Tackling loneliness with a well stocked communityBMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k2953 (Published 11 July 2018) Cite this as: BMJ 2018;362:k2953
All rapid responses
Socio-economic determinants of health are yet to find their way into routine clinical practice and loneliness and social isolation have not garnered the recognition and importance that they deserve. A focus on rapid processing of acutely unwell and complex patients with multimorbidities in busy healthcare organisations provides limited possibilities to delve into and optimise these for individual patients.
Loneliness with inadequate social connectedness continues to increase in society and is associated with higher rates of morbidity, mortality and disorders including depression and cognitive impairment. Although nearly half of the elderly population may be affected (1), loneliness is neither rare in the young nor seen as an issue in isolation. Poor health correlates with loneliness and high healthcare costs associated with lack of social connectedness is also now being increasingly recognised (2).
It is time to better appreciate the burden of loneliness and lack of social connectedness on quality of life, clinical outcomes and healthcare utilisation. Integrated care with its focus on community care and social determinants may hold the key to unlock opportunities with which to make a real difference. Group and community based programs may provide healthcare with impressive returns on investment but need to be explored further (3). It must however be recognised that interventions aimed to tackle loneliness may carry long time lags before objective benefits on health outcomes are realised, as is the case with any other chronic illness.
1. Gerst-Emerson K, Jayawardhana J. Loneliness as a Public Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults. American Journal of Public Health. 2015;105(5):1013-1019.
2. Morrison, J. Social Isolation should be a public health priority. 2018. The Guardian. [Internet]. Available from: https://www.theguardian.com/social-care-network/2018/feb/23/social-isola...
3. Pitkala KH, Routasalo P, Kautiainen H, Tilvis RS. Effects of psychosocial group rehabilitation on health, use of health care services, and mortality of older persons suffering from loneliness: a randomized, controlled trial. J Gerontol A Biol Sci Med Sci. 2009 Jul;64(7):792-800.
Competing interests: No competing interests