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Payer Program Addresses Loneliness as Social Determinant of Health

Cigna will offer patient-facing assessments for loneliness and the social determinants of health.

loneliness social determinants of health

Source: Thinkstock

By Sara Heath

- Cigna is joining the fight against patient loneliness, a key social determinant of health, by offering a patient-facing survey and personalized health improvement recommendations on its website.

Using a 10-question version of the UCLA Loneliness Index, Cigna will help patients reflect on their own loneliness and receive targeted suggestions from the health payer. The tool is available to all patients, not just Cigna members, at no cost.

Cigna has launched this tool as a result of its recent report on loneliness, published in May 2018.

“Our findings have prompted people from all walks of life to recognize the growing epidemic of social isolation and commit to addressing loneliness. There is increasing momentum to address this issue in our workplaces and communities,” Cigna president and CEO David M. Cordani said in a statement.

“At Cigna, we view each person’s physical, mental and social health as entirely connected. We need to go beyond addressing symptoms in silos. To help people achieve and maintain a healthy lifestyle, we must treat the mind and body as one.”

The Cigna Loneliness Index shone a light on loneliness as a key social determinant of health, the payer said. Loneliness can impact both a patient’s ability to attain health and can have consequences for a patient’s well-being, Cigna reported.

Again using the UCLA Loneliness Index, Cigna evaluated patterns in patient loneliness, finding that nearly half of respondents say they feel lonely sometimes or always. Forty-seven percent of respondents said they feel left out.

Twenty-seven percent of respondents said they often feel as though there is nobody who understands them, and 43 percent said that they believe their relationships are not meaningful and that they are isolated from others.

There are some predictors of loneliness, the Index revealed. Those who live with someone, for example, are less likely to be lonely, although those with children are more likely to feel lonely.

Generation Z (ages 18 to 22) adults also tend to feel lonely. This generation is deemed the loneliest generation, Cigna stated.

And social media use has little to do with it. Self-reported social media users averaged a loneliness scale of 43.5 out of 100 points, while those who said they rarely or never use social media averaged a score of 41.7.

Those who receive just the right amount of sleep, who spend the amount of time desired with their families, who exercise, and who work “just the right amount” also tend to be less lonely. These external factors require individuals to strike a “sweet spot” that can be difficult to attain.

“There is an inherent link between loneliness and the workplace, with employers in a unique position to be a critical part of the solution,” said Douglas Nemecek, MD, chief medical officer for Behavioral Health at Cigna. “Fortunately, these results clearly point to the benefits meaningful in-person connections can have on loneliness, including those in the workplace and the one that takes place in your doctor’s office as a part of the annual checkup. While one solution won’t stop this growing public health issue, we’ve started to make changes to our business to help our clients and others to tackle loneliness and realize their vitality.”

What’s more, loneliness can have serious impacts on one’s physical health.

Loneliness can have similar impacts on health as smoking cigarettes, Nemecek said in a statement. Between the physical toll these feelings can take and the ways in which loneliness limits social and patient engagement, loneliness is emerging as a critical health concern.

A 2015 report published in the American Journal of Public Health found that reducing loneliness in seniors can cut healthcare costs, improve outcomes, and better target health interventions.

Specifically, those with chronic loneliness – loneliness that persists for four or more years – have increased doctor’s visits. And although loneliness was not significantly associated with more hospital visits, it can be a predictor of inefficient engagement with the healthcare system.

As more healthcare organizations and payers continue to address the social determinants of health, they may consider the impacts that loneliness can have on patient health. Using tools to detect loneliness and designing positive heath interventions may help cut healthcare costs and improve patient outcomes.

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