Doctors say loneliness and social isolation should be discussed in health visits

Doctors say loneliness and social isolation should be discussed in health visits
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(NEW YORK) — Physicians are calling for primary care doctors to ask patients about loneliness and social isolation at routine health checks and when managing chronic diseases as emerging research suggests it could be just as important as checking blood pressure, heart health and lifestyle factors for health outcomes.

Published in the Annals of Family Medicine, the new guidance highlights several areas to better address social isolation and loneliness in the healthcare system through screening, chronic disease management, policies and partnerships with community resources in an effort to recognize this as a medical issue.

Last year, the U.S. Surgeon General, Dr. Vivek Murthy declared loneliness and isolation an epidemic and its health impacts have been compared to smoking up to 15 cigarettes a day.

Loneliness and social isolation can lead to a number of negative mental and physical health problems, according to research, and doctors say it’s important to discuss this topic in routine health visits and when managing chronic diseases.

“I think loneliness should be incorporated into healthcare and into primary care, because of how much it affects health,” Dr. Sebastian Tong, family physician at the University of Washington and corresponding author of the new guidance, told ABC News. “We’re seeing the prevalence is much higher than many chronic diseases.”

Research studies show that loneliness is common among young people and adults and estimates show about half of all U.S. adults experience loneliness, higher than the percentage of American adults who have chronic health conditions like type 2 diabetes or obesity, according to the U.S. Surgeon General.

“Patients should know that this is a common lived experience and may contribute to their emotional and physical health and health outcomes,” Dr. Mylynda Massart, family medicine physician, founder and director, UPMC Primary Care Precision Medicine Center and chair of Family Medicine at UPMC Magee Women’s Hospital, told ABC News.

Loneliness has been linked with higher rates of depression, anxiety and suicide, according to the Centers for Disease Control and Prevention. 

“If we can prevent or intervene early in loneliness, we may see a really nice downstream effect in terms of people’s overall mental health,” Dr. Jen Brull, president-elect of the American Academy of Family Physicians, told ABC News.

Social isolation has been associated with an increased risk of early death from any cause, a 50% increased risk of dementia, 29% increased risk of heart disease and 32% increased risk of stroke in older adults, according to the CDC.

“From my clinical experience, people come in with, for example, uncontrolled diabetes, and when I get down to the root of it, they’re living alone, they’re spending most of their time alone, and they aren’t able to motivate themselves people exercise or get healthy food,” Tong said.

Doctors say people can do their own self-assessment by asking questions like, “how often do you speak to someone outside of the home, are those meaningful conversations, do you feel fulfilled by your social interactions or do you think there is a gap in your social interactions and do these interactions impact your satisfaction with your current life situation,” Massart said.

But recognition is just the start as doctors say finding solutions that meet individual needs is necessary but challenging.

“Recognizing, understanding and diagnosing [social isolation and loneliness] is only half of the equation; we need system-wide treatments to find the right match for each patient based on their individual needs, environment, and preferences,” Massart said.

Community resources that involve group activities, therapy, or aid in transportation may already be in place in many areas that can mitigate social isolation and loneliness but these tools may miss some resources in more rural areas and doctors say this is where local health clinics may help the most.

“In smaller rural places, primary care docs have partnered and are aware of church organizations, community organizations, places that are in smaller pockets,” Brull said.

Massart said ultimately addressing social isolation and loneliness takes a village. 

“It always comes down to caring for each other and supporting each other through a network of more than one individual,” she said.

If you or a loved one are in crisis, free, confidential help is available 24/7 by texting or calling The Lifeline at 9-8-8.

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