one of
the reasons why, even though I did a lot of
work on COVID in the beginning, I have turned much
of my focus to mental health and well being because
I believe this is the foundation on which we build
everything else. Like our mental health is like the fuel
that allows us to show up at work, for our
families and our communities, in our schools. Our mental health
is not good. It's hard to really thrive in the

(13:48):
rest of our lives, and rebuilding that foundation is really
what I want to dedicate my time and effort to.

Speaker 2 (13:54):
What is your education? What enabled you to get a
job as Surgeon General of the United States.

Speaker 1 (14:00):
Funny thing, Martha is that I actually never thought I
would serve in this role. I never aspired to. But
I also actually never thought I would work in government.

Speaker 2 (14:06):
Yeah, ever, you hadn't thought about it, right, Is that.

Speaker 3 (14:09):
I had not? No.

Speaker 1 (14:10):
I was happily building a life outside of government. I
was at the time I was asked to serve in
this role. I was working as a doctor. I was
teaching medical students and residents. I was building a technology company.
Oh actually at the time, because I was very interested
in how technology could be used to advance research and health,
and I was starting to get involved in doing some
work around advocacy for a better healthcare system because I

(14:34):
had been working as a doctor for enough years at
that point that I realized there were just fundamental things
that were broken about our system that weren't serving patients well.
And I wanted to be a voice for correcting those
and for organizing other doctors to use their voice to
do the same. So that's what I was doing beforehand.
My birthday, actually in twenty thirteen, received this call out
of the blue from a two O two area code number.

(14:56):
And I knew enough to know that twoo two was Washington,
d C. Know which number it was and to compound things,
I had actually just come off of a red eye
flight from la I was living in Boston at the time.
I just wanted to go to bed, honestly, and my
hands were full of by dry clean that I just
picked up the dry cleaners, but the phone rings and
I almost didn't pick it up, and that ended up
being a call from the White House asking me if

(15:17):
I wanted to be considered for the position of Search
in General. And I'll tell you, Martha, at that time
that even though I didn't think that government was really
a place for me, what I did realize was there
was something actually very unusual about this job, which is
that it was an independent job where you are even
though you're appointed by a president, your job is not

(15:38):
to execute the agenda of a president or a political
party or anyone else. Your agenda is devised by you
based on science and the public interest. And so to me,
I like that independence. I liked the idea of being
able to focus on the issues that I thought were
most important to the public. And at the end of
the day, I'm grateful.

Speaker 2 (15:55):
To commander in chief, your commander.

Speaker 3 (15:57):
Ultimately, yes, yeah, absolutely, it is.

Speaker 2 (15:59):
Yeah, but doesn't sit your agenda.

Speaker 3 (16:02):
He does not.

Speaker 1 (16:02):
And one thing I'm grateful for is that this is
true not just for President Biden, but it was true
with President Obama as well. Is both of them understood
the role well enough and had enough respect for the
sacred nature of the role and also for the importance
of science as a driver for what the Search and
General's agenda is. That they never came to me and said,
you need to do this, or you should focus on this,

(16:23):
because this is my agenda. They always gave me the
opportunity and freedom to identify what I thought was most
important for the country to focus on that, and I'm
grateful for them.

Speaker 2 (16:32):
So who was the twentieth So.

Speaker 1 (16:34):
The twentieth Search in General was Jerome Adams, who was
appointed by President Trump to be Search in General. He
served in particular during that first year of the COVID
nineteen pandemic, and he used to be the Health commissioner
in the state of Indiana prior to serving as Search
in General, and he worked incredibly hard travel all over
the country during COVID, even before there's a vaccine available,
So he was putting himself at risk, but he did

(16:55):
it because it was his job, and he wanted to
serve as search in general. With ebola and with Zeca viruses, well,
there's a lot of times where things are changing rapidly
and you're figuring things out, and as you do that,
sometimes your recommendations change. So there were times in the
first year of the pandemic in the Trump administration with
doctor Adams where they were rapidly evaluating new data and

(17:15):
sometimes their recommendations were changing. I think sometimes people would
look at that and say, well, if you said do
something on day one, and then day thirty you're saying
to do something different, that must mean that you don't
know what you're doing. But that's actually the nature of
what you want the scientific discovery process to be. With
this is things happened so fast, they happened really fast. Yeah,
and this is with COVID in particular, was a time

(17:36):
where we were not only trying to learn from what
was happening in the US, but we were gathering data
from all around the world.

