Care Transformation Center Blog

Nearly half of Americans are lonely. Here's how leading organizations are responding.

by Clare Wirth and Tomi Ogundimu

Decades of research substantiate the devastating effects of social isolation. Loneliness is equivalent to smoking 15 cigarettes a day and increases the risk of death by 26-45%, which is on par with risk factors such as high blood pressure, obesity, and lack of exercise.

Learn more: How to integrate psychosocial risk factors into ongoing care

Isolation is not only unnerving, it is also widespread. Cigna's recent survey of 20K+ people revealed 46% of Americans report sometimes or always feeling alone. Although striking, this finding is not surprising to those following former Surgeon General Dr. Vivek Murthy, who has argued for years that the scale and impact of this issue make it an epidemic.

How leading organizations are addressing the loneliness epidemic

In many ways, the United States is behind compared with other parts of the world. Australia formed the Coalition to End Loneliness in 2016 and the United Kingdom appointed a minister for loneliness earlier this year. While little attention has been paid to social isolation in U.S. policy, some leading organizations are taking steps to address it among their patients—particularly among senior populations. Here are three things we've learned from them that you can apply to your target populations:

1. Screen for social isolation.

Since isolation can be a taboo topic, few patients will be forthcoming. In response, the integrated health plan and care delivery system CareMore appointed its first "Chief Togetherness Officer," who created the Togetherness Program targeted at senior patients.

To start, CareMore accepted 300+ self-referrals made in the first six months and began screening senior patients for loneliness during appointments. For at-risk patients, CareMore staff use regular phone conversations and home visits to discuss standard topics related to medications and driving habits. CareMore also organizes informal social hubs at clinics to facilitate interpersonal relationships (e.g., workout classes, connection to community organizations during the holidays).

2. Connect patients to virtual networks.

Online communities in health care are not new. However, virtual networks are rarely used in U.S. health care to help people overcome physical remoteness and stigma. The United Kingdom has several anti-loneliness programs, including the Silver Line Helpline, a free and confidential call center for people aged 55+ to discuss anything they wish. Many of the callers are simply looking for a human connection, even if they might not admit it.

Given the stigma around loneliness, most calls focus on trivial things. Because of this, helpline workers are trained to recognize signs of social isolation and may offer resources, such as the Silver Line Friend program, which connects callers to volunteers to talk with or write letters to. Today, the helpline receives around 10,000 calls per week.

3. Create regional networks through partnerships.

Partnerships between businesses and entities can serve as the eyes, ears, and potential support system for people suffering from social isolation. For instance, ElderCare of Alachua County (a 501c3 entity owned by University of Florida Health) partnered with the City of Gainesville to open the ElderCare Senior Recreation Center.

The ElderCare Senior Recreation Center is a 17,000 square-foot recreation and activity center that offers educational seminars, physical fitness classes, structured artistic and cultural activities, and social and volunteer events for local seniors. These programs foster belonging among senior patients so that they feel a sense of social connection. Further, ElderCare of Alachua County uses the recreation center to address wellness needs of Gainesville's broader senior population.

Tomorrow's challenge is today's loneliest population: Young adults

Initiatives combating social isolation in the United States tend to focus on the senior population. Unsurprisingly, most of today's provider innovation has been restricted to organizations with Medicare Advantage contracts. Few providers have focused on the loneliest population: 18- to 22-year-olds. While typically a low-risk population, young adults experience rates of loneliness and social isolation far higher than any other age group according to Cigna's recent survey.

Some design firms are working with hospitals to create common areas and group rooms within the hospital to promote positive interactions among young patients with behavioral health needs. However, rarely do interventions go beyond in-house treatment to combat social isolation.

If your organization is doing something innovative to address social isolation, we'd love to hear from you! Please email Clare Wirth at wirthcl@advisory.com.

Next, learn how to promote health and happiness at work

Programs aimed at promoting healthy habits among employees are likely to lead to improved employee engagement and productivity—but they're unlikely to reduce the total cost of care. To do that, you'll need to take a population health approach.

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