The year 2024 is about to end, and there are states which are almost at the brink of being declared the depressed states in the United States, and could enter 2025 being depressed. Loneliness has emerged as a significant public health issue in the US. The country's half of the adult population reportedly is experiencing loneliness.

Experts have also highlighted its grave impact on mental and physical health, including risks of heart disease, stroke, and dementia. Addressing this challenge requires rebuilding social connections, especially in states where isolation is most prevalent. Dr Vivek Murthy, the U.S. Surgeon General, has declared loneliness a serious mental health hazard, citing it as a public health epidemic in the United States. He had also early on brought attention to the mental health of parents and how it impacts them negatively.

Analyzing Loneliness Across U.S. States

Can you measure loneliness, depression and how bad is one's mental health? A recent study by Emisil evaluated social, economic, and psychological factors and it has then identified the 10 loneliest states in the US, based on those measuring metrics.

So, can you really measure depression? Well, as per the study, there are metrics such as the prevalence of depression, the percentage of single-person households, marital status, quality of marriage, rate of divorce and overall quality of life which are used to measure a person's mental state. While these are subjected, these factors do help to an extent. It is based on the score that these states are ranked from 10th to the 1st position.

The Top 10 Loneliest States

Nevada (Score: 100)

The first one on top is Nevada. This state ranks as the loneliest state, with 35% of adults never married, 53% living alone, and a 13% divorce rate. These factors indicate a lack of close social ties, leaving many residents feeling disconnected.

New Mexico (Score: 97.9)

With 56% of households comprising single individuals, New Mexico has one of the highest rates of solo living, contributing to widespread feelings of isolation.

Rhode Island (Score: 97.9)

Rhode Island shares the second spot, with 37% of adults never married and 55% living alone. The high percentage of solo residents highlights the need for stronger community networks.

Oregon (Score: 95.4)

Reporting a depression rate of 16.8% and 51% of households occupied by individuals living alone, Oregon highlights on the fact that how isolation can impact mental health and overall well-being.

Florida (Score: 89.5)

Despite having the lowest depression rate among the top ten, Florida still faces loneliness challenges, with half of its population living alone and 32% never married.

Michigan (Score: 87.5)

With a depression rate of 15.2% and 52% of residents living alone, Michigan’s economic challenges and high rates of isolation underscore the need for accessible support systems.

Connecticut (Score: 83.5)

In Connecticut, 36% of adults are never married, and 52% of households are solo residents. These figures reflect a growing trend of independent living, often accompanied by social isolation.

Maryland (Score: 77)

Maryland’s high percentage of single-person households (51%) and never-married residents (36%) points to a shift in traditional living arrangements, with fewer close-knit family units.

Mississippi (Score: 76.4)

Mississippi reports a depression rate of 16.1% and 53% of households with solo residents. Rural areas with limited social infrastructure may exacerbate the state’s loneliness challenges.

Ohio (Score: 75.6)

Ohio has the highest depression rate at 17.0%, with over half of its households comprising individuals living alone. The state demonstrates a strong need for mental health resources and efforts to combat social isolation.

Shifts in Living and Social Connections

It is not the first time that the experts have attributed rising loneliness to changes in how people live and connect.

There are many reasons and most of these reasons are on the rise. Some expert have pointed out that single-person households, higher divorce rates, and also the evolving social norms which has reshaped family structure, increased familial and economic burden has led to more and more loneliness and stress on individuals. At the same time the economic independence has encouraged many to live alone for extended periods. This could sometimes amplify isolation.

Rebuilding social connections and fostering community support are vital to addressing this growing epidemic. By understanding the factors driving loneliness, efforts can be directed toward creating stronger support networks in the most affected states.

Working long hours may alter the structure of the brain, a new study has found. The research, published in the journal Occupational and Environmental Medicine, found "significant changes" in the brains of people who were overworking. These changes were observed in the grey matter of the brain, which is the most essential type of tissue in the brain and spinal cord.

For the study, researchers observed the impact of overwork on specific regions in health workers who regularly clocked up more than 52 hours a week. Around 110 workers were included in the final analysis. Of these, 32 worked excessive hours and 78 worked standard hours.

