by tyler | May 4, 2023 | CNN, health
Covid-19 was the fourth leading cause of death in the United States in 2022, according to provisional data from the US Centers for Disease Control and Prevention.
It was the third leading cause of death in the first two years of the pandemic, but there were about half as many deaths from it in 2022 as there were the year before.
Despite the decline, about 1 out of every 13 deaths in the US in 2022 was associated Covid-19. The virus killed nearly 245,000 people in 2022, CDC data shows. It was an underlying cause of nearly 187,000 deaths and a contributor to about 58,000 more.
Covid-19 death rates declined for all racial and ethnic groups but remained highest among American Indian and Black people. Overall death rates were highest for these groups, too.
Unintentional injuries moved back to the third leading cause of death, as drug overdoses reached record levels.
Heart disease and cancer remained the top two leading causes of death, and rates for both increased in 2022. Nearly 700,000 people died from heart disease, and about 608,000 people died from cancer.
The pandemic may have contributed to this increase. One study, for example, found that people with Covid-19 are at an increased risk for cardiovascular diseases for at least a year after recovery.
Overall, the age-adjusted death rate in the US declined about 5% from 2021 to 2022.
The death rate for children ages 1 to 4 rose nearly 8%. The Covid-19 death rate for this group did rise in 2022, but it was not a significant contributor to the overall death rate. The report did not fully explain what drove the overall increase for children ages 1 to 4.
by tyler | May 4, 2023 | CNN, health
A team of doctors in Boston successfully performed a novel fetal surgery to treat a rare brain condition known as vein of Galen malformation.
Although in utero surgery – performed before a baby is born – has been used for other conditions, this ultrasound-guided procedure was among the first for this condition. Details of the procedure, which took place in March, were published in the journal Stroke on Thursday.
The condition occurs when the blood vessel that carries blood from the brain to the heart, also known as the vein of Galen, doesn’t develop correctly. The malformation, known as VOGM, results in an overwhelming amount of blood stressing the vein and heart and can lead to a cascade of health problems.
“Tremendous brain injuries and immediate heart failure after birth are the two big challenges,” Dr. Darren Orbach, a radiologist at Boston Children’s Hospital and expert in treating VOGM, told CNN.
Typically, infants are treated after they’re born using a catheter to insert tiny coils to slow down blood flow. However, Orbach said, the treatment often happens too late.
Despite advancements in care, “50 to 60 percent of all babies with this condition will get very sick immediately. And for those, it looks like there’s about a 40 percent mortality,” Orbach said. About half of infants that survive experience severe neurological and cognitive issues, he said.
When they learned of their fourth pregnancy, Derek and Kenyatta Coleman of Baton Rouge, Louisiana, were surprised and excited. Kenyatta, 36, and Derek, 39, have been married for seven years and were ready to welcome a new addition to their family.
Kenyatta said nothing seemed particularly notable about the pregnancy. After having three children, Kenyatta thought of ultrasounds as routine appointments.
“Baby was doing well. The anatomy scan came back unremarkable. All of her biophysical profiles were all unremarkable,” said Kenyatta, who spoke to CNN exclusively.
The Colemans even did genetic testing that characterized Kenyatta’s pregnancy as “low risk,” she said: “We honestly thought that we were in the clear.”
But when Kenyatta went for an ultrasound at 30 weeks into her pregnancy, something was different. She remembers her doctor sitting her down and saying she was worried.
“She shared with me that something wasn’t right in terms of the baby’s brain and also her heart was enlarged,” Kenyatta remembers.
After more investigation, there was a diagnosis: VOGM.
But the Colemans had learned about a clinical trial run by Brigham and Women’s and Boston Children’s hospitals that could provide treatment before their baby was born.
Kenyatta remembers being told about the possible risks – preterm labor, or brain hemorrhage for the fetus – but the Colemans felt there was no other option for them. They wanted to join the trial.
