All the Lonely People

Published on December 23, 2019

This week, during the end-of-year rush, we took some time out at Carrot Health to analyze how health is affected by the holidays. We were intrigued by one particular question: does loneliness in senior citizens impact their health status?

Loneliness is a tricky condition to measure mathematically. But using our vast database of consumer information, we can develop very good proxy measures for loneliness, and for other Social Determinants of Health (SDoH). We do this by applying our Carrot Social Risk Grouper (SRG), which scores every adult in the US by their individual SDoH fingerprint – much like a FICO score measures credit risk. The SRG score is based on consumer data variables drawn from four broad categories: behavioral, economic, social, and environmental.

Social isolation is one of the most heavily weighted factors in the Carrot SRG. We can assess a person’s degree of social isolation by looking at indications of low contact or connection with friends, family, and community. This information can come from many underlying data points, ranging from voting behavior to association with a religious community to the geographic proximity of family members.

Loneliness (a feeling) is not the same as social isolation (a circumstance). People can be socially isolated, yet not feel lonely. Even so, social isolation is a good proxy for loneliness.

When we analyzed a sample of 14,100 Medicare Advantage beneficiaries aged 65+ in a Midwest market… the data popped. During Thanksgiving week of 2018, Emergency Department (ED) visits increased by 121% over the previous week for socially isolated seniors. In contrast, ED utilization for non-socially isolated seniors stayed flat.

Every nurse, doctor and administrator knows that the holiday season is a difficult time of year for certain patients, leading to more ED visits and worsening chronic conditions. The data shows that loneliness is a significant factor.  

Why the spike in ED visits over the holidays? It’s easy to make some guesses. People may feel loneliness more keenly during times when it is normal for families and loved ones to gather. The physical and emotional stress of that lack of connection may worsen chronic health conditions. Alternatively, relatives visiting socially isolated family members may suddenly discover health issues that need to be urgently addressed.

The impact of social isolation on health status and overall care costs is real. Socially isolated individuals with no documented relatives, for example, account for 25% higher inpatient spend and 22% higher ED utilization. Research shows strong correlations between loneliness and a host of physical and mental conditions such as depression, anxiety, substance abuse, poor diet, cognitive decline, Alzheimer’s, a weakened immune system, obesity, heart disease and high blood pressure. Likewise, studies show that people who are engaged, active and purposeful feel more optimistic and energetic, and lead healthier lives.

Over the coming weeks, let’s think of the lonely and most vulnerable with compassion, knowing that their care needs are deeply rooted in the circumstances of their lives. Perhaps we can also resolve to help improve those conditions over the new year, knowing that strategically designed interventions can pay off by reducing costs and enhancing health status while improving quality of life and the health of our communities, too.

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