An Epidemic of Loneliness and Implications for Physical Therapists

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There are always a plethora of articles and studies to draw from to enhance our skills and PT practice but every once in a while there is a study or report that is really fascinating with huge implications. That report came out a few weeks ago from the nation’s top doc, the U.S. Surgeon General, Vivek Murthy.

While there are many health reports that come from this office to address overall health needs of the nation, this most recent advisory report was very illuminating not only from the identified health risks but also because of the societal impacts. What health condition might be of so much importance? Turns out it is loneliness.

Yes, loneliness. At first glance, my thought was, “Really?” But as I continued to read the report I was both fascinated and heartbroken. Fascinated because of the research that cites the very real physical, physiological, and mental health effects associated with isolation and loneliness. Heartbroken because it highlights very clearly that we have strayed from God’s design for relational community. We may be more connected than ever before in history but we are actually more isolated and lonely. And that has devastating effects on us as the report details. We were designed for relational community and yet it is eluding us as we run further and further from God’s original intent.
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But the fascinating part was all of the studies and research that has been conducted for many years, actually. This problem was identified years ago but we are seeing more fruit and fallout in recent days.. Just read this summative passage from the article relating to the epidemiology of isolation and loneliness:

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“The lack of social connection poses a significant risk for individual health and longevity. Loneliness and social isolation increase the risk for premature death by 26% and 29% respectively.37 More broadly, lacking social connection can increase the risk for premature death as much as smoking up to 15 cigarettes a day.4 In addition, poor or insufficient social connection is associated with increased risk of disease, including a 29% increased risk of heart disease and a 32% increased risk of stroke.38 Furthermore, it is associated with increased risk for anxiety, depression,39 and dementia.40,41 Additionally, the lack of social connection may increase susceptibility to viruses and respiratory illness.42 The lack of social connection can have significant economic costs to individuals, communities, and society. Social isolation among older adults alone accounts for an estimated $6.7 billion in excess Medicare spending annually, largely due to increased hospital and nursing facility spending.43 Moreover, beyond direct health care spending, loneliness and isolation are associated with lower academic achievement 44,45 and worse performance at work.46-48 In the U.S., stress-related absenteeism attributed to loneliness costs employers an estimated $154 billion annually.46 The impact of social connection not only affects individuals, but also the communities they live in. Social connection is an important social determinant of health, and more broadly, of community well-being, including (but not limited to) population health, community resilience when natural hazards strike, community safety, economic prosperity, and representative government.”13,15,17,34-36,49,50

​Click Here to Read the Full Report

So, you get an idea of the scope of this problem. A scope so large that the U.S. Surgeon General labeled it an epidemic. Now, a lot could be said about all of these things and indeed, in the article, much more detail is provided and there are proposed solutions. But, I want to try to provide a meaningful perspective from the Physical Therapy or rehab point of view. How can we, as PT’s, engage this epidemic? How can we learn from this information and apply it to our practice? Let me offer a few ideas. These are by no way exhaustive, but just some thoughts to help get you thinking about applying this information.
 
Awareness, Identification, Education. This is maybe a little bit obvious, but we should digest this information and share it with our colleagues. We all interact extensively with other people and we are a very relational profession so once we recognize and understand the value of this information, then we should definitely share it with our colleagues. Have a lunch meeting to discuss it. But then once we are aware we need to apply it to our patients and identify those patients that maybe exhibit the characteristics of loneliness and educate that with this information. Again, we will have that opportunity because we are a very relational profession spending extensive time with patients.
 
Be Gracious. By this, I mean, think about your patients and be patient with those who seem more interested in conversing than exercising. We have all had the patient that we think is just coming to hang out or talk with us. That patient may report not really getting better despite objective improvement. This report helps shed light to the fact that maybe combating loneliness is  actually the case for a particular patient. Many of our patients may be finding a sense of community as they interact with us.  Recognize that the patient may be coming more for social interaction and less for physical ailment so let’s be gracious and sensitive to that need and not dismiss the patient or discharge the patient prematurely thinking they just don’t want to get better. Maybe they are just struggling more psychosocially.
 
Take opportunities to invite patients to your Christ-centered community. I think for me this has been the greatest wake up call. People need community. God is a trinitarian God. God made us in his image to not only need but desire community and relationship. As this report highlights clearly, we thrive with community but crumble in isolation. In a world where authentic relationships are lacking, you and your church have a tremendous opportunity because God has designed the perfect antidote to loneliness and isolation in christian community. That is your church, your community group, or Bible study. Let’s not be selfish but invite those that are lonely into our community. Let’s pray that through these invitations, these individuals will encounter the true God that desires personal relationship with them and will never leave them nor forsake them.

What are your thoughts? As you process this information, how will you apply it to your life, family, and professional practice? I would love to hear your ideas so feel free to comment!

Jason

***Check out my book "Rehab the World" written for Physical Therapists to encourage us in our workplace and prepare us to serve those around us. If you like, please leave a review and spread the word!!***