Speaker 2 (17:41):
I was doing a sculpture at the time, a lot
of sculptures, but I was you know, this is this
is stay at home of that first hundred days. I
started a sculpture which was in the shape of a
giant egg, and all my colored eggs from my chickens
were blown out and being placed on this giant sculpture.
And I didn't know how many eggs it would take
to cover this giant egg. But on the eggs I

(18:04):
was writing when things happened during COVID, you know, when
when somebody famous died, or when somebody contracted COVID, or
when some new vaccine was being promoted. And so I
wrote these whole town, these eggs, and it was just
incredible to change of things happening, as you say, so fast.
And when I look back on those on those eggs,

(18:26):
now it's the history of COVID and the dates I
put dates on them, and I would people would die
and the number of people hospital Oh my gosh, it
was the most awful time in recent recent history, that
that kind of national awful time. But I can I
can understand. I mean, your job was so difficult, and

(18:47):
doctor Adam's job, of course is so it was so
difficult because he had believers and disbelievers around him.

Speaker 1 (18:54):
How did you manage during that first year of COVID?

Speaker 2 (18:56):
I know, so productive because I was able. I was
living on my farm, so I didn't have to go
to the store. I could just eat out of the
garden and eat from the chickens and all the eggs.
And you know, in Bedford, New York, so close to
New York, and I built one. I had an extra
house on the property. We turned that into a TV
studio and so we did three television shows, big shows,

(19:20):
thirteen episodes each show that year, and we were tested
every day. We had the tester at the gate for
people to come in. They had to be tested and
wait for the tests.

Speaker 3 (19:29):
To come back.

Speaker 2 (19:30):
We were all very careful and we really were extremely productive.
And we didn't come to New York because this office
was closed. It was a miserable time. But in the
first hundred days, I kept five people at my house
and I cooked one hundred different meals and we recorded everything.
It was kind of interesting. They and everybody had a

(19:50):
good time. And I allowed every night. I have a
wine cellar that I don't I'm not a serious wine collector,
but I had some pretty good wind center. Everyone was
allowed to choose a different wine every every night, one wine,
and we brought it up and we looked it up online.
What one night it was a two thousand dollars bottle
one night. It was a nineteen ninety nine bottle of

(20:11):
Why you Know? And everyone we laughed so much and
we played cards. We were not isolated at all because
we had five of us living there. We actually had fun.
But we knew how serious this all was, and we
could we could do this. And I constant conversations with
my daughter with their kids in the city who were
much more isolated because of where they were. But it

(20:33):
was it was an interesting time, but we were very productive.

Speaker 3 (20:36):
And that's a mind that five of you always have. Yeah,
going through that.

Speaker 2 (20:39):
And not only that, there was no chance to get depressed,
no chance to get feel isolated any way, because we couldn't.
But so few people had that opportunity. I mean people
who a family of three in New York stuck in
an apartment with a little baby or something. It's horrible.

Speaker 1 (20:56):
Yeah, I think it was incredibly hard for any families,
and I think for people who had to go to
work in settings where they may not have been a
lot of.

Speaker 2 (21:02):
Precautions as well. Public service workers.

Speaker 1 (21:05):
Many of them were putting their felt they were putting
their lives at riskum and this as there were but
they had come back and take care of their families,
and it was a very hard time.

Speaker 2 (21:12):
But it also got me really to be a believer
in the vaccines, to take care and just through the
stuff that they had to do, and believe in science.

Speaker 1 (21:23):
And in many ways, I think what we saw, even
dispet all the challeges on the way, is we saw
vaccine developed in a remarkably short period of time, with
the right safety checks taken to make sure it was
okay for the population.

Speaker 2 (21:37):
Did your office have a lot to do with that?

Speaker 1 (21:39):
Well, So the vaccine was developed during the last year
of the Trump administration, so this was before I came
back to serve as a surge general the second time.
But I do think it's important to credit them for
the work they did in getting the vaccine developed so quickly.
The Biden administration then took that baton and then really
ran a historic vaccination campaign around the country that vaccining

(22:00):
more people in a short amount of time than I
believe any other vaccination campaign that we've had. To me,
that was a great example of how two administrations could
actually do a good job, you know, in concert with
one another, even though they were subsequent obviously, but they
both had an important piece of the puzzle that they
helped put together to get us through COVID.

Speaker 2 (22:18):
Was it hard to transition from what did you do
in between? Yeah?

Speaker 1 (22:23):
So in between I was actually doing a portfolio of things.
I spent some time writing a book, ironically on loneliness
and isolation. I didn't know the pandemic was coming, but
it came out in the first month of the pandemic.

