Transcript: Brendan Case

My interview with the associate director of research at Harvard's Human Flourishing Program

Life in North America is becoming increasingly lonely — and this trend is impacting all areas of our lives, including our physical health. So much so, in fact, that the United States Surgeon General recently issued an advisory on loneliness, characterizing it as a critical public health concern. But my guest on this week’s program says that that report fails to grapple with the drivers of our loneliness epidemic, including economics.   

Brendan Case is the associate director for research at the Human Flourishing Program at Harvard University. His response to the Surgeon General’s report appears at Compact Magazine this week.

This edited transcript is for paid subscribers. You can listen to the interview for free here.

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TH: Brendan, welcome to Lean Out.

BC: Thanks for having me.

TH: It's great to have you on the program today. You published a powerful piece yesterday at Compact Magazine, reacting to the U.S. Surgeon General's advisory on loneliness. Before we get to your essay, you are the associate director for research at Harvard's Human Flourishing Program. What is that program — and can you describe the work that you do advancing it?

BC: Sure. The Human Flourishing Program is a smallish research institute in the Faculty of Arts and Sciences at Harvard University. Our twofold aim is to study and promote human flourishing, and to develop systematic approaches to the integration of knowledge from across the disciplines — which basically means helping the social sciences and humanities work together in fruitful, skillful ways to advance the work of our first aim. Which essentially is to conceptualize what a good life looks like for most people, to understand its components, key constituents, and then to better understand what core pathways to a flourishing life are for most people, on average.

A lot of our work is devoted to understanding how key institutions — like marriage and family, or religious participation, or work, education — serve as pathways to a life that's not just subjectively pleasant, a happy life or a satisfying life, but also a life that's filled with meaning and purpose, a life that's shaped by character and virtue, a life that's characterized by deep social relationships. That, in our view, is what a genuinely flourishing life amounts to.

TH: I was so interested to read about that. And I do want to come back to that later on. First, let's talk about the Surgeon General advisory. Vivek Murthy argues that social isolation is a critical public health concern. The report notes some startling data spanning mental health rates, healthcare spending, work absenteeism, community safety. And it talks about the much-discussed fact that lacking social connection can increase the risk of premature death as much as smoking up to 15 cigarettes a day. This is a sobering report, even for those of us who have been steeped in this data for some time. You argue in your essay for Compact that the Surgeon General basically misses the boat here. You call this paper a “cargo cult.” What does that mean?

BC: A cargo cult basically is a label for a family of apocalyptic religious sects that grew up in Melanesia, in the South Pacific, after the retreat of the U.S. Navy after World War II — which had brought unprecedented material prosperity to this, up to that point, quite isolated region. They vanished quite quickly. The bases were closed down and the ships disappeared with their cargo, as some of the islanders described them. The most famous of them was on the island of Vanuatu, where a group mobilized by a single apocalyptic religious leader essentially built a fake airfield. They built airplanes out of wooden palm fronds. They built air traffic control towers, and they would man them. They would go through the motions of inhabiting a U.S. military installation, in the hope of recalling this now-vanished world.

So, the conceit of the essay is that the same kind of magical thinking is evident in a lot of the Surgeon General's recommendations for how to address this epidemic of loneliness and isolation. He's absolutely right about the report. The report is quite good, in a lot of ways, in describing the current data — how critical the situation is.

But the recommendations that he offers, to my mind — most of them, not all of them, but most of them — are unserious in a way that really merits comparison to building wooden airplanes in the hope of luring back the U.S. Navy. This is the sort of thing you do if you don't really understand what's driving [the crisis], or if are unwilling to come to grips with it … I won't speculate about the state of his mind, but if you are not reckoning seriously with what's bringing this crisis into being. It's a somewhat tongue-in-cheek way of accusing the report of a degree of superficiality, which I think is disappointing in our highest-ranking public health official.

TH: In your essay, you draw attention to a couple of key facts that I want to repeat here. Roughly a third of Americans live alone, marriage and birth rates are at historic lows, and religious affiliation has fallen. You write that, "The report reflects a startling lack of interest in the actual drivers of contemporary social disaffiliation," as you've just talked about. Walk us through what these drivers are, on the economic side.

BC: There's been a lot of good work done in the last — let's say 30 years even, but especially in the last decade — on this issue. Robert Putnam's work is seminal in this regard; Bowling Alone and later books. Most recently, the book I draw on most heavily is Michael Lind's recently published book, Hell to Pay, about the way that the depression of wages in the U.S. economy is undermining our social fabric as a whole. Not just our economic lives, but our social lives.

The basic thesis, the through-line of all of these works … There's important disagreements, of course, among all these authors, and I don't mean to mash them into one lump to serve my own purposes. But one important area of agreement among these authors is that a critical driver of social disaffiliation, which is a trend that has been ongoing in this country since the '70s, as far as we can tell, and accelerating across a number of dimensions in recent decades … But a critical driver of social disaffiliation is the declining economic prospects of the median American worker.

