What is the number one public health challenge in America?

Loneliness.

That is not something that we typically associate with health.

Dr. Vivek Murthy became the Surgeon General of the United States in 2014. Dr. Murthy spent his first several months visiting communities large and small, urban and rural. He met with health care professionals and farmers, small business owners and teachers. Of course, he heard all about heart disease and diabetes, cancer, drug and alcohol addiction, the opioid epidemic and obesity. These were expected.

But what surprised him was to encounter, over and over, that people were experiencing loneliness and isolation in profound ways.

Now in his second stint as Surgeon General, Dr. Murthy’s department released, this past April, a general advisory for our nation entitled Our Epidemic of Loneliness and Isolation.

What is loneliness? First of all, it is subjective. We experience it when there is a gap between the social connections that we desire and those that we have. 

Aloneness and Loneliness are not the same. It is possible to be alone in a crowd, just as it is possible to spend large amounts of time by oneself and feel socially fulfilled. 

Consider your own life. If you have felt lonely at some point in the past year, and if you are comfortable doing so, I invite you to raise your hand…

A related, objective term is “social isolation.” This refers to having few social relationships and roles, group memberships and interactions with others.

Social isolation has been increasing in the United States for the past half century, and especially over the past twenty years. For example, between 2003 and 2020, the average number of hours adults spent by themselves increased by 24 hours per month. Time spent engaging, in person, with friends decreased from 30 to 10 hours per month. Even within households, we spent 5 fewer hours per month interacting with our family members.

This is bad for us. Decades of research has found connections between loneliness, social isolation, and health outcomes.

Lacking social connection puts a person at about the same risk of early mortality as smoking fifteen cigarettes a day and is a greater risk factor than drinking 6 alcoholic drinks a day, physical inactivity, obesity, or exposure to air pollution.

Those with poor social relationships are associated with having a 29% increase in risk for heart disease and 32% increase in risk of stroke. Similar links exist with hypertension, diabetes, cognitive decline, and dementia.

It should come as no surprise that those who are more socially isolated are more likely to experience depression and anxiety, to become addicted to opioids, and self harm.

Gun violence is exacerbated by loneliness and isolation.

Loneliness also brings an economic cost. First, the obvious: healthcare and social services. But there are other expenses. Children who are isolated have lower academic achievement. Workers experiencing loneliness are less productive in their jobs. One study found that loneliness led to increased rates of stress-related absenteeism, costing employers $154 billion each year.

There is one additional harm that bears mentioning. The terrible political and social polarization plaguing us is directly related to the loneliness and social isolation that has exploded over the past decades. Loneliness drives us to extremes.

How did we get here?

For most of human existence, survival required membership in deeply integrated social communities. Our prehistoric ancestors formed tribes for mutual protection from outside enemies as well as to meet basic needs, i.e., food, clothing, and shelter. Religious beliefs, moral codes, meaning, and purpose all emerged out of this collective social orientation.

Now, we can survive day-to-day without ever sharing air with another person. I can work remotely. I can have all my food, clothing and cleaning supplies delivered to my door. I can consume an endless amount of entertainment from the comfort of my sofa. And I can even complain to my therapist about my lack of a social life from the comfort of my laptop. 

In his final book, Morality, published in 2020, the late Rabbi Jonathan Sacks, z”l, points to the beginning of the Enlightenment, approximately 400 years ago, as the moment when humans began to shift the way that we perceive ourselves in relation to our communities.

Instead of existing as part of a collective “We,” individuals began to think of themselves as a unique, sovereign “I.”

Without going into a social, political, religious, and economic history of the past four hundred years, it is safe to say that the quest for meaning and purpose in life is now something that we each must figure out on our own. This has not always been the case.

In his 1961 inaugural address, President John F. Kennedy famously challenged, “And so, my fellow American: ask not what your country can do for you. Ask what you can do for your country.” It was a call for children and adults to do something to contribute to the public good, to selflessly give of themselves for the collective “We.”