The scientists found that being "overworked" could significantly impact mental health. The researchers used data, including MRI scans, to examine brain structure. "People who worked 52 or more hours a week displayed significant changes in brain regions associated with executive function and emotional regulation, unlike participants who worked standard hours," researchers said in a press release. "The results underscore the importance of addressing overwork as an occupational health concern and highlight the need for workplace policies that mitigate excessive working hours," they added. Besides emotional regulation, decision-making and planning were also equally impacted.

Epidemic Of Long Working Hours

Researchers also believe that their findings suggest a "potential relationship" between having an increased workload and challenges in these parts of the brain, providing a biological basis for the cognitive and emotional challenges reported by overworked people. According to SkyNews, Ruth Wilkinson, head of policy and public affairs at the charity the Institution of Occupational Safety and Health, said urgent action is needed to tackle "an epidemic of long working hours".

Cognitive fatigue is the deterioration in the ability to effectively and focus effectively. It is primarily caused by prolonged mental work. Many workers might spend their days completing a lot of tasks that aren't urgent or necessary, but do create lots of vacuums of time and mental energy to respond to. Cognitive fatigue occurs when we make many more micro decisions in the day than we need to, and there are so many different touchpoints that grab our attention in an office. These could be noise, colleagues, phones, Slack or meetings.

Dengue fever, a mosquito-borne viral disease, has long been a major public health challenge in tropical and subtropical regions worldwide. Yet, strangely enough, despite available vaccines, dengue cases and outbreaks are not only growing but are becoming bigger and less anticipated. This troubling trend has puzzled scientists, medical professionals, and policy makers as well. In order to grasp why dengue keeps spreading despite advances in medicine, we need to look at the intricate entanglement of viral biology, limitations of vaccines, environmental factors, and human drivers behind this worldwide health emergency.

The dengue virus causes dengue fever, spread mainly by the Aedes aegypti mosquito, an insect wonderfully specialized to live in human surroundings. Although it usually manifests with flu-like symptoms like fever, headache, and joint pain, severe cases can progress to dengue hemorrhagic fever—defined by blood vessel destruction, bleeding, organ failure, and even death. The virus comes in four different serotypes (DENV-1 to DENV-4), each of which can cause infection. Significantly, infection with a single serotype provides immunity to only that serotype, not the others, so individuals can be infected as many as four times in a lifetime. Secondary infections tend to carry an increased risk of serious symptoms.

Dengue cases varied historically with periodic epidemics. Recent decades have witnessed a steady and worrisome rise. In 2019, the number of reported cases was a record high, nearly doubling that of the previous year. Bangladesh witnessed a record number of deaths due to dengue in mid-2023. This spread and increase go beyond the classical tropical regions; the Aedes aegypti mosquito has also spread its geographical range into southern Europe and the United States, in Florida, Texas, and Arizona, due to its ability to adapt and global warming.

Are Dengue Vaccine So Irrelevant In Treatment?

Vaccination should theoretically cut disease incidence. New vaccines such as Qdenga have been approved by the World Health Organization for use in children in heavily endemic locations. India is set to introduce DengiAll, its local tetravalent vaccine, in the final stages of trials, which promises to cut dengue cases hugely locally.

However, as Dr. P. Venkata Krishnan, Senior Consultant in Internal Medicine, explains, "Even with the availability of dengue vaccines, cases worldwide are setting new records. This confusing trend suggests underlying issues, from lack of access to vaccines to mosquito spread due to climatic conditions, which require immediate attention beyond vaccination programs to actually contain the epidemic."

One is vaccine coverage and eligibility. The initial dengue vaccine, Dengvaxia, is only approved for those 9–16 years old who have already been infected with dengue. Giving it to dengue-naïve persons risks outcome of severe disease with subsequent infection, limiting its widespread use. Qdenga provides approximately 80% protection and less limitation but is not yet available worldwide. The complexity of dengue serotype diversity makes vaccine design and efficacy even more difficult. Protection against one serotype does not ensure immunity against others, and secondary infection can intensify disease severity.

How Far Do Environmental and Social Factors Push Dengue Diagnosis?