Speaker 2 (22:33):
I was also last night I was talking to a biochemist. Yeah,
I mentioned that I was going to be speaking to you. Oh.
He wrote an amazing book. Oh that's isolation.

Speaker 1 (22:41):
It was a labor of love, and it was really,
in many ways personally motivated as well, because I myself
have struggled a lot with loneliness over the years as
a child. In particular child I'm not Actually I have
a wonderful sister who's a year older to me, and
I never felt lonely at home.

Speaker 3 (22:56):
This is important.

Speaker 1 (22:57):
My parents loved me unconditioning and my sister did, and
I knew that, which was a saving grace for me.
But when I left home and went to school, that's
when things broke down for me. Because I was very shy.
I was introverted as well, it was hard for me
to make friends, even though I wanted to, And so
I would go to school each day and the day,
you know what, the time I dreaded the most in school, Martha,
it was lunchtime, walking into the cafeteria, not knowing if

(23:18):
there were somebody to sit next to or not, before
I'd be alone. And it's funny in recent years, I've
talked to some of my friends from elementary school and
I've told them a little bit about how I was feeling,
and all of them said, oh, wow, I felt the
same way, but I thought I was the only one.
It turns out many of us were struggling with loneliness,
but we thought we were the only one, and that
turns out to be the case for many people during
adulthood as well. So that's why for me there was

(23:40):
a big personal motivation to write this because not only
had I been affected by personally, had I taken care
of many patients over the years who struggled with loneliness.
But when I was searching on the first time around
and travel the country, I encountered so many people, students,
retired folks, younger parents who were all saying to me
that they felt in visi, they felt if they disappeared

(24:01):
tomorrow and no one would care, and they felt profoundly alone.

Speaker 2 (24:13):
Well, you wrote that your advisory our epidemic of loneliness
and isolation the beginning of this year, in twenty twenty three.
That's right, And how do people get this?

Speaker 1 (24:23):
So you can find this just on our website Surgeon
General dot gov and that'll take you to our priorities.
And this is one of our key ones, loneliness and isolation.
And in it, what we laid out was both the
extent of the problem, you know, noting in particular that
when into adults are struggling with loneliness, and even more
kids are and young adults, but we also laid out
what we can do about it as individuals, as organizations,

(24:45):
schools and workplaces, as neighborhoods, and as government. So my hope,
even though loneliness itself is a profound challenge, I wanted
people to understand why it's so important for us to address,
because this isn't just one more health issue in the
long list health issues for the country to deal with.
But what we realize is that when people struggle with
loneliness and isolation, when they're disconnected, their chances and risk

(25:07):
of depression, anxiety, and suicide all go up, but the
risk of physical illness goes up too. They have a
twenty nine percent increase in the rate of a risk
of heart disease, thirty one percent increase in the risk
of stroke, fifty percent increase in the risk of dementia
among older people, and the risk of premature death goes
up as well. We actually noted also that the mortality
impact Martha that you see with being disconnected from others

(25:31):
is similar to the mortality impact we see with smoking daily.
It's even greater than the mortality impact we see with obesity, and.

Speaker 2 (25:39):
So is an epidemic.

Speaker 3 (25:40):
It truly is.

Speaker 1 (25:41):
And this is one of the reasons I wanted people
to know that loneliness is more than a bad feeling.
It's a public health concern that we've got to take seriously.
And the good news is we can do a lot
about it. You know, we don't have to wait for
Congress to pass a law, you know, to address the loneliness.
There are things we can do in our day to
day lives to help strengthen connection and rebuild our relations.

Speaker 2 (26:00):
So you have to get that message out absolutely and
how were you doing that?

Speaker 1 (26:05):
So you were doing it through a lot of podcasts
like this, through going to events and talking to people,
to visiting communities across the country. But we're also next
week actually or actually to a few days, we're going
to be launching a college campus tour as well. We
were going to universities around the country to talk about
the loneliness crisis, but also to talk optimistically about how
we can come together to now rebuild social connection. And

(26:28):
this is a place market where I actually think that
even though young people are struggling the most with loneliness
and isolation, I really think that a movement of young
people to rebuild connection can help lead our country forward
in shifting how we engage with one another, in rebuilding
and knitting back into our culture. The importance of relationships, Mark,
I think the reason we became lonely is not because

(26:49):
one day we decided relationships weren't important. I don't think
that happened. I think we've always known at some deeper
level that our relationships are important. But I think what
happened is that we just allowed our relationship to drift
away as technology came in and our time got sort
of occupied with work and other things. We allowed more
and more things to reduce the time that we spent

(27:09):
in person with one another, and as people fell lower
and lower on our priority list, we became lonelier. But
we thought we were the only ones. Part of my
goal and this advisor, is for people to realize, if
you're struggling with loneliness and isolation, you're not alone. You're
not alone. You're not the only one. Many of us are,
and that's why it's important for us to talk about
it and to start addressing it.