His challenge presupposed a shared national identity and system of collective values.

Can you imagine a national politician putting out a similar call today?

By the way, the continuation of the speech included this line: “My fellow citizens of the world: ask not what America will do for you, but what together we can do for the freedom of man.”

I think we know, deep down, that we need each other, that we are better off when we face life’s challenges together, and that our society is more cohesive when we embrace a shared set of values.

But now it is not uncommon to ask, “What does my Judaism mean to me?” That is a lonely question that would have been considered absurd until very recently.

Facebook is less than twenty years old. Newer still are Instagram, Snapchat, Tik Tok, X—human beings around the world have never been more connected. Ironically, we have also never felt so alone.

Think for a moment about some of the terms we associate with social media: Influencer; My personal brand; Followers, The selfie.

While presented as tools to bring people together, these social media apps prey on our attachment to self and need for validation. But the result is that we feel inadequate. Do we feel more or less connected to fellow human beings after scrolling through our feed for an hour?  

So many of our face-to-face encounters have been replaced by screen time. Our social muscles are atrophying. Even when we are together, we are distracted. It is so disheartening to look around a restaurant and see families, friends, and colleagues mesmerized by their phones, oblivious to the person sitting across from them. Is this the purpose for which we are created?

Our tradition teaches that Rosh Hashanah, the first of Tishrei, coincides with the day on which humanity was born. After creating the first human in the Garden of Eden, God declares, lo tov heyot adam levado. “It is not good for a human to be alone.”

So, God makes all the animals off the ground and the air, bringing them to Adam, one by one. But no fitting helper can be found.  It is then that God casts a sleep upon the human and forms a woman out of its side. Now identified by gender, the man and the woman find companionship in each other. 

Humanity’s very first experience is loneliness. The Torah unambiguously declares it lo tov, “not good.” Its remedy, the solution provided by God, is human companionship.

Our present epidemic is not how we are meant to live, neither from a biological perspective, an evolutionary perspective, nor a religious perspective.

Turning to our Rosh Hashanah liturgy, we find the theme of loneliness woven throughout. In our Torah portion, after God remembers Sarah and blesses her with a child, she orders Abraham to banish Hagar and Ishmael. 

Cast out that slave-woman and her son, for the son of that slave shall not share in the inheritance with my son Isaac.

Genesis 21:10

This is not mere physical exile, but social excommunication. Hagar and Ishmael can no longer be part of the family. When their supplies run out in the wilderness, Hagar, depressed, abandons her son, thinking “Let me not look on as the child dies.” Hagar’s loneliness is answered when God sends an angel to announce that God has heard the cry of the boy “where he is.”

Our Haftarah tells the story of another barren woman. As the story begins, Hannah is teased and tormented continuously by Peninnah, her rival wife. Her tone-deaf husband, Elkanah, tries to console her:

Hannah, why are you crying and why aren’t you eating? Why are you so sad? Am I not more devoted to you than ten sons?

I Samuel 1:8

The Bible does not dignify Elkanah’s selfish words with an answer. Hannah prays, silently moving her lips while weeping. Even the priest Eli looks right past her. He scolds her as a drunk. Only then does Hannah recite her first words out loud.

Oh no, my lord! I am a very unhappy woman. I have drunk no wine or other strong drink, but I have been pouring out my heart to Adonai. Do not take your maidservant for a worthless woman; I have only been speaking all this time out of my great anguish and distress.

I Samuel 1:15-16

That must have taken a lot of courage: to speak up for herself, to own her sadness and loneliness, and to share it with a stranger. Now Eli really does see her. He prays for God to grant her wishes. As Hannah leaves, she eats and she is no longer downcoast. A moment of empathy, of being seen, has made all the difference.

These stories evoke our own loneliness. How have we been forgotten? Does God hear our prayers? Is there a remedy for our own loneliness?

