Vivek Murthy – The Health Care Blog

Succeeding in Fighting the Loneliness Epidemic

Jul 30, 2024

By JOSHUA SEIDMAN

In 2023, U.S. Surgeon General Vivek Murthy boldly declared that our country has a “loneliness epidemic.” In the Surgeon General’s public health advisory, “Our Epidemic of Loneliness and Isolation,” he draws on decades of empirical evidence demonstrating the tremendous toll that loneliness has on people’s quality of life, and how it also increases the risk of premature death by 26%.

The question is: What can be done to tackle this intractable public health crisis? Perhaps even more pointedly, what is anybody actually doing that successfully reduces loneliness?

Steps Required to Reduce Loneliness

The first thing we have to do, as the Surgeon General said in his report, is “consistently and regularly track social connection using validated metrics.” Without ongoing measurement, we can’t even assess the problem, understand whether it’s getting better or worse, and know what interventions might be helping.

Furthermore, we need to tie those measurements to some sort of payment model. In order to focus providers and other stakeholders on the importance of loneliness, we need to hold them accountable for outcomes. Since we know that loneliness dramatically impacts both the quality and length of people’s lives, we should raise it as a priority for providers by tying some portion of their payment to their success in reducing loneliness.

We need to orient the health care system toward addressing factors that substantially affect the health of the population. Since the powers that be in the health care world accept smoking cessation as a valid performance measure, then it absolutely makes sense for payers and purchasers to hold providers accountable for addressing loneliness, a condition that the Surgeon General’s research equates to smoking 15 cigarettes per day.

Case Study of Success in Tackling Loneliness

Just as with any other proposed performance measure used to hold providers accountable, it’s fair to demand evidence that providers can actually influence outcomes for their patients. New research from Fountain House does just that —making clear that, with the right interventions, it is absolutely possible to measure and dramatically reduce loneliness in a way that meaningfully improves lives.

Fountain House pioneered the clubhouse model, a psychosocial rehabilitation model that supports people with serious mental illness (SMI). By addressing social drivers of health, we not only facilitate recovery, but we also reduce Medicaid costs by 21% relative to a comparable high-risk SMI population. An economic model we built also found that clubhouses reduce overall costs to society by more than $11,000 per person annually (when factoring in costs for mental and physical health, disability, criminal justice, and productivity/lost wages).

More to the point here, our population (and people with SMI generally) faces tremendous economic and social isolation and therefore are 2 to 3 times more likely than the general population to be lonely. Furthermore, research demonstrates that loneliness can be more intractable in the SMI population and failure to address it compromises their recovery and raises risk for an array of acute health events.

Advice to Vivek Murthy: Be Nonpartisan, Use Common Sense and Move Americans

Dec 18, 2014• 28

By SAURABH JHA, MD

In defiance of dire predictions, children haven’t been sent to workhouses and women haven’t been chained to utensils after the GOP gained strength in the House and the Senate. And Vivek Murthy, the unabashed Obamaphile, was finally confirmed Surgeon General.

To be honest, I always thought the controversy surrounding Murthy’s nomination because of his stance on gun control was rather daft. Stopping doctors from pontificating over guns, such as the Docs versus Glocks legislation, is like banning me from trying to convert Pope Francis to Hinduism. The legislation is a parody not just for its own sake but because what it seeks to prevent is parody as well.

Murthy’s first challenge is to raise the position of the Surgeon General from that tokenism of a career UN bureaucrat to something vaguely useful. Which means Murthy must resist the call of banality, the banality of ideology and the ideology of making all of mankind’s imperfections public health problems.

Mixing Politics and Science Is Injurious to Public Health

Mar 18, 2014• 9

By Saurabh Jha, MD

If Obama’s nominee for the position of Surgeon General, Vivek Murthy, is not endorsed by the Senate because Senate Democrats from conservative states are too scared to vote for him for fear of losing votes from a population, egged on by the National Rifle Association (NRA), that passionately supports firearms, the first words that come to mind are ‘unfortunate,’ ‘tragic’ and ‘daft,’ although not in that particular order.

Words that do not come to mind are ‘surprising’ or ‘unprecedented.’ This is the natural result of decades of actively encouraging science to mix with politics.

In an ideal world, or I should say reasonable world, noting that perfection is not a pre-requisite to being reasonable, it would scant matter what Murthy thought about firearms.

He would be judged on his (impeccable) credentials, (unmistakable) leadership, and (imaginative) entrepreneurship not to mention his gumption in standing up for what he believes.

It would, of course, be utterly naïve to believe that in the real world his politics do not matter.

I doubt Murthy would have advanced so precociously, let alone been nominated for the position of Surgeon General, if he were a second amendment absolutist, an implacable limited government advocate or had written extensively about the role of free market in healthcare, all things else being equal.

We applaud him for standing up for his convictions not just because of his standing up but for the nature of his convictions.

This is not to suggest that Murthy’s worldview is expedient. There’s no reason to doubt its sincerity. It’s to suggest that a certain weltanschauung is incompatible with progress in academia and beyond.

That’s because despite living in an age of unprecedented reason we have been unable to render unto science what is unto science and render unto politics what is unto politics, a distinction our species has made little progress in making in the last two thousand years.