On March 15, exactly one month after the ultrasound that spotted the malformation, Kenyatta underwent surgery.
But for this surgery, there were two patients: Kenyatta and her baby.
Doctors had to make sure the fetus was facing the right position, with its head facing the mother’s abdominal wall. Dr. Louise Wilkins-Haug, division director of Maternal Fetal Medicine and Reproductive Genetics at Brigham and Women’s Hospital, partnered with Orbach to make sure that the fetus was not only in the right position for the procedure, but stayed there.
Wilkins-Haug explained they used a technique borrowed from previous in utero cardiac surgeries. Once the fetus is in the optimal position, it “gets a small injection of medication so that it’s not moving and it is also getting a small injection of medication for pain relief,” Wilkins-Haug said.
From there, the doctors inserted a needle through the abdominal wall, carefully threading a catheter through the needle, so that the tiny metal coils can fill up the vein, slow the blood flow and reduce the pressure.
The baby showed signs of improvement immediately, with scans showing decreased blood pressure in key areas.
“It was exhilarating at the moment that we had technical success at doing the embolization,” said Orbach.
But success wasn’t defined by that moment alone, but rather, what would follow.
“Will she be able to continuously show progress after? Will she need just additional support after I have her? Will she go into immediate heart failure still?” Kenyatta wondered.
After the procedure, Kenyatta was slowly leaking amniotic fluid. Two days later, she went into labor at 34 weeks.
On March 17, Denver Coleman was born, weighing 4 pounds and 1 ounce.
“I heard her cry for the first time and that just, I – I can’t even put into words how I felt at that moment,” remembers Kenyatta.
“It was just, you know, the most beautiful moment being able to hold her, gaze up on her and then hear her cry.”
Her doctors were also pleased. “In the immediate new newborn period, she was very stable and didn’t need any of the immediate treatments that they typically need, whether it’s placing coils or whether it’s supporting her heart function with medications,” said Wilkins-Haug. “Our hope is that she won’t need any further coils placed.”
Derek remembers visiting Denver for the first time in the neonatal intensive care unit and doctors asked if he wanted to kiss her.
“I gave her a kiss and she was just making little baby noises and stuff,” he said. “That was all I needed right there.”
Now, nearly two months after Denver was born, she continues to thrive, spending most of her time sleeping and eating. She’s not taking any medications for heart failure, and her neurological exam is normal. There’s no indication that she needs any additional interventions.
“She’s shown us from the very beginning that she was a fighter,” Kenyatta said, “she’s demonstrated … “Hey, I wanna be here.’ “
by tyler | May 3, 2023 | CNN, health
After a 60-year scientific quest, the world has its first vaccine to protect against respiratory syncytial virus, or RSV – and more are on the way.
On Wednesday, the US Food and Drug Administration approved Arexvy, made by GSK, which is designed to be given as a single shot to adults 60 and older.
It could be available for seniors as soon as this fall, pending a recommendation for its use from the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices, which next meets in June.
“Older adults, in particular those with underlying health conditions, such as heart or lung disease or weakened immune systems, are at high risk for severe disease caused by RSV,” said Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, in a statement. “Today’s approval of the first RSV vaccine is an important public health achievement to prevent a disease which can be life-threatening and reflects the FDA’s continued commitment to facilitating the development of safe and effective vaccines for use in the United States.”
Although RSV is a disease that’s often associated with babies and young children, it can also be dangerous for seniors. In the US, an estimated 159,000 adults 65 and older are hospitalized each year with RSV, and an estimated 10,000 to 13,000 die as a result of their infection.
“RSV certainly is an important disease in the elderly. In some years, the burden of RSV disease comes close to the burden of flu in the elderly. And this is really a wonderful development,” said Dr. Ruth Karron, a professor of international health at Johns Hopkins Bloomberg School of Public Health, who was not involved in the development of the vaccine.