Speaker 2 (27:28):
Yeah, when the computer became a common tool, I remember
saying to everybody, oh my gosh, this is the best thing,
because it's going to enable us to get our work
done faster, to make time, to spend time with our families,
to let us go on more vacations, to really enjoy
life a little bit more. How wrong I was, you know,

(27:50):
it really made it. It was such a different result
because what it did was become all consuming and that
computer that handheld you know, first it was the desk top,
then it became the tablet, then it became the iPhone.
So important to us and we carry it around like
the most treasured thing with us all the time has

(28:11):
to be charged, it has to be this, it has
to be that, And it really did take away a
lot of free time because, as you say, kids don't
go and play sports, they rather look on their phone.
What are they looking at? They're looking at Instagram, They're
looking at tiktoks, they're looking at inanity sometimes, right, Yeah.

Speaker 1 (28:29):
And the truth is, like I don't entirely blame kids
for this, because some people say.

Speaker 2 (28:33):
Hey, you can't you know, you can't blame that. Yeah.

Speaker 1 (28:35):
I think what's happened is the environment has changed around
them and many of these devices, as you know, Mark
that the devices themselves, and social media in particular, have
been designed to capture all of our attention, oh yes,
and to maximize how much time we spend on it.
Like what I care about when I think about my kids,
and I care about a lot of this person for
almost as a parent of a five and seven year old.
Thankfully they're not on social media attech yet, but that

(28:57):
day is coming and I know it. But do you
think a lot of times when our kids are on
these devices about the fact that we want them to
spend their time, Well, we care about time. Well, spent,
not quantity of time to spend as much, but they're
designed to maximize quantity of time spent, and that's what
I worry about, and it's one of the reasons why
end the advisory. One of the things I called for

(29:19):
government to do is to put real safety standards in
place that are actually enforced, that have teeth, so that
when parents are introducing their kids to social media, they
understand that it has been vetted that safety measures have
been put in place that are adequate. Many companies will
say now that they put safety measures in place, but
what I care about as a parent is are they enough.

(29:39):
Are they working to keep my child safe? Or are
they manipulating my child to spend more and more time
on them, exposing them to harmful content, exposing them to
harassment from others. And unfortunately, that is the common experience
that many kids are going through today. It's just not right,
but it's also fixable, but it has to be addressed
with urgency.

Speaker 2 (29:55):
Well, do you have a rule of thumb for when
children should get their eyes phone?

Speaker 1 (30:00):
That's a great question. So here's how I think about it.
The challenge with getting a phone today is that it
comes with a whole bunch of other stuff. Many parents
get a phone for safety reasons, whether child to be built,
call in case and emergency, right, But with that you're
buying access to the internet more broadly, to social media
in particular. So here's how I think about it. I

(30:20):
for my own kids, my plan is to delay the
use of social media until past middle school, and then
to reevaluate when they're in high school based on whether
there are safety standards in place, based on what the
data says at that time about their safety, and based
on their maturity. Now, I know that's not going to
be easy because there's a lot of peer pressure to
get on your devices and on social early. So my
wife and I are planning to partner with as many

(30:41):
other parents as we can in this, knowing that there's
strength and numbers, and our kids and won't be the
only kids who are delaying use but for safety purposes.
There are more and more parents for getting their kids
what people some people call dumb phones, right, which are
phones that don't necessarily all the bells and whistles in
terms of social media access, but they can make phone
calls text in a case of emergency, you can reach

(31:02):
your parent if you're a child and vice.

Speaker 2 (31:04):
Versa, but no access to the other stuff exactly.

Speaker 1 (31:08):
And I think that's actually very very inappropriate of middle
ground strength.

Speaker 2 (31:12):
I didn't even know about dumb phones.

Speaker 1 (31:13):
Look, I know there's a lot of pressure here, and
this is one of those things where I think the
thing that worries me as a parent, Martha is I
think we've put the entire burden of managing all of
this technology and social media in particular on the shoulders
of parents, and we've said good luck, and we just
walked away as a society. And I just think that
that is wrong, and the vast majority of.

Speaker 2 (31:33):
Parents offering the guidance that they really need.

