Together: Why Social Connection Holds the Key to Better Health, Higher Performance, and Greater Happiness

by Vivek H. Murthy

why do some cultures seem more connected than others?

Scholars such as British historian Dr. Fay Bound Alberti suggest that concerns over loneliness arose in Milton’s time because of cultural shifts away from a congregational society toward more individualism. According to Alberti, “Since God was always nearby, a person was never truly alone”—at least, this was the assumption before the 1600s—so there was no need to warn anyone against isolation. But the trends that paved the way for the Industrial Revolution changed that. “The growth of the consumer economy, the declining influence of religion, and the popularity of evolutionary biology all served to emphasize that the individual was what mattered—not traditional, paternalistic visions of a society in which everyone had a place.”4

His conference there was concluding when he realized that he’d mistakenly booked his flight home for a day later, meaning that he was stuck in Ottawa, a city where he knew no one. Standing in his high-floor hotel room after all his colleagues had left and looking through the window at the busy street below, he had an unexpected insight. “I suddenly had a perfect sense of how loneliness feels. I could see the world around me, but I was not part of it.”

Loneliness, Ami told me, occurs when our social experience fails to meet our social expectations.

Loneliness involves a fine balance between social norms and individual needs and desires, and this balance can shift dramatically from culture to culture.

“loneliness threshold” in which people with different cultural values and expectations need different levels of social connection.

What, then, does it look like today when a community goes all in on collectivism? I found one answer in the ethnoreligious colonies of the Hutterites. The forebears of this Anabaptist Christian sect landed in North America in the late nineteenth century after enduring centuries of persecution in Europe. Their philosophy can be summed up by Acts 2:44 of the New Testament: “And all that believed were together, and had all things common.”9 This idea is taken seriously: private property is not permitted, and all income goes to the colony manager who then provides housing, food, and basic home goods to the rest of the colony. Though often compared to other rural religious communities like the Amish and Mennonites, the Hutterites differ in that they embrace the use of modern farming technology.10 Nearly five hundred colonies of Hutterites exist today in parts of Montana, the Dakotas, and Western Canada, each home to about 150 members.11 The colonies are kept small so that everyone is accounted for and has meaningful work to do. The Hutterites believe in self-surrender and a focus on serving one another. Within the colony, everyone is taken care of from cradle to grave. Elderly members are looked after and respected, and new mothers get help from family and community members. When a woman has a baby, a young girl between eleven and fifteen (or sometimes a young boy if no girls are available) becomes her “Sorgala,”12 or apprentice, to help take care of the baby and any older child...

“When we go back to a Hutterite colony today, there are no phones in the living room and every generation is there—young people, babies, middle kids, they are incurably curious. The living room is packed with women and men of all ages.” Like the gatherings I remember from my great-grandmother’s house in India, all this closeness encourages sharing. “And sharing creates connection,” Mary-Ann said, “because sharing our stories, reminiscing about our lives, and laughing at our own foolishness is deeply bonding.” She recalled what Dr. Brené Brown, noted author and expert on shame and vulnerability, said: “People are hard to hate close up.”

Cacioppo and Hawkley had shown that loneliness increases the frequency of microawakenings, those near awakenings that disturb the quality and restfulness of sleep.14 This relationship between loneliness and microawakenings was demonstrated in the Hutterite community as well by a team of researchers led by Lianne Kurina and Carole Ober, who also found the Hutterites have significantly lower rates of loneliness than other communities.15 Cacioppo told me that the frequency of microawakenings in the Hutterite community was the lowest of any community he had studied.

there are lessons the Hutterites can teach us about building a more connected culture. Mary-Ann Kirkby has been following these lessons for decades now, as she lives apart from her colony of origin with her non-Hutterite husband and son. When she hosts a gathering, for example, she remembers how her childhood neighbors would ensure that time spent together was high quality. With this in mind, she tries to make meaning in every conversation. “I start with a question that we all discuss. Last time it was, ‘What did your parents teach you about marriage?’ Gathering together and taking the time for that is important. No phones. Just look into each other’s eyes.”