Look around the room. We come to shul.  We sit side by side. We sing in harmony (or something resembling harmony). We catch up. We wish each other a good year. Amidst the angst and uncertainty that fill our lives, we come together to share our loneliness. And suddenly we are not so lonely.  All of us recognize, at some level, that the only way to celebrate the new year is together.

It should not surprise any of us to learn that people who are involved in religious communities are less lonely, and experience higher levels of social support and integration. In other words, Shul is good for your health – emotionally, psychologically, maybe even physically. (Although we might want to take it easy during Kiddush.)

To reverse our loneliness epidemic, Rabbi Sacks suggests that we need to shift our focus back from “I” to “We.” How do we begin?

In one experiment, participants were given a sum of money. Half were told to spend the money on treats for themselves. Half were told to spend the money on a person in need. The subjects were asked questions before and after to measure their relative levels of happiness. Which group do you think was happier at the end of the experiment?

It was the group that spent the money on someone else. Taking those few moments to think “What would make another person happy,” increased their own happiness. We experience the greatest joy when we stop thinking about ourselves. 

Instead of turning to “Self-Help” to work on what is wrong with us, how about trying “Other-Help?”  What if, every day, we consciously do one thing solely for another person’s benefit. 

There is a particular concept in Judaism that Rabbi Sacks suggests could help us reframe our relationship to community: the brit, or covenant. A covenant is different than a contract. In a contract, I am me and you are you. Contracts deal with tangible things and specific responsibilities. I agree to pay you five thousand dollars, and you agree to give me a car in working order. When we complete our responsibilities as outlined by the contract, we never have to see each other again. A covenant is different. It establishes a relationship. Fundamentally, it calls on the parties of the covenant to be loyal to one another. It transforms you and me into we. 

As Jews, we are quite familiar with this idea, at least conceptually. Covenant is how we describe our relationship with God. Our brit establishes mutual loyalty, care, and compassion; not only between God and us, but between and among one another. If I am not responding to the needs of my fellow Jew, I am not being faithful to the covenant. Meaning in is found by sharing a common set of stories and values that tell us where we come from, who we are, and what our purpose is. 

Rabbi Sacks argues that it is our mutual loyalty to one another and to God which forms the basis of morality. Living covenantally asks me to give up some of my need to self actualize and self authenticate, to set aside my self interest and prioritize the other. The goal of any society should be to prioritize the well-being of all its members, and to serve the common good, rather than the interests of a select few. If I am to belong to that society, those must be my priorities as well.

Covenants can exist at varying levels. At the smallest, a marriage is a covenant between two people who make a commitment of loyalty and care to one another. As the Torah explains after the creation of man and woman: v’hayu l’vasar echad. “They become one flesh.”

Ostensibly, the Jewish people are covenantally committed to mutual care and compassion. Kol Yisrael arevim zeh la-zeh, goes the saying. “All of Israel are surety for one another.” How well we live up to that ideal is debatable.

Do we have a national covenant that binds Americans together in loyalty and mutual responsibility? At the moment, it does not seem like we do.

Rabbi Sacks even posits the existence of 

a covenant of human solidarity that binds all [eight] billion of us alive today to act responsibly toward the environment, human rights, and the alleviation of poverty for the sake of generations not yet born.

Jonathan Sacks, Morality, 313-314

How different our world would be if humanity truly saw itself committed to this shared vision. Perhaps that is the meaning of the words of Zekhariah that conclude the prayer Aleinu, originally recited only on Rosh Hashanah.

V’hayah Adonai l’melekh al kol-ha’aretz,
bayom hahu yihyeh Adonai echad ush’mo Echad

Adonai shall be ruler over all of the earth.
On that day, Adonai will be One and the name of Adonai, One.

Let us each take the steps within our power to bring that day closer.

This year, may we dedicate ourselves to cultivate compassion and empathy, to truly see one another, and to put other before self. May we, together, be worthy of a year filled with health, happiness, meaning, and growth. L’Shanah Tovah.