The Surgeon General said it best, “Loneliness has profound consequences for our health—both our mental and our physical health…” But factors like loneliness and social isolation don’t always fit the mold for traditional health care. We’re taught to think in terms of symptoms and how we can treat them for what they are. We receive antibiotics for infections, decongestants for colds, pain medication for a sprained ankle—and for more chronic conditions, a slew of daily or weekly pills that can manage hypertension, high cholesterol, and diabetes.
But what’s the prescription for social connection and community? Is it possible to reduce the risk of some chronic conditions entirely by taking a closer look at the external factors that drive them?
Increasingly, non-medical interventions are being prescribed the same way as antibiotics, pain relievers, and beta-blockers. Take the “food is medicine” movement as an example: doctors can recommend medically tailored meals, and food ‘farmacies’ fulfill prescriptions for nutritious food. Results have shown to reduce HbA1c in people with diabetes, lower body mass index (BMI), and even reduce the need for oral antibiotics in children.
It’s an unfortunate truth that the U.S. spends more on health care compared to other developed nations, with the worst health outcomes. We continue to focus on treating symptoms reactively, with expensive drugs and hospital visits, while ignoring what is often the true root cause. In 2021, the U.S. healthcare system spent $603 billion on prescription medication. Clearly, these interventions are not making people well, and it’s time to take a preventive approach and a closer look at what’s making people sick in the first place.
Lack of social connection, which affects one in three adults aged 50-80, can lead to anxiety and depression, an increased risk for cardiovascular disease and stroke, and a 60% higher risk of developing dementia. But when social support, enabled through companionship and community, is prioritized, people are more likely to have better health outcomes and make healthier choices. As a society, we can work together to address the factors that directly impact health–ensuring living environments are safe, enabling access to food and transportation, and providing a helping hand or listening ear through all of life’s moments.
Today’s healthcare approach follows the same binary model we’ve always known: wait for the symptoms, then use medication or other treatments to reduce their effects. But in most cases, we are better off turning the current model on its head, and starting at the source. Focusing on social connection to address unmet needs should be seen as a form of medicine.
Before prescribing a beta-blocker or ACE inhibitor, what if we knew the reason for a patient’s cardiac stress was a major shift in their ability to socialize, brought about by a workplace injury, leaving them home-bound and without much connection to the outside world?
Frank’s story: A life saved through human connection
In 2007, Frank, 57, suffered a terrible accident while on the job as a long-time ironworker. The injury left him disabled and in chronic pain, and he was unable to continue working. Nearly 15 years went by, and Frank became hopeless. On the cusp of losing his independence entirely, Frank struggled to find help with everyday errands and tasks. He was also lonely—it had been years since he had found someone to talk to or have over for visits.
Reflecting on this time, Frank shared, “When you take your medication all of the time, it cures the pain, but it doesn’t cure the heart.”
Frank’s life changed when he was notified of a companion care offering available to him through his health plan. He connected with caregivers who not only eased loneliness, but also provided social support–a ride to doctor’s appointments, therapy, and assistance with picking up groceries and running other errands. “They let you know that there’s somebody out there who does care. I’ve been in the hospital before with no way to get home. I thought, “Let me call.. and they sent someone!”
“I never want to bother anybody–everybody’s working or has their own life. But there are people out there that care.The companionship helps a lot,” says Frank. “When you have someone to talk with, it takes away the strain. It’s incredible, they care. They’re very kind, they’re angels to me.”
Promoting connection—and reducing healthcare costs—with social care
The notion of prescribing companionship, like we would a statin, might seem far fetched—until you consider the data. Researchers have identified a correlation between lack of social connection and visits to the emergency department (ED). In fact, one study showed people lacking companionship are admitted to hospital emergency rooms 60% more often, and in another study, 40% of readmitted patients reported a challenge at home contributed to their hospital readmission.
A recent study observed a group of Michigan Medicaid members over age 45 who had a history of frequent ED visits. This group was enrolled in regular social visits through companion care services, and showed a 25% decrease in ED care, and a 14% decrease in hospital readmissions within a span of six months. Another program for Medicare Advantage members who screened positive for loneliness saw an 11% decrease in acute hospital admissions when the members started to receive weekly phone calls from companions and home visits.
As we navigate the aftermath of the pandemic, we must increase social support to address the social isolation many adults face. Studies have shown a persistent uptick in loneliness since the onset of Covid-19, inversely related to the sharp decline in human connection due to physical distancing and limited social gatherings.
Today, returning to human connection and community is the best way to combat social isolation and its effects on health. Weaving companionship into health care as we would a blockbuster drug can help us circumvent expensive healthcare services like emergency department visits and hospitalizations. We can take lessons from the ‘food is medicine’ movement in prescribing for social needs. With this model, we can go beyond just nutrition, to tackle issues like loneliness and other social factors to treat the whole person based on the specific set of circumstances driving their health.
We can continue to reduce healthcare costs and promote positive outcomes, starting at the source. Let Frank’s story be the lesson. We can’t drive whole health for all without reorienting care in this way.
Photo: zhaojiankang, Getty Images