These small kindnesses reflect the Hutterite belief that each person is the responsibility of the community. Put another way, we take care of each other, even when we are strangers.

traditional societies around the world are grounded in shared history, intertwined lineage, local values, interwoven stories, and religious beliefs. As with the Hutterites, belonging is central to such cultures—so much so in South Africa that there’s a special phrase in Zulu—“Umuntu ngumuntu ngabantu,” which means “I am because you are, and you are because we are.” This ideal is distilled in the term “ubuntu,” meaning to live through others. In contrast to individualist cultures, ubuntu stresses one’s connection to the group first, and harmony foremost.16 Researchers use the term “collectivist” to describe societies that structurally emphasize the group over the individual, in contrast to individualistic societies which do the opposite.17 A third group of cultures are “in transition” from being collectivist to individualistic. Ami Rokach has found that the elderly in transitional cultures often are at particular risk of loneliness because they’re accustomed to strong social support and may not know how to cope when their communities disperse. While the elderly in a country, like Norway, with individualistic traditions, may be used to living by themselves, Rokach says, the elderly who are left alone in Japan or Israel often view their aloneness as abnormal, which makes it both difficult to admit and depressing. They’re also more likely to take social isolation personally, as if being alone means “I’m not worth visiting.”

As easy as it may be to romanticize traditional and other collective cultures, however, it would be a mistake to think of them as an automatic antidote to loneliness. Many allow so little room for individual development and expression that a different strand of loneliness, akin to alienation, emerges if you stray outside the norms or resist the pressure to conform. When belonging is strictly conditional, even minor infractions can provoke painful repercussions. Rebels and violators of the code may...

“Real meaning and purpose in community,” Derek reflected, “comes from having a common cause, rooted in a common belief.” Whether these beliefs are based in religion, politics, or the arts or sports, they reflect a particular vision of an ideal world. But when the beliefs that serve as a basis for connection are based on hatred and fear, they distill a poison that slowly corrodes the integrity of the community and, ultimately, the well-being of its people. This is true not just for extremists like white nationalists but also for the many less visible groups whose defining tie is rejection and hatred of others whom they view as “different.”

link between kindness and social connection is crucial. He told me about Dennis Hickey, a retired philosophy professor he’d met at a senior citizens’ home, who cared deeply about kindness. “He told me there was another word I had to know: the German word ‘mitsein,’ which means ‘being with.’ That’s the higher level of kindness; that’s where the action is. To be kind in the deepest way is to be with others and build connection with them.”

Buettner has spent years identifying the areas of the world known as “blue zones,” which have the statistically highest life expectancy or rate of people who live to the age of one hundred. And while he believes that most of their longevity is a function of an environment that nudges them into eating plant-based foods and moving naturally all day long, Dan has found that they also enjoy an unusually high degree of social connection. In the blue zone of Okinawa, Japan, Buettner discovered an inspiring social system called the moai. The term, which means “meeting for common purpose,” originally described a communal pool of funds that supported the whole village, but it’s evolved to describe a social support network of close friends. In traditional times, Okinawan parents initiated a moai by bringing infants of similar ages together in groups of five, as if they were siblings. The families of these children supported one another, so the group grew up together and relied on one another, continuing as adults to meet daily or weekly. Today’s moais still help one another financially, when needed, but the “common purpose” now has more to do with companionship and advice. A moai is like a second family.

Dan Buettner has established the Blue Zones Project in more than two dozen cities throughout the US. While I was surgeon general, my team reached out to him, and he was gracious enough to walk me through the work they were doing. His idea for American moais was to bring people together around a common interest or activity, like cooking, or walking, or gardening. Then, Dan explained, “We nudge them into hanging out together for ten weeks. We have created moais that are now several years old, and they are still exerting a healthy influence on members’ lives.”