In a clinical trial of nearly 25,000 older adults whose results were published in the New England Journal of Medicine, the GSK vaccine was 83% effective at preventing lower respiratory tract disease caused by the virus.
Lower respiratory tract disease was defined in the study as a positive test and two more symptoms for at least a day, including new or worsening cough, wheezing, shortness of breath, an elevated respiratory rate, lowered blood oxygen or crackles in the lungs, which a doctor would pick up with a stethoscope.
The vaccine was 94% effective at preventing severe disease in seniors. People were considered to have severe disease if they needed supplemental oxygen or needed mechanical help to breathe, like a ventilator.
GSK’s RSV vaccine works by using a small piece of the virus: a protein that sticks out on its surface called the fusion, or F, protein, which helps the virus glom onto and infect cells in the body’s upper airways. The protein pieces in the vaccine are made in a lab, using cells specially programmed to manufacture them.
The vaccine builds on a pivotal discovery made a decade ago by researchers at the National Institutes of Health, including some of the same scientists who helped make the Covid-19 vaccines.
Normally, the F protein is wiggly, it flips back and forth, changing shapes after it fuses with a cell.
The NIH researchers figured out how to freeze the protein in the shape it takes before it fuses onto a cell. In this shape, the body can develop strong antibodies against it.
The GSK vaccine uses this potent pre-fusion form of the protein, along with an ingredient called an adjuvant, which boosts immune activity.
When researchers looked specifically at how well the vaccine worked in the most vulnerable seniors – those with underlying health conditions like COPD, heart failure or heart disease – they found that it was 94% effective at preventing lower respiratory tract infections.
“That’s really exceptional information, because that’s the type of disease we want to prevent. We want to prevent people from ending up in the hospital with RSV,” said Dr. Len Friedland, director of scientific affairs and public health at GSK.
The most common side effects reported by people in the clinical trial included pain at the injection site and fatigue. Those usually resolved within a day or two.
There were a small number of serious adverse events in the study. Friedland said they were balanced between the group that got the vaccine and the group that got the placebo. Friedland says the researchers will continue to monitor for safety signals as the vaccine rolls out to a wider population.
It’s unclear exactly how durable the protection from the vaccine will be, he said. The researchers are following study participants for three years and will continue to evaluate vaccine efficacy over time. So far, protection appears to hold up well for about a year.
Three other RSV vaccines for older adults are also in the final phases of testing.
The FDA is expected to make a decision on Pfizer’s RSV vaccine for older adults by the end of May. The agency is also reviewing Pfizer’s maternal vaccine to protect infants and is expected to make a call on that one by the end of August.
Moderna is finishing its Phase 3 trial of an mRNA vaccine for RSV in older adults and expects to submit the results to the FDA for approval within the next few months.
Bavarian Nordic, maker of the Jynneos mpox vaccine, says it will report results from a Phase 3 trial of its RSV vaccine for older adults this year.
Paul Chaplin, president and CEO of Bavarian Nordic, says there’s a saying in Britain that you’ll wait a long time for a bus, and then four will show up at once. The race to the finish line for an RSV vaccine is a little bit like that, he says.
“We’ve been waiting decades for a safe effective RSV vaccine, and there’s been numerous attempts that have failed,” Chaplin said.
“And I know GSK will likely get the first approval, but there are others coming through, including us. And I just think it’s fantastic, because RSV is a huge unmet medical need that a lot of people underestimate the importance of, and we will hopefully now have a number of effective vaccines that will help protect people.”
The hunt for an effective vaccine for RSV is a story of scientific triumph over tragedy.
In the 1960s, two children died and many others were hospitalized with severe RSV when the experimental vaccines they had been given turned out to enhance the infection rather than defend against it.
That study tested a vaccine made with an RSV virus that had been chemically treated to render it inert and mixed with an ingredient called alum, to wake up the immune system and help it respond.
It was tested at clinical trial sites in the US between 1966 and 1968.
At first, everything looked good. The vaccine was tested in animals, who tolerated it well, and then given to children, who also appeared to respond well.
