Why Staying Connected To Your Community Is Good for Your Health
In 2017, Ontario’s chief medical officer of health proclaimed loneliness to be a major societal challenge that must be addressed. “Loneliness and social isolation are serious public health problems that cost us all. They affect our productivity, health and well-being – even how long we live.”
Loneliness is a common occurrence amongst older adults that is linked to negative health outcomes.
But what is loneliness?
Social isolation is the objective lack of social resources. Loneliness, on the other hand, is the subjective perceived lack of social resources; a discrepancy between a person’s preferred and actual social contact. It is distinct from social isolation because someone can have little social contact and not feel lonely, or have many resources but still feel alone.
According to research by Dr. Nathan Stall, loneliness affects three dimensions. First, it affects emotions that lead to feelings of desperation, boredom and self-deprecation. Second, it leads older adults to have negative attitudes towards themselves and others. Third, it leads older adults to become self-involved and passive.
Loneliness can lead to other negative health outcomes. Among older age groups, loneliness can lead to depressive symptoms, functional limitations, dementia progression and increased nursing home admissions. It is common among older adults, with 40% experiencing loneliness, and is associated with a 45% increased risk of death. Older adults who are not married, are less educated, and live with low-income are at greater risk of experiencing loneliness.
Older Torontonians, however, are less likely to feel socially isolated than millennials. The recent National Institute on Ageing co-sponsored Toronto Social Capital Study demonstrated that “older adults exhibit among the highest levels of social capital of those surveyed. Older Torontonians were more likely to have a close friend in their neighbourhood, and to be satisfied with the frequency of contact with family and friends.”
Older adults who are lonely, however, often desire increased social contact and interaction, but for any number of reasons, are not able to achieve it. As a result, as Dr. Stall also points out, loneliness can be an important contributor to health care use, with lonely older adults tending to make more frequent appointments to boost their social interactions.
The NIA is currently working on a policy paper to establish best practices and push for constructive public policies that can better address loneliness in older adults, and to help drive understanding of an emerging and important issue that affects a significant number of older Canadians.
In the meantime, health care practitioners are starting to consider the uses and benefits of social prescribing, a new practice aimed at increasing social interactions. Often co-created with patients to complement clinical treatments, social prescribing considers a patient’s strengths and interests, as well as their health needs. In order to avoid ‘downstream’ services, such as emergency department visits and hospital admissions, the approach directs patients to ‘upstream’ community supports. “Prescriptions” can include social activities, nutrition programs, caregiver support, and more.
A ‘social prescription’ is typically made by a patient’s primary care provider, after carefully considering their needs and whether social prescribing will benefit them. This begins a process that involves a navigator who helps connect the patient to appropriate resources and supports the patient to fulfill their social prescription.
In Ontario, a network of 11 community health centres has undertaken a pilot project to promote social prescribing to its clients, called Rx: Community. The health centres connect older adults to non-clinical supports and interventions, such as volunteering opportunities, museum visits, breakfast clubs, park and nature walks, bereavement support groups, yoga and meditation. The project, which brings together Ontario-based community health centres from Ottawa, Guelph, Thunder Bay, Temiskaming, and Belleville, has found social prescribing to be a low-cost feasible intervention that addresses real health issues in the community.
The practice has also been trialed in the United Kingdom. In that time, health care providers have found that social prescribing contributes to improved self-esteem, mood, opportunities for social contact, self-efficacy, transferrable skills and confidence. All of these outcomes are positive in and of themselves, but social prescribing can also lead to enhanced engagement in other health-related activities. In the UK, researchers also found that social prescribing resulted in overall per-patient cost reductions due to fewer appointments and admissions to hospital.
Staying socially connected to friends and family members is becoming increasingly recognized as a good strategy to help us age independently in our communities and remain as healthy as possible. Better understanding that social isolation and loneliness are growing issues for our ageing population will be the first step in understanding the actions we can take to create more well-connected communities as we age where eventually social prescribing may become a key prescription to enable healthy ageing.
The National Institute on Ageing is a Ryerson University think tank focused on the realities of Canada’s ageing population. We are Canada’s only think tank dedicated to policy solutions at the intersections of healthcare, financial security, and social well-being. Through our work, our mission is to enhance successful ageing across the life course and to make Canada the best place grow up and grow old. Follow us on Twitter.
By Dr. Samir Sinha | Director of Health Policy Research, National Institute on Ageing | Email: info.nia@ryerson.ca