“I wish we saw each other more often,” I said. They murmured in agreement, knowing that with our family and work commitments, we were unlikely to meet again any time soon. That’s when I realized we could create our own virtual moai. We agreed to meet once a month by video conference, during which we’d spend two hours (or more if needed) talking honestly about whatever was on our minds, including our joys and our challenges. We also agreed that we would be one another’s source of accountability. This meant that when we discussed major challenges, we’d speak up if we felt each other’s decisions didn’t support our highest values. It also meant that when we made commitments for our health, such as diet, exercise, or meditation, we would keep each other honest in following through. Finally, we made a commitment to talk about the hard stuff that normally doesn’t come up in routine conversations with friends: our fears, our health, and our finances. All of these decisions turned our friendship into an intentional and valued source of connection in our ongoing lives. Instead of relying on fate or impulse to bring us together, we made an explicit commitment to be there for each other. The moai structure enabled us to act on that commitment. It minimized the risk that inertia would let us drift apart.

But the success of our moai also begs the question: Why is group friendship like this so rare today—especially within the culture of men?

Bill opened the door and was met with an enthusiastic handshake and an outpouring of gratitude for “stepping up for his community” and being the hero the community needed. He was confused, but the idea that the community needed him stirred something inside. So he joined the team. And he loved it. Maxine was encouraged by what she saw: her father was becoming himself again. She decided to bump up her clandestine interventions to the next level: she called the police. The local police oversaw the “neighborhood watch” program, and volunteers were often in short supply. After Maxine’s call volunteering Bill (again without his knowledge), two uniformed policemen showed up and knocked on her father’s door. “Bill, we really need you,” they said. Would he help by being his neighborhood’s coordinator? This official call for help had a powerful effect on Bill. It gave him a sense of purpose and connection. It convinced him that he still mattered to other people. He said yes to the policemen, and he enthusiastically took on his new role. Bill remained the neighborhood coordinator until the day he died. Thanks to Maxine’s initiative, her father’s postretirement years became busy and fulfilling, and Bill was restored to his social self. Although he never learned how Maxine had influenced this change, her mother knew and was eternally grateful.

since she expected women to be more sociable than men, but she wondered what the men were doing instead. It didn’t take her long to find out. She simply needed to look out the window, where she found them in the parking lot, alone in their cars, reading the newspaper, waiting for their wives. Many spent hours like this several times a week, year after year, until they died. Their much-healthier wives then survived them as widows. Suspecting that social disconnection was contributing to the men’s declining health, Maxine thought the guys would benefit just as much as their wives from the services provided at the club. But when she started going out to the parking lot to invite the husbands in, the answer was always a steadfast no. Women might need social programs, they told her, but men? Never! “They were very defensive and proud,” Maxine told me. “They felt if they walked in the front door of any community service operation, they were saying ‘I am a sick person.’” The mind-set of the men she encountered reminded her of her father: good at heart but stubborn, isolated, and resistant to help. Maxine began to imagine a different space, where men could socialize together without feeling labeled as sick or lonely. She also recognized that the older men she wanted to help would not listen to advice from a woman. There was what she called “a huge barricade around the men. We can help create the environment that helps them, but we can’t get them in. They are the only ones who can ...

the men they were trying to help were more likely to connect with one another while doing something that didn’t directly focus on themselves—something like watching a game or working together. So, in 1993, they built a “men’s shed” next to the club. There, men could work on carpentry, this being one of Alf’s skills. They created a separate walkway from the parking lot so the men wouldn’t feel conspicuous approaching the shed. They also kept Alf’s dog tied to the front entrance to signal when Alf was inside. After that, men started to wander down the walkway whenever they saw the dog out front. “We just came down to see what Alf is doing,” they’d often say—then stay for hours. Initially, most just watched Alf work, but as they got more comfortable, they’d pick up some wood and start sawing, sanding, and carving.

Maxine discovered that the men in the shed communicated differently from the women in the club. The men would talk occasionally while they worked, but they rarely had the sorts of long, confiding conversations that women did. Men’s talk seemed to Maxine like surface conversation, yet it ended up creating an environment of comfort and familiarity. In his book The Men’s Shed Movement: The Company of Men, Barry Golding described it: “Women talk face to face while men talk shoulder to shoulder.”20 As time went on, the men’s group grew to ten. The shed became their refuge from a world where they often felt like they weren’t understood and didn’t belong. They got so comfortable being there that their wives had a hard time getting them home. What made the shed so appealing, Maxine reflected, was that it simultaneously enabled “retired men to be productive, reclaim their networks, and enjoy themselves.” Most important, Maxine deliberately took a back seat to allow the volunteer men to own the shed.

