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By Kathryn Armstrong
BBC News
A top US health official has warned the country is facing an epidemic of loneliness that is as dangerous to health as smoking 15 cigarettes a day.
The Surgeon General, Vivek Murthy, has released an advisory calling for social isolation to be treated as seriously as obesity or drug abuse.
It warns that almost half of all Americans from all walks of life are thought to have been affected.
Mr Murthy has also unveiled a national framework to rebuild social connection.
Loneliness is reported to increase the risk of premature death by almost 30% - through health conditions including diabetes, heart attacks, insomnia and dementia.
Lack of social connection is also linked to lower academic achievement and worse performance at work, according to the advisory.
The issue has been exacerbated by the Covid pandemic, which led many people to reduce the size of their social circles.
One study quoted in the report found a 16% decrease on average in the social network size of participants from June 2019 to June 2020.
In order to tackle this, Mr Murthy has called for a collective effort to "to mend the social fabric of our nation" in order to "destigmatise loneliness and change our cultural and policy response to it".
His strategy has six pillars that include efforts to strengthen social infrastructure in communities, in part by utilising public health systems.
The advisory calls for more "pro-connection public policies" that are developed with the help of a research agenda to help address gaps in the data surrounding the effects of social isolation.
It also highlights the need for more data transparency from tech firms and a reform of digital environments.
The advisory is part of the Biden administration's broader efforts to address mental health, White House press secretary Karine Jean-Pierre said on Monday. May is Mental Health Awareness Month in the US.
While the declaration is intended to increase awareness, no new promises of federal funding to combat the issue have so far been made.