Social Determinants of Health

It’s All Connected: Tackling a Newly Recognized Health Issue

June 19, 2018 11:15 am

Traditional healthcare stakeholders are going beyond conventional boundaries to address a different kind of health issue—loneliness.


Everyone knows that loneliness takes a toll on a person’s mental health, but the extent of its effects on physical health are only starting to be recognized. Loneliness and social isolation are linked to increased blood pressure, higher cholesterol levels, depression, and Alzheimer’s disease. Loneliness is just as much a threat to health as obesity, smoking 15 cigarettes a day, or being an alcoholic. 


The effects of social isolation on Medicare spending were quantified in a study conducted by AARP—Medicare spends about $130 per month more on people who are very socially isolated than on non- or less-isolated beneficiaries.

Going Beyond Comfort Zones

In this case, knowledge does not necessarily equate with power. Healthcare providers and health plans don’t have a great track record of using lifestyle interventions to address issues like weight loss and smoking cessation, despite having numerous treatments, toolkits, and resources at their disposal.

So, it would take courage and innovation to tackle a problem like loneliness, which has not been viewed as being inside the healthcare domain. Talk about stepping outside of one’s comfort zone.

Adopting Strategies for Success

But that’s exactly what organizations like Humana, Cigna, and Anthem subsidiary CareMore Health are doing. Their loneliness initiatives reflect three strategies that we, as an industry, are using to improve the value of health care in areas that are beyond our comfort zones.

First, forward-looking organizations are recognizing the importance of social determinants of health and taking ownership of them. Research shows that states with a higher ratio of social to health spending have significantly better health outcomes in areas like diabetes, lung cancer, asthma, and heart disease, leading policy organizations like Brookings to suggest that more social services should be delivered within the healthcare sector. Trinity Healthand Dignity Health are among the health systems that are leading the way. 

Second, healthcare stakeholders are framing social determinants as health conditions that can be diagnosed and treated and following through by tracking outcomes. That means applying rigor to their approach to “soft” issues like loneliness. Research in these areas is being translated to practice, thanks to shared resources such as the Social Interventions Research and Evaluation Network’s Evidence Library.

Third, traditional stakeholders are collaborating with other organizations, recognizing that it takes teamwork to cover all the bases. For example, to build public awareness of loneliness and isolation, CareMore hosts Togetherness Forums in partnership with community leaders and organizations to foster dialogue and develop collaborative solutions. Humana includes extensive information on accessing and engaging with community resources in its loneliness toolkit, developed for use by its members.  

Casting a Wide Net

Although many programs focus on senior populations, chronic loneliness is experienced by Americans of all ages, including young people and middle-aged men. In fact, studies suggest that younger people experience higher rates of loneliness than seniors do. As a growing number of healthcare organizations begin to take on social determinants, they will be challenged to reach out to groups that traditionally have had low levels of interaction with the healthcare system. 

When it comes to addressing loneliness and other social determinants of health, taking the long view, collaborating with other organizations, and using an evidence-based approach will go a long way toward building a value-based, sustainable healthcare system. And in the process, we might just wind up feeling a bit more connected to others. We don’t need research to know that’s a good thing for everyone. 


Joseph J. Fifer, FHFMA, CPA, is president and CEO, HFMA. Follow Joe Fifer on Twitter @HFMAFifer.



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