Speaker 1 (31:35):
Yeah, and the support, Like you know, when I was
old enough to drive, my parents didn't need to go
and check the breaking system on every car, investigate the transmission,
tests out the frame with hammers themselves, and make sure
we're strong enough. They were safety standards in place so
that they knew if they bought a car that it.

Speaker 3 (31:52):
Meant those safety.

Speaker 1 (31:54):
A parent should be able to expect the same thing
from the technology that their kids use.

Speaker 2 (31:59):
That's a very good point. I don't know if you
know this, but at Mount Sinai. We have a Martha
Stewart Center for Living and we've long focused on the
impact of isolation and with older people. I mean it's
been especially in a city scape like New York the loneliness.
Is it more prevalent in a crowded city or less
prevalent loneliness?

Speaker 1 (32:20):
Yeah, it's really interesting. I think it honestly depends on
the culture of this city. I think when you have
a city where people are look. People have said this
to me about New York City while there. I think
the Department of Public Health here has recognized loneliness as
a problem. They're trying to build tools, you know, for
people to engage more with one another, hotlines for people
to call who are on crisis. The truth is, you've
got a lot of people together, but a lot of

(32:41):
times they're not paying attention to each other. Right, they're
walking there, We're on our phones even when we're walking
down the streets. Right, So when we're in cafes, we're
doing our own thing. We're just not We're on the subway,
you know, we're catching up on emails, looking at social
on the phone. We're passing by each other, but we're
not engaging with one another, and I think that can
leave the people to a profound sense of loneliness. You know,

(33:01):
in rural areas, I think the challenge of isolation is real,
you know, and a lot of times you may have
a lot less interaction. But one of the things that
we have realized is what matters, Martha, is the quality
and not the quantity of your connections. If you have
two or three people in your life who know you,
who you can go to during a crisis, who you
can show up for during a crisis, that can be
more invaluable to you than having one hundred friends who

(33:23):
are your contacts on social media, but who you don't
really feel you can be yourself with, who you can't
be vulnerable with. But the good news, I think is
that as huge as a problem is, it is small
steps actually, Martha, that can make a huge difference.

Speaker 2 (33:36):
Are those small steps.

Speaker 1 (33:38):
So here are some simple things I would offer to individuals.
If you were to spend fifteen minutes a day reaching
out to someone that you cared about. It could be
just to say, hey, I'm thinking about you. I want
to know how you're doing. It could be a phone call,
could be swinging by their home if you live in
the same neighborhood, it could be a text to say
I'm thinking about you. That can make a difference in
how you feel. The second thing is if you take
the time that you have with people actually give them

(34:00):
the benefit and the blessing of your full attention by
putting your device away during that short time you're with them,
that can have the effective stretching time. It can make
fifteen minutes feel like it's an hour. Start a bridge club, Yeah,
and activities help a lot too, right, And so whether
it's a bridge club, whether it's a volunteer activity. It
turns out that when we serve other people, that's actually

(34:21):
one of the most powerful antidotes of loneliness. And service
doesn't always have to be volunteer an organization. It could
be recognizing there's somebody at my workplace who's having a
hard time and just offering to help them out, or
lending a listening year.

Speaker 2 (34:32):
I want to touch base, that's great. Yeah, I want
to touch base. And I worry about some of my friends.
You know, they don't have to worry about me as
much as I have to worry about them. Yeah, it's
something that I take seriously.

Speaker 1 (34:46):
Well, I think it makes it a big difference. I mean,
I imagine if your friends, you know, have a need and
you're reaching out to them, which it sounds like, is
what's happening. It means a lot to them to know
that you're thinking of them.

Speaker 2 (34:56):
Oh yeah, I think so. It's a tough challenge. I'm
so happy that you're bringing it to the forefront. I
think it's very important and I hate that it's called
an epidemic, but I can see why.

Speaker 1 (35:09):
Yeah, and unfortun you know, Marthy, turns out we're not
the only country also dealing with this.

Speaker 2 (35:13):
No, England is right now. I mean, I did tell
you My godson, Augustine Booth Clibburn started a company with
his partner, who was a Saudy prince. They started this
company called Hello Tomo. When he told me about it
about five years ago, I said, what the heck are
you doing? I just had a call at a Cambridge
and he's starting this company dealing He says, there's so

(35:33):
much loneliness in our country and we're trying to make
an app so that people can connect via our app,
Hello Tomo. And he sold it for a lot of
money to a much bigger company very involved in loneliness,
epidemic and isolation, and he's now working for that larger company.

