Takeaway
Clinicians can play a crucial role in combating the epidemic of loneliness and social isolation by asking about patients' social networks, identifying deficits, and connecting them to community resources.
Lifelong Learning in Clinical Excellence | September 9, 2024 | 2 min read
By Mfon Umoh, MD, PhD, Johns Hopkins Medicine
A woman in her mid 80s in clinic once told me, “All my friends have died. I don’t want to hurt myself but I’m ready to go. I don’t feel that I have any purpose or friends left.”
Social disconnectedness is a public health crisis. The U.S. Surgeon General Advisory released in May of 2023 highlighted the destructive impacts social disconnectedness has on collective health and emphasized the restorative power of relationships. Social disconnectedness includes social isolation and loneliness, often due to limited contact with others and perceived limited meaningful connections.
Social participation matters for everyone. Older adults are especially at risk of social disconnectedness given situational factors, changes in social networks, and societal customs that have typically been assumed to be a usual part of aging (i.e retirement, death of loved ones and/or spouse, living alone). And patients of all ages are at risk for poor social health given the changing dynamics of social relationships, further magnified during the COVID-19 pandemic.
Many clinicians are aware of the physical conditions their patients face, but relatively few even ask about social health. This is important not just for boosting health by partnering with patients and their support networks to optimize health but is also critical for overall well-being. Clinicians can play a role in promoting social health by considering the following points:
1. Be aware of the epidemic of loneliness and social isolation.
Acknowledge the importance of social health. Prioritize social health in the same manner we target other health risk factors.
2. Ask patients about their social networks—who they interact with and feel connected to.
Asking questions can identify deficits in social connections and can also help highlight resources within a patient’s network that can support and promote health. Specifically, the National Academies of Sciences, Engineering, and Medicine recommends clinicians regularly evaluate patients who may be at risk and connect them to community resources for help. They recommend using the Berkman-Syme Social Network Index (for social isolation) and the three-item UCLA Loneliness Scale (for loneliness), in clinical settings.
3. Familiarize yourself with community resources for connections.
Boosting social health may require social prescribing. To do this well, it’s important to know what resources are available. I encourage you to drive around the neighborhoods your patients come from, know the local community centers and resources at the local, county, city, and state level. Though social disconnectedness is examined in individuals, it’s a broader issue that influences communities and can be related to other social determinants of health often associated with service and treatment inequities. There are online resources targeting social disconnectedness (AARP tool connect2affect. The administration for community living resources. The NIH social wellness toolkit). You can also leverage resources available in your healthcare systems (i.e. community navigators: community health workers, social workers, health promoters, and case managers).
4. Be vocal and promote policy changes that increase social participation.
It’s important to be aware of policies in the areas you practice and support those that promote social health.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.