The members of the Camden Town Shed don’t see each other much outside the shed, and even when they are there, they aren’t sitting down to have profound, revealing conversations. So what, in fact, was happening between them? “The shed gives men the opportunity for banter,” Mike told me. “Banter is really important for men to form connections with each other.” As if on cue, Mick began ribbing one of the other men about his smoking. “He disappears every few hours and says he’s taking a break, but I really know he’s smoking,” Mick quipped with a smile. The other man grinned, too. Mick never used the word “lonely” to describe how he felt before he joined the men’s shed, yet when I asked him to name the most valuable thing that he got out of the shed, he said it was the relationships. They filled a hole in his life that he had felt, even if he couldn’t put his finger on it exactly.

one reason for the men’s shed movement’s success is that it doesn’t require men to admit that they’re lonely. As Maxine noticed and other researchers have found, men are less likely than women to admit to feeling lonely.22 They’ll suffer in silence as if it’s required of them, and, over time, their loneliness will deplete their energy, change their personalities, and erode their health.

in the early grades, boys will walk with their arms around one another and huddle close together as they talk. Little boys and girls tend to talk about their friendships similarly—with excitement, enthusiasm, and passion. In childhood, boys will develop deep, meaningful friendships with emotional honesty and intimacy. But as they approach puberty, they learn that social closeness is not okay. “When I share with twelve-year-old boys the story of one of their peers who confided he feels sad and deeply hurt about friendships that are lost,” Niobe told me, “the boys typically laugh. But when I tell them 85 percent of the boys I talk to say the same thing in private, they are silent. And then they start sharing about their friendships and challenges. All I have done is normalize emotions.” But when no one steps in to encourage this normalization, growing boys tell themselves they don’t need to confide their feelings in friends anymore. They begin to mold themselves to a model of manhood that they believe will be desirable to women and acceptable in society. This version of masculinity, delivered through the media, as well as by their families and local culture, emphasizes independence, physical power, and emotional stoicism. One emotion that this model allows men to express is anger. That’s because anger so often ignites displays of power and toughness. As such, it’s one of the few emotions a man can express and still feel masculine. But unlike feelings such as sadness, joy, an...

Dr. Michael Kimmel, a sociologist specializing in the field of masculinity, does not see emotional suppression as a uniquely Western aspect of masculinity. He says virtually all cultures around the world frame traits like ambitiousness and assertiveness as masculine and qualities such as vulnerability and love as feminine. Most of these cultures also regard these feminine stereotypes as weak and inferior. The price of this emotional mutation is steep for both men and women.

In virtually every country, men are more likely to take their own lives than women are. This, in spite of the fact that women are more likely to be diagnosed with depression.28 Mara Grunau, executive director at the Centre for Suicide Prevention29 in Canada, says that women are protected in part because they’re encouraged at a young age to communicate their emotions. “Mothers talk way more to their girl children than their boy children,” she told the BBC in 2019, “and they share and identify feelings.” But boys are told to tough it out and hide any sign of vulnerability, and they are also less likely to go to the doctor or seek help.30 We are forcing boys into a mold of “toughness” that actually leaves them emotionally defenseless. As Niobe Way observed, when men feel emotionally isolated, they’re as likely as women to feel lonely. But the harder it is for them to acknowledge their feelings, the more likely it is for their loneliness to come out as verbal abuse, short temperedness, impatience, and irritability.

Unlike masculinity, which has traditionally revolved around power and rivalry, femininity in most cultures is rooted in relationships. Girls historically have been raised to be attentive wives, loving mothers, and helpful friends.

“the more puzzling aspects of women’s psychology: the tendency for women to become selfless or voiceless in relationships, to care for others by diminishing themselves, to use their gifts for empathy and relationship to cover over their own feelings and thoughts, and to begin not to know what they want and know.”31 This nurturing role can make women a powerful force for building connections and weaving our social fabric. Yet when relationships falter or fail, girls and women tend to blame themselves. The resulting shame and loneliness are even more acute when women have blurred their sense of self in service of those relationships.