(35:53):
But he said, he just aproached me yesterday because I
reached out and said, just tell me a little bit
about what your job entails now. He said, you know,
I'm I'm in charge of reaching out around the world
to other people who are working for this much larger company.
But we're on zoom and he said, I'm not seeing
these people in the flesh, and I'm feeling isolated now

(36:16):
and they're trying to help all the other people around them,
but they're on zooms and they're on you know, and
not seeing anybody. Yeah, he says, it's like it's like
a nightmare for him that he's not talking to anybody
in person. Do you know this company, Lyra. You have
to look it up. You have to look it up
and see what exactly they're doing. But he's he was
one of the new Entrepreneurs forty under forty in England,

(36:40):
you know, for the Forbes thing. And it's so interesting
to see that that he's experiencing what he's trying to solve.

Speaker 1 (36:47):
And I'm really impressed that he recognizes as an issue
more than five years five. Oh, yes, you know a
lot of other workplaces are dealing with the same challenge
of like how especially after the pandemic, with so many
people who started working virtually.

Speaker 2 (36:58):
Okay, well tell me about that, because I want to
know what you think about a three day work week
as opposed to a five day work week. I mean,
it was it nineteen and I think it was nineteen
thirties when we became a five day a week workplace
after six days and no pay was cut. The president
did not cut pay, or but or somebody somebody didn't
cut the pay. And I thought, the five day work

(37:20):
week seems reasonable. And what do you think of this
three day work week that's that everybody's following?

Speaker 3 (37:25):
Now, that's well, I hadn't heard of the three day
work week. Overall.

Speaker 1 (37:28):
What I have heard about is companies that are devising
policies to bring people back for two or three days
a week and then let them work virtually for a
couple of days a week. And look, I think I
recognize that people are trying to strike a balance. Or's
some families and individuals for whom having that flexibility to
work virtually can be very powerful in terms of saving
on commute times, being able to make it home to
have dinner with your kids, you know, or pick them

(37:49):
up from school like those are really valuable and powerful.
There's also you have to bounce out, I think with
certain the cost of never being together, which creates its
own loneliness, and.

Speaker 2 (37:59):
Going to create a company. It's very difficult.

Speaker 1 (38:01):
Yes, And then I'm glad you mentioned creativity because one
of the interesting things that one of my former business
school professors studied and taught me was was that when
people struggle with loneliness and disconnection in the workplace, it
actually negatively impacts their creativity, their engagements, their retention, as
well as their overall productivity. And that's so that matters
a lot. But you don't it's hard to much harder

(38:23):
to forge those relationships when you don't at least have
some in person time. Now for some companies that might
mean being in person a couple of days a week
for others, and maybe more or less frequently. But but
this is where I think it's really important to recognize
that there is a cost to being virtual, all virtual
all the time. You lose those connections, and those matter
tremendously to our satisfaction and to our overall productivity.

Speaker 2 (38:53):
The college tours sounds very good. Are you going to
be going to your alma maters Harvard and Yale?

Speaker 3 (38:58):
No, unfortunately, not on the coledge this college tour.

Speaker 1 (39:01):
We'll be starting actually at Duke University and then going
to many other places from there. It'll be a chance
for us to talk about the power of social connection.

Speaker 3 (39:09):
We're going to have.

Speaker 1 (39:09):
Actually, we've set up an experiential sort of afternoon with
the students where we'll be actually engaging with them in
some actual exercises that through a shake and build connection.
We're actually putting forward a challenge to them as well,
with something we call our five or five challenge, which
is we're asking them to take five days, and each
of those five days to reach out to someone and
experience human connection, and to do so doing one of

(39:31):
three things. Either expressing gratitude to someone, lending support to someone,
or asking for help. And it could be something as
simple as calling a friend to say, hey, you know
that thing that you did for me last month when
you're help me when I needed to move That meant
a lot to me. Thanks for doing that. It could
be asking somebody you know lending support. If you had

(39:52):
a friend who had a hard time, you know, let's
say they broke up with someone recently and they're struggling,
just calling them to say, hey, I'm just checking on you.
I just want to know how you're doing in the
last month. Was has been pretty rough on you? That
could also be asking for help. This is something that
is tough for us to do now. But calling someone
and even to a good friend, to say, look, I
am struggling, I'm having a hard time. Do you think
you could help me out? Maybe could we hang out

(40:14):
or you know, I might need help? You know doing this,
you know activity in my life. Can you come with me?
That might be hard to do. But two things happen
when you ask for help. One is you get help
more often than not, and people are more willing to
help us than we realize. Studies show we'd be often
underestimate people's willingness to help us. But the other thing
that happens when you ask for help is you tell
the other person that it's okay to ask for help.

