The 61% That Isn't the Headline: Young Adults in the Surgeon General's Advisory

The figure that traveled furthest from the U.S. Surgeon General’s 2023 advisory on loneliness and isolation was that roughly half of American adults report experiencing loneliness. It is a genuinely striking number, and it has done real work in moving loneliness onto federal, state, and health-system agendas. It is also an average, and averages of this kind flatten a distribution that, in the underlying literature, is not flat at all.

The subgroup the headline obscures most consistently is young adults. Several sources that predate and postdate the advisory converge on the same pattern: loneliness in the 18-to-25 range runs well above the population figure, by a wide enough margin that treating “about half” as descriptive of that group understates it substantially.

What the young-adult-specific data shows

The Harvard Graduate School of Education’s Making Caring Common project surveyed loneliness in early 2021 and found 61% of adults aged 18 to 25 reporting serious loneliness, against 36% for the sample as a whole. Among that same age group, 43% said their loneliness had increased since the pandemic began. Roughly half of lonely young adults reported that no one had taken more than a few minutes in recent weeks to ask how they were doing in a way that felt genuine.

This is 2021 data, collected during a period of unusual disruption to in-person contact, and it should be read as a pandemic-era snapshot rather than a stable baseline. But the direction it points in — young adults substantially exceeding the general population on loneliness measures — shows up in sources that are not tied to pandemic conditions. Cigna’s 2020 workplace survey, fielded before the scale of the pandemic’s disruption was clear, found 73% of workers aged 18 to 22 reporting loneliness, and over 80% among employed Gen Z workers more broadly. Gallup’s 2023 global survey of 142 countries found the same age gradient outside the United States: adults aged 19 to 29 reported the highest loneliness rate of any age band, at 27%, against 17% among adults 65 and older — the reverse of what a simple “isolation increases with age” intuition would predict.

That last point is worth sitting with. The AARP Foundation’s 2018 survey of adults 45 and older, using the 20-item UCLA Loneliness Scale, found one in three midlife and older adults lonely, with physical isolation and small, undiverse social networks as the strongest predictors. That is a serious rate on its own terms. But set beside the young-adult figures from Harvard, Cigna, and Gallup, older adults are consistently the lower-loneliness group in cross-sectional comparisons that include both. The conventional association of loneliness with old age — the image the phrase “loneliness epidemic” most readily calls to mind — does not match what these surveys measure.

Why the instruments do not agree with each other on magnitude

None of this is fully commensurable across sources, and stating that plainly matters more than trying to force agreement. The Harvard figure (61% among 18-25) and the Cigna figure (73–80%+ among 18-22 workers) were generated by different instruments, different sampling frames, and different reference periods, one general-population and one workplace-specific. Gallup’s 27% for 19-29-year-olds comes from a global sample using a different question wording again, embedded in a 142-country comparative survey rather than a U.S.-focused one. The Surgeon General’s advisory itself draws the roughly-half figure from an aggregation of such sources rather than a single fielded instrument.

The gap between Cigna’s 73–80% and Gallup’s 27% for what is nominally an overlapping age band is not a contradiction to be resolved. It reflects that “workers aged 18-22 reporting loneliness” and “adults aged 19-29 worldwide reporting feeling very or fairly lonely” are different questions asked of different populations at different times. What survives comparison across all of them is the relative pattern, not the absolute rate: young adults score higher than the general adult population on essentially every instrument that breaks the data out by age, whatever the instrument’s own baseline.

The workplace angle sharpens rather than complicates this

Gallup’s 2024 State of the Global Workplace report adds a dimension the advisory’s topline figure does not capture at all: work arrangement. Loneliness among fully remote employees runs at 25%, against 21% for hybrid workers and 16% for fully on-site employees, and loneliness is higher among employees under 35 specifically. Young workers are disproportionately represented in remote and hybrid arrangements in many sectors, which means the age effect and the work-arrangement effect are plausibly compounding rather than independent — though the Gallup report does not provide the cross-tabulation that would confirm this directly, and this piece is not asserting one.

The American Enterprise Institute’s 2021 survey on American friendship adds a structural explanation that fits the age pattern without being reducible to a single cause: the share of Americans reporting no close friends rose from 3% in 1990 to 12% by 2021, with the decline in close-friend counts sharpest among men. Younger cohorts are living through the tail end of that decline as their default social starting point, not as a departure from an earlier, richer baseline they once had and lost. That is a different problem from the one implied by “loneliness among older adults,” which more often involves the erosion of a network that existed and then contracted through bereavement, retirement, or reduced mobility. Both are real. They are not the same policy problem, and a strategy calibrated to one may do little for the other.

What the averaging costs a policy response

The Surgeon General’s advisory lays out a six-pillar national strategy addressing social infrastructure, health-care engagement, and other domains at a general population level. That framing is defensible given the advisory’s remit, and it does not preclude a targeted response. But a policy or funding decision built on “roughly half of adults” as the operative figure will, by construction, size interventions to the average rather than to where the concentration actually sits. If young adults are experiencing loneliness at a materially higher rate than the population figure suggests, and through a different structural mechanism — thin friendship networks built during a formative period, rather than a previously adequate network that later contracted — then interventions designed around social prescribing to clinical patients, a channel skewed toward older adults with more health-system contact, will reach the higher-loneliness group less well than the topline number implies it should.

None of the sources reviewed here were designed to test that implication directly. It follows from putting several independently fielded surveys next to each other, which is a weaker form of evidence than a single study designed to compare subgroups on a common instrument.

What would settle this more firmly

A study built to answer the subgroup question directly would need a single loneliness instrument fielded consistently across age bands, work arrangements, and years, rather than the current patchwork of Cigna’s workplace framing, Harvard’s general population framing, and Gallup’s global framing, each with its own wording and sampling logic. It would also need to track individuals rather than compare cross-sectional snapshots, so that a claim like “young adults today are lonelier than young adults were in 1995” — which the current literature does not actually support, since comparable youth-specific data from three decades ago is not available in these sources — could be tested rather than assumed. Until then, the honest claim is narrower: on every instrument reviewed here that breaks results out by age, young adults report more loneliness than the population average the instrument itself produces. The size of that gap depends entirely on which instrument is asked.