When women like Gina Clayton-Johnson feel torn between hiding some shameful part of themselves or losing their community, they often choose to bury other true feelings along with the shame. Rosalind Wiseman, author of Queen Bees and Wannabes,34 watched a similar struggle play out many times during the decade that she spent studying friendship in children. “Girls have a feeling of constant comparison,” Wiseman told me. This comparison exposes them to the shame of social failure and increases their risk of loneliness. “There’s a fear of missing out, yet you can never keep up.”

Lots of teenage friendships are healthy, of course, and Wiseman emphasized that they can be invaluable. “Many girls will make it through their teen years precisely because they have the support and care of a few good friends. These are the friendships in which a girl truly feels unconditionally accepted, understood, and sometimes even challenged when she’s doing something that’s not good for her—like dating someone who doesn’t treat her with respect.” And through these high-quality friendships, girls learn how to form and maintain nourishing relationships later in life. At the same time, she went on, “Girls’ friendships are often intense, confusing, frustrating, and humiliating.” The joy and security of “best friendships” can be shattered by devastating breakups and betrayals. And the very importance that friendship plays in the identity of young women can make them vulnerable to hurtful relationships that they mistake as friendships. When girls can’t navigate the social currents, that resulting shame can extend far beyond childhood. “Girls can develop patterns of behavior and expectations for future relationships that stop them from having healthy relationships with others as adults.” And that can place them at heightened risk for loneliness.

Wiseman takes care to point out that boys and girls both need meaningful relationships. “Sometimes we make judgments about girls’ friendships being deeper, but that is absolutely not backed up by the research. When we look at girls who are talking all the time on Instagram, we might think those relationships are more intimate than boys who aren’t talk...

My view is that we have veered too far away from the group and toward the individual—throwing culture out of balance in the process—more out of benign neglect than anything else. We’ve emphasized freedom of individual expression without also ensuring that the underpinnings of community are protected and strengthened. Now we need to recapture our investment in the collective elements that matter—our relationships, our community organizations, our neighborhoods, our social and cultural institutions—and we must do this while continuing to protect individual expression.

Two decades ago in his book Bowling Alone, Robert Putnam famously described the erosion of social networks and social norms in the US that began in the latter third of the twentieth century. His research found that various measures of social engagement had declined precipitously—including religious participation, membership in community organizations, and the frequency with which people were inviting friends to their homes.1 According to Putnam, many of these trends have only worsened in the years since his seminal publication.2

Today Amy is a contributing editor at Harvard Business Review, but early in her career she worked for a consulting firm based in New York, with a special focus on the unofficial networks and communities in organizations that govern how people work together in practice. Despite her specialty in workplace connection, however, she often struggled with a personal sense of profound disconnection, especially when her assignments sent her thousands of miles from home.

In exchange for efficiency, we’re all letting more and more genuine human contact slip from our daily lives. I remember being jubilant when online grocery delivery services arrived on the scene. I told Alice that they’d liberate us from all that time trekking back and forth to the store. But those grocery store visits were when we met friends in our neighborhood sorting through produce or trying to make sense of baby food options. They were where we got to know the clerks who helped us track down hard-to-find items, where we commiserated with fellow parents over crying children. These seemingly small interactions were an important part of what kept us connected to the larger fabric of our local community. They contributed to our sense of belonging.

This dizzying speed means that, like the fabled Sorcerer’s Apprentice, we barely have time to get used to one innovation before it’s replaced by multiple new apps, devices, or platforms. Technology dares us to keep up. This unspoken dare creates an underlying tension within the social fabric. Those who can’t keep up get left behind, while those who can are constantly chasing the next new thing. They do this not just out of curiosity but because “keeping up” has become synonymous with having a competitive edge. Whether we realize it or not, the pace of change has created the impression that we have only two choices: adapt quickly to stay marketable, employable, and desirable; or fall back and lose out. This sets up a state of competition between tradition and innovation, between old and young, between online and physical communities, and between transactional and human interactions. These pervasive tensions make modern loneliness different than anything previous generations ever experienced.

