Social isolation kills. It increases your risk of death by 30% — roughly the same as smoking cigarettes and much worse than factors such as obesity and sedentary living.
Americans are living through what researchers call a friendship recession, spending less time with friends than at any point in recent history.
In 2023, the U.S. Surgeon General declared loneliness an epidemic. Deaths from factors like suicide, addiction and alcoholism, referred to as deaths of despair, continue climbing.
While doctors routinely check patients’ blood pressure and ask about exercise habits, they rarely assess social health.
Public health guidelines urge Americans to eat their vegetables, exercise for 150 minutes weekly, sleep seven to nine hours nightly and drink less than one or two alcoholic beverages per day. But few public health bodies have addressed social connection — until now.
As scholars who focus on public policy and social determinants of health and well-being, we are part of an international team of more than 100 experts who undertook the first systematic effort to develop evidence-based guidelines for social connection.
These guidelines, which are now publicly available, aim to do more than offer advice. Elements of them are already being embedded into policies in the Netherlands and the U.K.
Our hope is that the guidelines can elevate the importance of social connection to the same level as basic public health practices such as exercising, not smoking and relying on a designated driver when you go out drinking with friends.
The value of guidelines
Research has shown for decades that social connection is crucial for good health. The World Health Organization’s constitution, adopted in 1946, defines health as “complete physical, mental and social well-being.”
Codifying different dimensions of health into evidence-based guidelines matters because guidelines allow people to put recommendations into action. Nutrition labels help people understand what they’re eating. Exercise recommendations help people know how much movement protects their health. Blood pressure cutoffs tell both patients and clinicians when it’s time to intervene.
Guidelines also shape systems in ways people feel every day. Exercise guidelines, for example, helped motivate cities to invest in walkable streets and bike lanes, workplaces to design wellness programs, and schools to include physical activity in curricula.
Social health guidelines can play a similar role.
Standardized metrics for social well-being can help health care providers identify when someone is socially isolated, enable employers to design workplaces that foster connection, and give schools and cities clearer targets for building socially supportive environments.
They also lay the groundwork for “social prescriptions” — structured ways to connect people with community programs or group activities — which some health care systems are already beginning to test.
The science of connection
Beginning in the summer of 2023, our team spent more than two years developing a set of international guidelines for social health by drawing on more than 40 plain-language evidence summaries, numerous case studies, conversations with marginalized communities, and extensive consultation with global experts.
What we found highlights several foundational principles of social well-being.
First, there are no universal rules for social health. There is no magic number of friends or ideal number of weekly social hours. Social needs vary widely. Both introverts and extroverts need connection, but they meet that need differently. A new parent’s social world is completely unlike a retiree’s. And quality trumps quantity: One meaningful conversation can be more nourishing than a dozen quick exchanges.
Second, technology is not the villain it’s often made out to be. Passive scrolling can harm well-being, but active, intentional use can strengthen bonds — whether through video calls with distant family, group chats that sustain friendships or apps that help neighbors organize local meetups. The key is using technology to facilitate real connection rather than replace it.
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Third, relationships are shaped as much by systems as by individuals. Social health isn’t just about personal effort. It emerges from local environments that make connection possible. Research shows that investments in social infrastructure – the places and spaces where we connect, such as libraries, parks and cafes – measurably improve well-being. And communities that have denser concentrations of such spaces have better health outcomes after disasters.
Finally, diverse networks matter. Strong social health includes both close relationships and “weak ties” — acquaintances, neighbors, local business staff and others you see in passing. These lighter-touch interactions offer meaningful benefits: the barista who remembers your order, a colleague you exchange a few words with, a fellow dog walker along your route.
Studies show that weak ties provide novel information, unexpected opportunities and a broader sense of belonging that close friends alone can’t provide. A mix of ties — deep and shallow — forms the basis of a socially healthy life.
From research to reality
Forward-thinking institutions are already experimenting with principles that underpin our guidelines.
Some workplaces now assess social health when making decisions about policies such as remote work or office layout, recognizing that communication norms and physical design shape how employees connect. Schools are teaching emotional intelligence and friendship skills as core curriculum, not extras. Cities are investing in social infrastructure — community centers, shared public spaces and plazas — that naturally bring people together.
On a personal level, the guidelines suggest a few simple shifts:
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Prioritize face-to-face time. Even short, in-person interactions boost mood, reduce stress and build trust.
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Use technology actively, not passively. Reach out to someone, schedule a video call or use apps to create opportunities for connection — not just to scroll.
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Treat solitude as restoration, not failure. Healthy social lives include both meaningful interaction and the downtime needed to recharge.
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Build routines that create natural interaction. Walk the same route daily, become a regular at neighborhood spots or join recurring community activities to create predictable opportunities for connection.
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And most importantly, take initiative. In a culture that treats socializing as a luxury, prioritizing connection is quietly radical.
