New data from the American Time Use Survey, research conducted by the U.S. Census Bureau and the Bureau of Labor Statistics, shows that Americans now favor eating in-home compared with eating out at restaurants.

Corroborating this shift is other data from the National Restaurant Association sharing that 74% of all restaurant traffic in 2023 came from “off premises” customers — that is, from takeout and delivery — up from 61% in the pre-COVID era.

What does this mean for our health, well-being, and sense of community and connectivity?

 

 

 

 

 

 

I’m preparing a new talk to give later this week to a global group of business people involved in high-cost health care. The convener has asked me to speak about health equity and social determinants of health.

In crafting my remarks, I’m updating our traditional categories of SDoH to include five “new” drivers of health — one of which is social isolation and loneliness.

One of my origin sources on the growing erosion of social capital, and thus personal isolation, in America is Robert Putnam’s book, Bowling Alone. Published in 2000, the book presciently saw the collapsing of American community — as we saw the demolishment of bowling alleys, among other social spaces for convening and communing among people living in our local towns.

 

 

 

 

 

 

 

The slide above is from my talk, and in this second graphic I focus in on the right side of the chart which illustrates granular data from the American Time Use Survey. This displays the shift from eating and dining out-of-home down and to the left to eating and dining at-home, from 2019 to 2023.

In fact, Americans shifted many activities to-home as shown in the lower-right quadrant. These life flows included shopping from home, working from home, exercising at home, and other pandemic-era behaviors that are persisting five years later since the pandemic was pronounced as the public health emergency. 

 

 

 

 

 

 

Health Populi’s Hot Points:  The shift from Bowling Alone to Eating Alone is part of a larger phenomenon we read about in Derek Thompson’s column titled “The Anti-Social Century,” published in The Atlantic in February 2025.

It is important for us to connect the dots from this phenomenon, quantified by the ATUS survey from the Census Bureau, to public and individual health. The more we are doing/living/working/learning/gaming from home, the less time we are connecting with our local communities in a second network outside of our families with whom we live or our friend-group who are physical room-mates.

And “local” is key because that’s where trust is built. “Trust Remains Local,” Richard Edelman wrote in his assessment of the 2025 Edelman Trust Barometer in January. “Despite a 3-point drop to 75 percent trust among employees, ‘my employer’ remains the most trusted institution,” Richard reminds us.

 

 

 

 

 

 

We know from Gallup’s poll published earlier this month that Americans’ self-reported mental health is at a low, even lower than we felt at the start of the pandemic.

This week, we also saw the update for The World Happiness Report, finding that U.S. fell to its lowest level since the study launched. 

 

 

 

 

 

 

 

 

In looking to bolster a civil, civic society and a healthy, productive workforce, it will take local collaboratives to re-build trust, and working across industries and organizations to do so. Re-building local “third spaces” for convening, including returning to eat in restaurants, drink coffee in bookstores and cafes, and pick up basketball games in safe outdoor spaces, will all be pieces of the broader roadmap.

I myself have picked up pickleball (while not bowling, it’s a good thing), eating out at locally owned food places, and spending more time talking with my fishmonger, my butcher, my postal clerks (yes, I still go to the post office), and friends with whom I haven’t connected in way too long. The equivalent for businesses and other organizations in the larger health/care ecosystem are collaborating to focus on one or more drivers of health that can support people/patients/citizens in communities — addressing healthy food and nutrition, connectivity (technical and/or social), and/or trust-building and expertise-sharing.