stiff breeze, unable to get our bearings as we unwittingly lose sight of what matters and who matters to us. We

I felt inspired 25 percent of the time and inadequate 100 percent of the time. As one friend put it, checking your social media feed is like comparing everyone’s best days to your average days—and you always come up short. I noticed something else that disturbed me. I originally began posting on social media to share experiences and reflections with friends. But soon I found myself preoccupied with how many people would like, comment, and share my content. I remember posting a reflection on 9/11 during one of the anniversaries and feeling the genuine emotion that I’d poured into the piece dissolving as I kept checking to see if people liked the post. It turned an authentic act of expression into a hollow exercise. Chasing validation like that made me feel bad about myself.

crunching the data on more than 350,000 adolescents, they concluded that smoking marijuana and bullying do far more damage than use of digital technology. Przybylski and his colleague Dr. Netta Weinstein had previously shown that the amount of time spent in front of screens makes a difference in overall impact.5 According to this “Goldilocks hypothesis,” the mental well-being of adolescents does not appear to be harmed if they’re spending one to two hours per day in front of screens, but much more than that can be detrimental. Interestingly, kids with zero screen time seemed worse off than those with moderate use, possibly because in a world where everyone around you is online, having no participation could lead to a sense of being left out and isolated.

how we are using our screen-based devices may be more important than how much we are using them. A few minutes of harmful content for a susceptible child in the wrong circumstances could be devastating whereas an hour of screen time as part of a rich family experience might be very positive. “The problem is we’re focusing so much on time spent on screens but not focusing enough on the content, type of technology, or motivation to use it,” she said. As we learn more about these various dimensions of technology, it is increasingly clear that technology holds mixed blessings for us. Social media can help people find meaningful connections, especially when they come from communities that have traditionally been isolated or marginalized. But in the wrong circumstances, it can exacerbate loneliness by amplifying comparison, enabling bullying, and substituting lower- for higher-quality relationships.

The more time we spend on the platform, the more revenue it generates, usually in the form of advertisements. In other words, our time is social media’s money. In this way, apps have become the quintessential products of the attention economy.

It creates the illusion that we can satisfy our curiosity in a dozen directions at once, simultaneously hearing a friend’s story about his new baby, checking out a neighbor’s vacation photos, picking up a text about a parent’s trip to the doctor, and Googling the latest news about our favorite sports team. In fact, when we multitask, we’re splitting our attention into smaller and smaller fragments, reducing efficiency and diminishing the quality of engagement we bring to each task.

it takes an average of twenty-three minutes to fully reengage10 with our original subject of focus.

Parigi compared them with friendships that developed organically between offline hosts and travelers. “What we found is that when the couch surfer had more information about that other person he or she was going to meet, the resulting friendship after they met was weaker than in a world where the couch surfers did not have that amount of information about the unknown other.” Virtually front-loading the relationship with social information, it seemed, was a trade-off that eased entry but made the resulting connection “less binding.”13 In contrast, the effort that the group with less up-front information had to put into learning about each other from the ground up actually paid off in friendship. It’s not just what we know about each other that counts, it’s how we get to know it. And time and attention, with a little struggle thrown in, can make a real difference in strengthening connection.

When we’re on the digital tether, she says, we’re not fully present in either our virtual or our physical life. Also, we’re not fooling anyone. Others can tell when we’re not paying attention, and it makes them less likely to share as much or as deeply.

Andrew Przybylski and Netta Weinstein found in their experiments, the mere sight of phones during conversation negatively impacted “the extent to which individuals felt empathy and understanding from their partners.”

This increasingly common phenomenon of people snubbing each other in favor of their phone even has a term: phubbing. A 2015 study that surveyed 453 US adults found that 46.3 percent of respondents said their partner had phubbed them. A second survey found that those whose partners phubbed them reported more fights and less relationship satisfaction than those where phubbing was less frequent.16

In 2010, researchers at the University of Michigan found empathy scores among college students had dropped about 40 percent from 1979 to 2009, with the biggest drop coming after 2000.17