(40:36):
They are probably somebody who might be struggling with thinking
I have a need, Is it okay for me to
ask for help? So we can be examples, you know,
in asking for help and make it easier for other
people to do the same. But in these three ways,
you know, again expressing gratitude, lending support, or asking for help.
We're asking people to do this each day over the
course of five days, and then to let us know
how they feel afterward, to tag you know, three other

(40:58):
friends and ask them to take that challenge. And by
doing so, we're hoping to create the experience of connection
and hopefully make this more part of people's day to
day lives.

Speaker 2 (41:06):
Well, I certainly hope your message of connection resonates. I
really do, thanks, because I think we need it so
much and it's very hard to believe that we are
in trouble like this culturally and politically, at such odds
with so many other things. Really, previous surgeon generals have
tackled smoking, they've tackled drinking, and so these awareness campaigns

(41:30):
really have a tremendous impact, don't they.

Speaker 1 (41:34):
Well, I like to think they do. They're not the
entire solution, but they can be catalysts for a lot
of the actions that we need to solve.

Speaker 2 (41:40):
Small was the whole clampdown on smoking, and is that
the surgeon General.

Speaker 1 (41:46):
Yes, so in nineteen sixty four that was Surgeon General
Luther Terry.

Speaker 2 (41:49):
I remember, I remember that whole campaign. I was so
happy because I hate it smoking so much, even though
I had to learn how to smoke for a tarriage
and commercial. Really yeah, I was when I was like sixteen.
They made me learn how to smoke inhale and I
had to blow smoke out of my mouth and I thought,
oh god, this is the worst thing on earth.

Speaker 1 (42:10):
Yeah, that was important, and you know, that was a
multi year campaign. But either smoking rates Martha in the
United States at that time or around forty two percent.

Speaker 2 (42:17):
I know, it was horrible.

Speaker 3 (42:18):
It was terrible.

Speaker 1 (42:19):
And now thankfully we're under thirteen percent.

Speaker 3 (42:22):
But not enough, not enough, A lot of program.

Speaker 2 (42:24):
Boy, there there's so many people smoking, you know, everywhere.
And what about drinking. Drinking someone a doctor just told
me that in the there's there's this big list of
dangerous things to take into your body, and the most
dangerous of all out of forty things is alcohol.

Speaker 3 (42:44):
Yeah, so alcohol is.

Speaker 2 (42:45):
Most dangerous, I mean, above heroin.

Speaker 1 (42:48):
Well so, I think a lot of this depends on
how you're using these substances. The thing about alcohol is
that you know. But in twenty sixteen when I when
I issued when I was searching on the first time,
I issued a report on alcohol, drugs and health. Yeah,
and the alcohol was a part of it because I
think many people had I think somehow erroneously felt that
alcohol is not a big deal because it's legal. It's not,

(43:10):
it doesn't have any health risks associated with it. But
you know, sadly, we have, you know, many people who
are addicted to alcohol. We have many people who drink excessively,
and alcohol leads to significant amount of disease and death
each year in our country and causes us a tremendous
amount in terms of lives loss, but also in terms
of money spent on health care costs and economic productivity losses.

(43:31):
In fact, when we detail the overall cost of addiction
in the country, the hundreds of millions of dollars, the
majority of that actually was related to alcohol, not to
other drugs. And so it's important for us to recognize that.
I think many people also don't recognize that kids are
still drinking like underage that continue. There was a problem

(43:52):
when I was growing up, it continues to be a
problem today. Thankfully, there's been some improvement there, and based
on recent data in terms of underage shrinking, that's a
good thing. But this is a place where we have
to be vigilant. I worry that similar thing has happened
with smoking. Many people think that smokes on a problem anymore,
that we solve that problem. It was only problem fifty
years ago. We still have millions of people who are
struggling with smoking. We still lose nearly half a million

(44:15):
people to tobacco related disease each year.

Speaker 3 (44:17):
In the United States.

Speaker 2 (44:19):
And opioids, the.

Speaker 1 (44:20):
Opiate epidemic is is deeply concerning because we are seeing
continue to increases in the rate of overdose steps. We
are we've seen that number starting that growth curves start
to level off over the past year or two, but
still at dangerously high levels. And one of the challenges
mark that is people when they thought about opiods, they

(44:40):
used to think about heroin. They would think about oxy cootone,
the pills that people were taking. But now increasingly what
we're seeing is that there's an even more powerful form
of opio it's called fentanyl, which is now poisoning even
more dangerous. Yes, the supply of opioids such that many
people don't even know they're taking products that contain venttional

(45:02):
but because it is so strong, it can overwhelm your
respiratory system and lead people to stop breathing and ultimately
can lead to death. And so that is a big
part fentanyl of what is driving the opioid overdose crisis today.