Unfortunately, when RSV season started that fall, many of the children that were vaccinated required hospitalization and got more severe RSV disease than what would have normally occurred.
A study on the trial found that 80% of the vaccinated children who caught RSV later required hospitalization, compared with only 5% of children who got a placebo. Two of the young trial participants died.
The outcomes were a seismic shock to vaccine science. Efforts to develop vaccines and treatments against RSV halted as researchers tried to untangle what went so wrong.
Many of the guardrails currently in place around clinical trials of vaccines grew out of the failures of the RSV vaccine.
The scientific breakthrough that allowed scientists to freeze the virus’s F protein into place also allowed NIH scientists Drs. Jason McLellan and Barney Graham to stabilize the spike protein of the coronavirus, speeding the development of a Covid-19 vaccine.
“RSV has been one that’s taken us a while to be able to unlock its mysteries and secrets,” said Dr. Steven Varga, dean of the Graduate School of Biomedical Sciences at St. Jude Children’s Research Hospital who has spent his career studying the virus and has designed a nanoparticle vaccine against it.
“It’s a really exciting time. It’s been a long time coming,” he said.
Minnesota resident Tania Richter wishes the vaccine had been available for her grandfather Adam Kaseman, a retired school bus driver who died after a bout of severe RSV last summer. He was 95 but otherwise in good health and in assisted living in Jamestown, North Dakota, when RSV tore through the facility.
He was hospitalized and later recovered enough to be discharged into a nursing home, but Richter said it was the beginning of the end for him. He died a few weeks later.
“He was a great-grandpa. I didn’t get to see him too much the last couple of years, just with Covid, trying to keep everybody safe, kept that from happening,” she said.
“I really wish it had been around before this happened because the vaccines give us a fighting chance,” she said. “Hopefully, it will save someone else’s grandpa.”
by tyler | May 3, 2023 | CNN, health
An experimental Alzheimer’s medication slowed declines in patients’ ability to think clearly and perform daily tasks by more than a third in a large clinical trial, drugmaker Eli Lilly said Wednesday.
Based on the results, in people with early symptomatic Alzheimer’s disease, Lilly said it plans to file for approval from the US Food and Drug Administration by the end of June.
The medicine, donanemab, works by removing plaque buildups in the brain known as amyloid that are a hallmark of Alzheimer’s disease. However, there were some side effects reported; there were three deaths in the trial among people taking the drug, two of which were attributed to adverse events such as brain swelling or microhemorrhages, known as amyloid-related imaging abnormalities or ARIA. The trial was run in more than 1,700 patients for 18 months.
“For every medicine, for every disease, there are potential risks and potential benefits,” said Lilly’s chief scientific and medical officer, Dr. Daniel Skovronsky. But he noted that almost half of the participants taking the drug, 47%, showed no decline on a key measure of cognition over the course of a year, compared with 29% of people taking a placebo.
That’s “the kind of efficacy that’s never been seen before in Alzheimer’s disease,” Skovronsky said.
Alzheimer’s affects more than 6 million Americans, with an estimated 1.7 million to 2 million people over 65 in the early stages of the disease, according to Lilly. Drug development for Alzheimer’s has been riddled with failures, but Lilly’s drug is among a new group showing promise. The first, Eisai and Biogen’s Leqembi, received accelerated FDA approval in January.
Skovronsky, who noted he’s been working in the field of Alzheimer’s for 25 years, said the new class of medicines is different because of “the amount of amyloid they can clear and how quickly they can clear it.”
The medicine is given by infusion once a month. Donanemab clears amyloid so effectively, the company says, that a majority of patients in the trial – 52% – were able to stop taking the medicine by one year, and 72% were able to do so by a year and a half. Researchers will continue to monitor these patients’ progress.
