Social Connection: The Missing Piece in Addressing Social Determinants of Health
Social Connection: The Missing Piece in Addressing Social Determinants of Health
Discussions in the public health sector often center around tangible factors like access to quality healthcare, education, and economic stability. Yet, a crucial aspect that tends to be overlooked is social connection. Research underscores the significance of social ties in shaping health outcomes, with studies suggesting that 40% to 80% of health and wellness can be attributed to social factors.
In fact, studies reveal that individuals with robust social connection have higher odds of survival, while those lacking social connections face an increased risk of premature death from all causes.
Specifically, research demonstrates that:
Poor social relationships predict a 29% increased risk of coronary heart disease and 32% increased risk of stroke
Inadequate social connection among heart failure patients is associated with a 55% increase in hospital readmission
In children with chronic physical conditions, poor social connection correlates with greater chronic physical complaints
Social isolation increases the risk of dementia
Conversely, social connection is a protective factor against developing dementia. Additionally, individuals with greater social connection exhibit resilience against upper respiratory illnesses, highlighting the protective effect of social ties on health.
Recognizing the role that social connection plays as it relates to health is crucial as public health initiatives center around the concept of addressing “social determinants of health (SDoH).” SDoH is defined by the Centers for Disease Control and Prevention (CDC) as “conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life-risks and outcomes.”
Social and community context is one of the five key domains identified by the national initiative “Healthy People 2030” to address SDoH. However, despite being identified in this initiative, social connection still often takes a backseat relative to the other domains.
This is where we believe the concept of social prescribing becomes an important initiative. Social prescribing involves healthcare providers recommending community-based services to address patients' social needs alongside their medical concerns.
Given what the evidence shows of the health benefits of social connection and arts engagement, we propose that the integration of social engagement with healing arts modalities like arts, music, mind-body activities, and movement through social prescribing offers a holistic approach to well-being. This approach acknowledges that health is not solely determined by pharmaceutical interventions but also by social and emotional factors.
The UK was the first country to implement social prescribing and has demonstrated promising results. Prior to the implementation of social prescribing, the UK identified that 20% of general practitioner visits were to address nonmedical issues that could be resolved through social interventions. Following implementation of a one-year social prescribing pilot program, evidence demonstrated a 53% reduction in nonmedical visits.
The results of pilot programs in the UK demonstrate the potential of social prescribing initiatives to alleviate strain on healthcare systems while enhancing patient care. Additionally, pilot social prescribing programs here in the U.S. have demonstrated positive impacts on healthcare providers as well, with providers reporting increased fulfillment and job satisfaction with being able to recommend positive interventions to their patients. In a time when we are facing a nationwide healthcare shortage related to provider burnout, the capacity to implement a program that addresses not only provider mental health, but also costs to the healthcare system while also enhancing patient health, is pivotal.
Here at the Benjamin Goldberg Foundation, we recognize the multifaceted benefits that social prescribing has on the health and well-being of children, caregivers, and the community at large. This is why we are so committed to promoting social prescribing education, awareness, and implementation in Hampton Roads. Through initiatives like our upcoming Social Prescribing Roundtable Convening, we aim to raise awareness and foster collaboration among key stakeholders to integrate social connection into healthcare practices.
Resources:
Golden TL, Maier Lokuta A, Mohanty A, Tiedemann A, Ng TWC, Mendu M, Morgan N, Kuge MN, Brinza T. Social prescription in the US: A pilot evaluation of Mass Cultural Council's "CultureRx". Front Public Health. 2023 Jan 19;10:1016136. doi: 10.3389/fpubh.2022.1016136. PMID: 36743160; PMCID: PMC9892638.
Holt-Lunstad J. Social Connection as a Public Health Issue: The Evidence and a Systemic Framework for Prioritizing the "Social" in Social Determinants of Health. Annu Rev Public Health. 2022 Apr 5;43:193-213. doi: 10.1146/annurev-publhealth-052020-110732. Epub 2022 Jan 12. PMID: 35021021.