Speaker 2 (45:14):
Well covid, can you talk about long covid? What is
that about?

Speaker 1 (45:19):
So long covid is is a syndrome where people experience
prolonged symptoms long after their initial episode of COVID has
a resolved. And those symptoms could be shortness of breath,
it could be fatigue, it could be overall muscle aches
and pains. It could be dizziness and vertigo. There's a
whole host of symptoms that can go along with long COVID.

(45:41):
President Biden actually directed the administration of the Department of
Health Human Services to stand up an initiative to understand
more clearly what drives long COVID, where the risk factors
for it, most importantly, how do we treat it, how
do we address it?

Speaker 2 (45:55):
Is there is there a treatment?

Speaker 1 (45:57):
So right now there isn't a definitive sure if you
will for long covid It's a lot of patients with
long COVID end up working with clinicians who try to
manage some of their individual symptoms. But we need a
more comprehensive understanding of how to diagnose and treat and
prevent long COVID. The good news is that there's a

(46:17):
lot now more attention and money going into addressing that.
The bad news is they can't come quickly enough because
there are many people in the United States and around
the world who are suffering with long COVID.

Speaker 3 (46:27):
I know many of them.

Speaker 1 (46:28):
I've had the chance to sit and talk with them
and understand what it's like. It is debilitating for many
of them, has taken away their quality of life, and
you can imagine that with that have come mental health
strain and mental health challenges as well.

Speaker 2 (46:39):
A big challenge. What about obesity? Is that still considered
a very serious disease here in the United States.

Speaker 1 (46:48):
Absolutely, our rates of obesity have unfortunately continued to go
the wrong way. More than forty percent of adults in
America are living with obesity. Equally, if not more concerning,
around twenty percent of our kids are now abyese. This
is a dramatic change from over the last twenty years. Yes,
and we're talking about obesity. There are even a greater

(47:09):
number who are actually obese or overweight, right. So what
we reason we get so concerned about obesity is because
it puts people at risk for high blood pressure, for
other forms of heart disease, for diabetes. And then there
are other concerns as well with obesity. You imagine your
body is carrying a lot of weight that puts more
strain on your joints. You think about the development of arthritis,

(47:31):
you know in other musclo skeletal conditions which can impact
your quality of life. So these are profound challenges and
I worry that part of what is driving them is
that we are is our food environment has changed dramatically
over the last half century. We have much more highly
processed foods and foods with high levels of refined sugars,
which we know contribute to the obesity epidemic.

Speaker 2 (47:54):
So, as a doctor, what advice do you wish we
would all hear?

Speaker 1 (47:59):
There are a few basic pillars which if we focus on,
can give us a good shot at living a healthy life.
One of those pillars is around sleep. Getting seven to
nine hours of sleep a night really matters for your
health physical and mental. The second is around our physical activity,
just being able to even if you don't have time

(48:22):
to go to the gym every day and work out,
just walking, making sure that you're walking whenever you can,
to stay physically active, that matters. The third has to
do with your nutrition. We all probably could do more
when it comes to drinking more water and eating more
fruits and vegetables and reducing our intake of highly processed foods.
And finally, there's our relationships, which are just as important

(48:44):
as the other three. Spending a little time each day
connecting with people we love and care about, reaching out
to friends, being there to support coworkers. That can go
a long way toward making us feel like we have
a true social network and a social safety net, which
all of us need, whether we say it or not,
not all of us have.

Speaker 2 (49:03):
Well, thank you so much. This has been such an
interesting conversation for me, and I know for all of
our listeners, doctor Murphy, you are fantastic and all of
you out there can listen to house calls with doctor
Vivek Murphy whenever you listen to podcasts. Well, thank you,
thank you, thank you so much very much, and good

(49:24):
luck on the college tour.

Speaker 3 (49:25):
Thank you. I'm very exciting.

Speaker 2 (49:26):
I might enroll now for is there any other degree
that you could possibly get.

Speaker 3 (49:32):
I think I'm all tapped out and a degree, so.

Speaker 2 (49:35):
Well, good luck and thank you so much. And you're
doing a great job for the United States and all
of us here in the United States and elsewhere.

Speaker 1 (49:44):
I appreciate that much. I really enjoyed this conversation. Thanks,
thank you.
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