Dengue's spread is not just a medical or biological issue—it is inextricably linked with our environment and society. Dengue has been propelled by rapid urbanization that developed high-density human populations where Aedes mosquitoes breed so abundantly. The mosquitoes breed in small collections of water, even as small as a bottle cap, so controlling them is very difficult.

"Rapid urbanization, inadequate sanitation, and climate change have raised the number of breeding sites for mosquitoes," says Dr. Krishnan. "Increased temperatures and rainfall create perfect breeding conditions for Aedes mosquitoes, boosting their density and the transmission rates of the virus."

Climate change, with increasing global warming and unstable rain patterns, has increased the geographical distribution and breeding periods of mosquitoes. Increased humidity and higher temperatures provide optimal conditions, as in Bangladesh, where premature rains and heat brought a rapid increase in mosquito infestation, resulting in a widespread outbreak of dengue fever.

What are the Challenges in Mosquito Control?

Improved mosquito control is still the bedrock of dengue prevention but is woefully absent in large parts of affected countries. Surveys have reported as high as 49.76% mosquito breeding site prevalence measured in terms of the 'house index' well above the 10% so-called safety level. This indicates poor infrastructure, absent public health interventions, and meager resources available in most of the countries battling dengue.

This provides a perfect storm- high populations of mosquitoes, high human hosts density, and generalized viral transmission, enabling the virus to be transmitted at high speed.

Is Human Behavior and Globalization A Risk Factor Too?

Human activities also contribute to the spread of dengue. Urbanization and population growth add breeding sites and human-mosquito contact. The virus and eggs of mosquitoes can be carried by travelers from one continent to another. Used tires or containers with water can transport mosquito eggs around the world, spreading Aedes mosquitoes to new regions.

Tourism also has a major role to play; dengue now ranks as the second most frequent cause of feverish illness among travelers following malaria. Human mobility and mosquito flexibility facilitate dengue's spread worldwide.

Vaccines hold out promise, but they alone are not the answer. "Vaccines are a key tool against dengue," Dr. Krishnan contends, "but presently available constraints, combined with environmental, social, and infrastructural constraints, have enabled dengue to keep on rising across the world."

It calls for an integrated strategy- the enhancement of mosquito control programs, sanitation in urban areas, community awareness, expenditure on climate adaptation planning, and the quickening of vaccine availability.

In high-income nations, widespread indoor living minimizes contact with mosquitoes, capping outbreaks. In low- and middle-income tropical countries, where individuals tend to reside in open or vernacular housing, the situation is not the same.

Dengue fever's increasing incidence in the presence of vaccines illustrates the intricacy of controlling infectious disease in an integrated, warming world. The interrelationship of viral heterogeneity, restricted vaccine penetration, climate change, urbanization, and inadequate mosquito control generates intractable challenges. Global dengue control requires an integrated strategy that incorporates medical technology with environmental management and improvement of social infrastructure.

It is only through such concerted action that we can hope to stem the tide of dengue fever and protect millions around the world from this increasingly unstable and lethal disease.

Dr. P. Venkata Krishnan is a Senior Consultant, Internal Medicine at Artemis Hospitals, Gurugram in India

World Health Organisation (WHO) has declared a polio outbreak in Papua New Guinea and called for an "immediate" vaccination campaign. Samples of the highly infectious virus were found in two healthy children during a routine screening in Lae, a coastal city in the country's northeast.

Less than half of the country's population are immunised against the potentially deadly disease, which is close to being wiped out, but has recently surfaced in some parts of the world. "We have to do something about it and we have to do it immediately," said Sevil Huseynova, WHO's representative in Papua New Guinea, warning that the disease could spread beyond the country. We have to make maximum effort to get 100% [vaccination] coverage," Dr Huseynova said at a media conference on Thursday. Polio knows no borders.

Polio is highly contagious and can be transmitted through droplets from sneezing or coughing, as well as through contact with virus-laden faeces, also known as stool. The virus can easily spread and enter the body through the mouth, and it can also be present in water contaminated with feces from a person infected with the poliovirus. In 1994, India launched the Pulse Polio Immunisation Program to eradicate polio, which at the time accounted for about 60% of global cases. In January 2011, the last reported cases of wild polio in India were in West Bengal and Gujarat. Subsequently, in 2014, the WHO declared India polio-free.