In the trial, researchers looked at the participants in two groups, separated by levels of a brain protein known as tau. A 35% slowing in cognitive and functional decline was seen in the group with intermediate levels of tau, whose disease hadn’t progressed as far. When this intermediate group was combined with the group with higher levels of tau, the figure was 22%. The results have not been peer-reviewed or published in a journal.
Lilly filed for accelerated approval with the FDA for donanemab based on earlier results but was rejected in January as the agency sought more data. With these results, the company will file for full approval, which is expected to lead to broader insurance reimbursement for the medicine. Leqembi was approved on an accelerated basis in January, and Medicare is not expected to cover the drug broadly until it receives full approval as well, most likely by early July.
Leqembi is priced at $26,500 a year. Skovronsky declined to discuss potential pricing for donanemab before the drug is approved.
by tyler | May 2, 2023 | CNN, health
Breast density is known to naturally decrease as a woman ages, and now a study suggests that the more time it takes for breast density to decline, the more likely it is that the woman could develop breast cancer.
Researchers have long known that women with dense breasts have a higher risk of breast cancer. But according to the study, published last week in the journal JAMA Oncology, the rate of breast density changes over time also appears to be associated with the risk of cancer being diagnosed in that breast.
“We know that invasive breast cancer is rarely diagnosed simultaneously in both breasts, thus it is not a surprise that we have observed a much slower decline in the breast that eventually developed breast cancer compared to the natural decline in density with age,” Shu Jiang, an associate professor of surgery at Washington University School of Medicine in St. Louis and first author of the new study, wrote in an email.
Breast density refers to the amount of fibrous and glandular tissue in a person’s breasts compared with the amount of fatty tissue in the breasts – and breast density can be seen on a mammogram.
“Because women have their mammograms taken annually or biennially, the change of breast density over time is naturally available,” Jiang said in the email. “We should make full use of this dynamic information to better inform risk stratification and guide more individualized screening and prevention approaches.”
The researchers, from Washington University School of Medicine in St. Louis and Brigham and Women’s Hospital in Boston, analyzed health data over the course of 10 years among 947 women in the St. Louis region who completed routine mammograms. A mammogram is an X-ray picture of the breast that doctors use to look for early signs of breast cancer.
The women in the study were recruited from November 2008 to April 2012, and they had gotten mammograms through October 2020. The average age of the participants was around 57.
Among the women, there were 289 cases of breast cancer diagnosed, and the researchers found that breast density was higher at the start of the study for the women who later developed breast cancer compared with those who remained cancer-free.
The researchers also found that there was a significant decrease in breast density among all the women over the course of 10 years, regardless of whether they later developed breast cancer, but the rate of density decreasing over time was significantly slower among breasts in which cancer was later diagnosed.
“This study found that evaluating longitudinal changes in breast density from digital mammograms may offer an additional tool for assessing risk of breast cancer and subsequent risk reduction strategies,” the researchers wrote.
Not only is breast density a known risk factor for breast cancer, dense breast tissue can make mammograms more difficult to read.
“There are two issues here. First, breast density can make it more difficult to fully ‘see through’ the breast on a mammogram, like looking through a frosted glass. Thus, it can be harder to detect a breast cancer,” Dr. Hal Burstein, clinical investigator in the Breast Oncology Center at Dana-Farber Cancer Institute, who was not involved in the new study, said in an email. “Secondly, breast density is often thought to reflect the estrogen exposure or estrogen levels in women, and the greater the estrogen exposure, the greater the risk of developing breast cancer.”
In March, the US Food and Drug Administration published updates to its mammography regulations, requiring mammography facilities to notify patients about the density of their breasts.
“Breast density can have a masking effect on mammography, where it can be more difficult to find a breast cancer within an area of dense breast tissue,” Jiang wrote in her email.
“Even when you take away the issue of finding it, breast density is an independent risk factor for developing breast cancer. Although there is lots of data that tell us dense breast tissue is a risk factor, the reason for this is not clear,” she said. “It may be that development of dense tissue and cancer are related to the same biological processes or hormonal influences.”
