By Chloe Chehovin
*This is an opinion-based article submitted by a resident. Any views, opinions, or statements made are those of the author and are not intended to represent the Dale County Chronicle. If you wish to submit a topic for consideration, email us at [email protected]
When Americans talk about health policy, we usually talk about hospitals, insurance premiums, prescription costs, and physician shortages.
Those issues matter, but they also point to a deeper problem in how we think about health itself.
The United States spends more on healthcare than any other country in the world, devoting nearly 18 percent of its gross domestic product to healthcare expenditures. Yet despite this spending, Americans continue to experience poorer health outcomes than many peer nations, including lower life expectancy and higher rates of chronic disease.
That raises an uncomfortable question: what if our health policy is missing the central factor that keeps people healthy in the first place?
One of those central factors is surprisingly simple: human connection.
Most of us do not think of introducing ourselves to a neighbor as a health decision. We associate health with annual checkups, prescription medications, healthy diets, and exercise. Rarely do we place a neighborhood conversation in the same category.
Perhaps we should.
Research increasingly shows that social connection is not merely beneficial for emotional well-being. It is a central determinant of physical health.
In 2023, U.S. Surgeon General Vivek Murthy warned that loneliness and social isolation represent an urgent public health challenge. His advisory cited evidence showing that lacking social connection can increase the risk of premature death by more than 60 percent. Murthy wrote that “loneliness is far more than just a bad feeling—it harms both individual and societal health.”
The data are striking.
According to the Surgeon General’s advisory, the mortality impact of social isolation is comparable to smoking up to 15 cigarettes a day. Other research has linked chronic loneliness to increased risks of heart disease, stroke, depression, anxiety, dementia, and weakened immune function.
This may seem surprising, after all. Loneliness is not a disease. You cannot diagnose it with a blood test or treat it with a prescription.
And yet, here is an uncomfortable truth: America may be overlooking loneliness as a health issue.
We have become remarkably good at treating the symptoms of disconnection while often overlooking its root causes. We prescribe for anxiety, medicate depression, and discuss burnout, stress, and emotional exhaustion. Yet we rarely ask what happens when people stop belonging to one another.
Not every struggle is clinical. Some are communal.
Health policy experts increasingly refer to factors such as housing, education, income, transportation, environmental quality, and social connection as social determinants of health. The Centers for Disease Control and Prevention estimates that clinical care accounts for only about 20 percent of health outcomes, while social, behavioral, and environmental factors account for the remaining majority.
In other words, hospitals matter, but they are not the whole story.
For most of human history, survival depended on community. Families lived close together. Neighbors relied on one another. People belonged to churches, civic organizations, volunteer groups, and local institutions that provided support, accountability, and a sense of belonging.
Today, many of those structures have weakened.
Americans are less likely to participate in civic organizations than previous generations. According to the U.S. Census Bureau, formal volunteering and civic participation declined sharply in recent years, particularly following the COVID-19 pandemic. Technology has made communication easier, but connection more complicated. Being reachable is not the same as being known.
As someone who grew up in a military family, I learned this lesson early. Before graduating high school, I moved eleven times. Every move meant rebuilding a support system from the ground up. This repeated process underscored the argument that resilience is closely tied not only to geographic location but, more importantly, to the strength of social connections within a community. My own experience supports the growing body of research showing that a sense of belonging and interpersonal connection is essential to individual well-being and contributes significantly to overall health outcomes.
That matters for policy because community is not accidental. It is shaped by the environments we build and the institutions we support.
When communities lose civic organizations, parks, libraries, community centers, volunteer groups, or gathering spaces, they lose more than amenities.
They lose infrastructure that supports public health.
That word matters: infrastructure.
We usually reserve it for roads, bridges, and utilities. However, social infrastructure warrants similar recognition for its impact on public well-being. As sociologist Eric Klinenberg explains, social infrastructure comprises physical spaces and organizations that structure social interactions. Klinenberg’s findings, along with supporting research, indicate that communities with robust social infrastructure not only foster stronger interpersonal ties but also experience significantly better survival outcomes during crises. This is attributed to the fact that well-connected neighborhoods enable residents to check on and assist one another, thereby cultivating resilience during disasters (Klinenberg, 2018; Murthy, 2023).
In that sense, community is not soft policy.
It is health policy.
This is especially important in rural communities like Dale County, where churches, schools, youth sports, and volunteer organizations often serve as the connective tissue of civic life. These institutions help create the trust and belonging that protect people from isolation.
A neighbor who checks in after a storm. A church member who brings a meal during illness. A volunteer who notices someone struggling.
These moments may seem small, but they represent something health policy often struggles to quantify: belonging.
We can measure hospital capacity and healthcare expenditures. Measuring the health value of a trusted neighbor is far harder.
That does not make it less real.
If policymakers are serious about improving health outcomes, the conversation must extend beyond hospitals and insurance systems. In addition to considering how to fund healthcare, we must examine how to foster environments and cultivate social infrastructure that support enduring well-being. This requires actively investing in community-building initiatives, designing public spaces that encourage interaction, and supporting organizations that promote social cohesion. By broadening the health policy agenda to include these strategies, we can address the root causes of poor health and create the conditions necessary for individuals and communities to thrive.
Because health is not created only in clinics and emergency rooms.
It is also created on front porches, in fellowship halls, at local ball fields, and in conversations between neighbors, which is why those spaces matter to policy.
In an era of rising loneliness, one of the most overlooked public health interventions may also be one of the most human: Community.
Sometimes, better health begins not with a prescription but with knowing your neighbors—and with policies that make that possible.
Chloe Chehovin is a Dale County resident, military spouse, and Training Coordinator at All In Credit Union. She holds degrees in Neuroscience, Psychology, and Political Science from West Virginia University and has experience in public policy, government relations, and workforce development. Hernandez previously served on the Morgantown Health and Wellness Commission and has worked with both state and federal policymakers. She writes on issues affecting local communities, consumer well-being, and public policy.
References
Vivek Murthy. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General’s advisory on the healing effects of social connection and community.
Centers for Disease Control and Prevention. (n.d.). Social determinants of health.
Centers for Disease Control and Prevention. (n.d.). Social connection and health.
Organization for Economic Co-operation and Development. (2023). Health at a glance.
U.S. Census Bureau. (n.d.). Current Population Survey volunteer and civic life supplements.
Palaces for the People. Klinenberg, E. (2018). Palaces for the people: How social infrastructure can help fight inequality, polarization, and the decline of civic life.
