I’d make 3 points on loneliness:
1/ First, Loneliness is pervasive.
50% or more of the US is experiencing loneliness. And what’s concerning is that it’s higher for lower income, lower literacy, and other groups who are already typically disadvantaged. Bottom line, it’s a big problem.
2/ Second, Loneliness impacts health: health equity, health quality, health outcomes.
There’s a 32% higher risk of stroke, 29% higher risk of heart disease, 26% higher risk of premature death.
For our sickest like our CHF patients, there’s a 55% HIGHER risk of hospital readmissions.
This is not just a public health problem, it’s a big problem for our health system.
3/ The third point is the bright spot, the SOLUTION.
And it begins by appreciating — you can’t change something, until you understand it.
And I’m not saying to just understand this in the theoretical or the macro sense. We need to understand the driver of loneliness at the individual level.
For that 1 person —
- Is their loneliness driven by underlying depression or anxiety? Or is it poorly-managed heart failure — which is keeping them from being out and about?
- Or is it the stigma of taking their injectable diabetes medications in public, or a broken wheelchair — that they can’t afford to fix — that’s keeping someone literally locked inside their home?
- OR is it from not being able to afford putting food on the table, so they stopped inviting family over? Or is it grief from the recent loss of a spouse of 40 years who used to manage all of the finances?
Which one is it? Or is it something different altogether?
The honest answer is we don’t know.
We can’t figure that out unless we get that person to trust us enough — to let us in.
Look, as I see it… Loneliness is a symptom, it’s a signal of something deeper.
As a species, we survived for millennia in tribes. Being alone literally was a threat, and physiologically, being alone actually spikes our stress hormones as IF we are in an emergency — our epinephrine, cortisol — our fight or flight response.
We put our guard up, we push others away — which worsens the feeling of loneliness and our ability to get help.
It’s therefore not as straightforward as telling someone — hey, you are lonely — well, go out and join your local YMCA and make some friends.
In my experience, once things have gotten bad enough that a provider or health plan notices in their claims or in their quality scores, it’s going to take much more than just telling someone to increase their social connections.
But… if we invest in proactively connecting with that person in a way that EARNS their trust and then we deploy EMPATHY — we can understand what’s really the driver.
And THEN we can work with them 1-on-1 to address those barriers… and address not just their loneliness, but many other barriers that also get in the way to health outcomes.
In the end, deploying that type of proactive, 1-on-1 connection with empathy, at scale, is the key.