The findings of the new study demonstrate that breast density serves as a risk factor for breast cancer – but women should be aware of their other risk factors too, said Dr. Maxine Jochelson, chief of the breast imaging service at Memorial Sloan Kettering Cancer Center in New York, who was not involved in the study.
“It makes sense to some extent that the longer your breast stays dense, theoretically, the more likely it is to develop cancer. And so basically, it expands on the data that dense breasts are a risk,” Jochelson said, adding that women with dense breasts should ask for supplemental imaging when they get mammograms.
But other factors that can raise the risk of breast cancer include having a family history of cancer, drinking too much alcohol, having a high-risk lesion biopsied from the breast or having a certain genetic mutation.
For instance, women should know that “density may not affect their risk so much if they have the breast cancer BRCA 1 or 2 mutation because their risk is so high that it may not make it much higher,” Jochelson said.
Some ways to reduce the risk of breast cancer include keeping a healthy weight, being physically active, drinking alcohol in moderation or not at all and, for some people, taking medications such as tamoxifen and breastfeeding your children, if possible.
“Breast density is a modest risk factor. The ‘average’ woman in the US has a 1 in 8 lifetime chance of developing breast cancer. Women with dense breasts have a slightly greater risk, about 1 in 6, or 1 in 7. So the lifetime risk goes up from 12% to 15%. That still means that most women with dense breasts will not develop breast cancer,” Burstein said in his email.
“Sometimes radiologists will recommend additional breast imaging to women with dense breast tissue on mammograms,” he added.
The US Preventive Services Task Force – a group of independent medical experts whose recommendations help guide doctors’ decisions – recommends biennial screening for women starting at age 50. The task force says that a decision to start screening earlier “should be an individual one.” Many medical groups, including the American Cancer Society and Mayo Clinic, emphasize that women have the option to start screening with a mammogram every year starting at age 40.
“It’s also very clear that breast density tends to be highest in younger women, premenopausal women, and for almost all women, it tends to go down with age. However, the risk of breast cancer goes up with age. So these two things are a little bit at odds with each other,” said Dr. Freya Schnabel, director of breast surgery at NYU Langone’s Perlmutter Cancer Center and professor of surgery at NYU Grossman School of Medicine in New York, who was not involved in the new study.
“So if you’re a 40-year-old woman and your breasts are dense, you could think about that as just being really kind of age-appropriate,” she said. “The take-home message that’s very, very practical and pragmatic right now is that if you have dense breasts, whatever your age is, even if you’re postmenopausal – maybe even specifically, if you are postmenopausal – and your breasts are not getting less dense the way the average woman’s does, that it really is a reason to seek out adjunctive imaging in addition to just mammography, to use additional diagnostic tools, like ultrasound or maybe even MRI, if there are other risk factors.”
by tyler | May 2, 2023 | CNN, health
US Surgeon General Dr. Vivek Murthy released an advisory Tuesday addressing the “epidemic of loneliness and isolation” affecting the country and laying out a framework for a “National Strategy to Advance Social Connection.”
The advisory is part of the Biden administration’s broader efforts to address mental health, White House press secretary Karine Jean-Pierre said Monday.
“In recent years, about one-in-two adults in America reported experiencing loneliness,” Murthy says in the advisory. “And that was before the COVID-19 pandemic cut off so many of us from friends, loved ones, and support systems.”
Research has showed that loneliness and isolation are linked to sleep problems, inflammation and immune changes in younger adults. In older people, they’re tied to symptoms such as pain, insomnia, depression, anxiety and shorter life span. In people of all ages, they may be associated with higher risks of heart disease, stroke, diabetes, addiction, suicidality and self-harm, and dementia.
But social connection can help, Murthy’s office said in a statement, serving as a buffer to health problems while making communities more resilient.