The causal pathways are manifold here. It's not a simple story to tell. But effectively, the basic idea is that a necessary condition — it's not the only thing that matters — but a necessary condition for most people to find a place within a rich and life-giving social fabric is to achieve the ability to do meaningful work for decent pay. At the household level; it doesn't mean everybody has to work, by any means.

I think Lind, in particular, is quite critical of the move towards full employment. This idea that every able-bodied adult needs to be working, no matter how many tiny dependent children they have, for instance, in their house. So, the issue is not that working for pay is a sine qua non for everyone to have a meaningful life. But economically, you need to be able to find your footing in the world. This is particularly important for men, even still, because there is a pronounced double standard which endures today. I'm not using that in a pejorative sense. There just is descriptively a double standard whereby women tend to care a lot more about the economic prospects of their potential mates than men do. Women rate men's economic prospects much more highly in considering them as candidates for husbands than men do in considering women as candidates for wives. This is called the problem of men's marriageability. If men's economic prospects are collapsing, as they have across large segments of American society … This is driven in large part, but not only, by de-industrialization. Which is driven, in turn, by trade policy, by immigration policy, to some extent by automation, perhaps.

As the pathways which used to provide pretty clear routes for people to go, say, from high school into a unionized, potentially lifelong career in manufacturing, as those have collapsed, the routes for people to form families in these communities [have also collapsed]. So, the old tried and tested strategies for bringing men and women together to form families, then to settle down into communities to invest in the lives of their children and the lives of their neighbours — as those have broken down, we've seen the social fabric fray. That's a simple version. Not that simple, I suppose, but a relatively simple version of the story.

TH: I did want to spend a moment, too, on digital technology, which you say the Surgeon General actually covered quite well here. What role is that playing?

BC: Yeah. This, to my mind, is the one real bright spot in the report. It’s not just reckoning very seriously with the now overwhelming empirical evidence that there's effectively a dose-effect response between rates of consumption of digital technology, especially social media, and declining mental health. There’s just very clear evidence of that, especially among the young and especially among girls. Adolescent girls have been hardest hit. But this is true across the board. So, reckoning very seriously with that evidence.

But then also, one of the six pillars of his proposed response to this crisis does involve reforming the digital technology environment. He proposes some helpful and serious potential legislative changes that we might introduce. For instance, requiring much greater data transparency from big tech companies about who is using their technology and how. And also gesturing at least towards the possibility of imposing, say, nationwide age restrictions on using these devices. On the model of the law that the state of Utah recently passed, which basically requires social media companies to set an age threshold for use — to prevent pre-teens from using them, or young teenagers. It's still probably too low, in my view, to be honest.

Again, the drivers here are complicated. To some extent, digital technology is a problem because of the opportunity cost of using it. People who are glued to their phones six hours a day are just missing out on interacting with other people face-to-face, in a fuller orbed way, which [is how] our species is adapted to engage with others. There are some pernicious dynamics that are internal to these platforms as well — which, I think, we're just ill-suited for, psychologically. It's the first time in history, for instance, that teenagers have been able to very precisely quantify how much less they matter socially than all of their friends. You can see follower counts, you can see likes. This is just not information that anybody needs to have.

It's a spoils system. The people who land at the top of the heap, the influencers or whatever — I’m not saying I recommend this as a lifestyle either — but you can see, at least, how, short-term, this is a very attractive lifestyle. But the reality is that the vast majority of users are left at the bottom basically feeling left out, feeling quite marginalized. I should say, I have a smartphone. I'm not a luddite, by any means. I use Twitter, probably more than I should.

My view about this, I guess, is that we are in the phase of our relationship with digital technologies, with smartphones and social media, that's somewhat analogous to the pre-seatbelt phase of the automobile. This went on for decades. There was just this general sentiment that 35,000 automobile fatalities a year was the price of having cars. And kids were bouncing around off the windows in the backseat of cars. Eventually, we fixed that problem. There are sensible, legislatively-mandated changes that you can impose on technologies that make them safer — especially for kids. Something like that is what we need, I think, for social media and smartphones as well.

TH: It's interesting. I found this piece so fascinating, because the approaches to loneliness so often are personal, as opposed to collective. I actually wrote a memoir about my own crisis with loneliness. I was turning 40. I was single at that time. I did not have children. My work was [intense and therefore] isolating. I went through a ton of strategies to try to address this. The conclusion I came to in my book is that loneliness is really is a collective problem, and we need to view it holistically. It does seem like the Human Flourishing Program applies a big, wide holistic lens. I was watching a talk you gave some time ago online. You were talking about three components to flourishing: A life well-led, a life that is going well, and a life that contains joy and satisfaction. Can you flesh out that model a little bit for us?