“Loneliness I think of as a great masquerader. It can look like different things,” Murthy told CNN’s Erin Burnett on Monday. “Some people, they become withdrawn. Others become irritable and angry. … I think the time you get concerned is when you start experiencing a feeling of loneliness for prolonged periods of time. If you feel lonely, you pick up the phone and call a friend, and then it goes away, or you get in the car and go see a family member, that’s OK. That’s loneliness acting like hunger or thirst, a signal our body sends us when we need something for survival. It’s when it persists that it becomes harmful.”
Social connection is as essential to humanity as food, water or shelter, the advisory says. Humans have historically needed to rely on each other for survival, and modern people remain wired for that connection and for proximity to others.
“Given the profound consequences of loneliness and isolation, we have an opportunity, and an obligation, to make the same investments in addressing social connection that we have made in addressing tobacco use, obesity, and the addiction crisis,” Murthy says in his advisory. “We are called to build a movement to mend the social fabric of our nation. It will take all of us – individuals and families, schools and workplaces, health care and public health systems, technology companies, governments, faith organizations, and communities – working together to destigmatize loneliness and change our cultural and policy response to it.”
The framework is rooted in six pillars.
The first, strengthening social infrastructure in communities, involves boosting programs like volunteer organizations or religious groups, policies like public transit or education, and physical elements like libraries and green spaces.
“Investing in local communities and in social infrastructure will fall short if access to benefits is limited only to some groups,” the advisory notes. “Equitable access to social infrastructure for all groups, including those most at-risk for social disconnection, is foundational to building a connected national and global community.”
The second pillar calls for more “pro-connection public policies.” Governments and institutions are urged to adopt an approach that recognizes that policies can benefit or hinder connection and that “every sector of society is relevant to social connection.” Policymakers should focus on reducing disparities in connection.
The third pillar relies on the crucial role of public health and health care delivery systems to address social connection. Murthy calls for increased investment in educating health care providers about the physical and mental benefits of social connection and the risks of disconnection. Patients’ needs should be assessed and supported, and organizations should track prevalence of disconnection in communities and advance local solutions, he says.
For the fourth pillar, reforming digital environments, Murthy singles out the “tangible impact” of technology on Americans’ daily lives and connections. “Technology can also distract us and occupy our mental bandwidth, make us feel worse about ourselves and our relationships, and diminish our ability to connect with others. Some technology fans the flames of marginalization and discrimination, bullying, and other forms of severe social negativity.”
The framework calls for more data transparency from tech firms, as well as the establishment and implementation of safety standards such as age-related protections. It also encourages development of “pro-connection technology to promote healthy social connection, create safe environments for discourse, and safeguard the well-being of users.”
The fifth pillar, deepening knowledge, urges stakeholders such as officials, policymakers, health care providers and researchers to collaborate on a research agenda to address gaps in the data. “Consistent measurement will be critical to better understanding the driving forces of connection and disconnection, and how we can be more effective and efficient in addressing these states.”
The final pillar urges a culture of connection in which Americans “cultivate values of kindness, respect, service, and commitment to one another.” Everyone can use their voice to emphasize these values and model healthy connections, Murthy says, and the nation’s institutions should invest in demonstrating them.
The advisory concludes with suggestions about how specific groups – including governments, health organizations, schools, workplaces and individuals – can help advance social connection.
Parents and caregivers have an especially powerful role, the advisory says. They can model healthy connection by spending time together, setting aside time for screen-free socializing, and engaging in constructive conflict resolution. They’re also urged to encourage individual friendships and group activities, to be aware of how young people spend their time online and to watch for potential warning signs of loneliness or isolation.
Individual Americans might take time out of each day to connect with a friend or family member and minimize distractions during conversations. Regularly practicing service and gratitude can encourage others to do the same. Cut back on things that lead to disconnection, such as harmful social media use or time spent in unhealthy relationships. Be open with health care providers about significant social changes that may affect levels of connection, and reach out to a loved one, counselor, provider or crisis hotline in times of struggle.
