Social connection can make sick people feel better.


What if, before you were released from the hospital, on top of medical advice, someone instructed you to sign up for, say, a Spanish class as part of your recovery plan?

Or, instead, to spend a few hours a week volunteering at the local dog rescue?

Thanks to “social prescribing” programs, which are drawing attention to the importance of social connection in the healing process and better health outcomes in general, this kind of advice is becoming more common. The growing movement is one that’s supported by recent research from the University of Toronto showing that, across a range of illnesses, people who were “thriving” in recovery all had one thing in common — social connection.

“I’m always interested in looking at what helps people thrive and there’s a lot of literature suggesting that it’s important to be socially connected,” explained Esme Fuller-Thomson, researcher and professor at U of T’s Factor-Inwentash Faculty of Social Work. “So I looked for the most extreme cases, which are people without a single person to confide in.”

Esme Fuller-Thomson, researcher and professor at the University of Toronto's Factor-Inwentash Faculty of Social Work.

Fuller-Thomson used secondary data gathered from the Canadian Community Health Survey-Mental Health and looked at the outcomes for those without even a single confidant who were also suffering from Chronic Obstructive Pulmonary Disease. COPD has high mortality rates and is also associated with serious disability and depression.

And while she said it hadn’t been so surprising to find that people with at least one confidant had better outcomes, what was striking was just how much better people with social connection fared.

“People with COPD, who had even one confidant, were seven times more likely to be in excellent mental health than people who didn’t,” said Fuller-Thomson.

And it wasn’t just COPD. Fuller-Thomson used the same data to find that “social connection” was a common denominator among people who reported they were thriving after being treated for a spectrum of health problems, including stroke, generalized anxiety disorder and attempted suicide.

To address this, a growing movement of researchers and health care workers are advocating for “social prescriptions” being incorporated into the treatment plan.

What would that look like? Health centres would have a department with dedicated social connection counsellors who would interview patients to find out what their needs and interests were and then, taking cues from the patient, recommend specific activities to engage in during aftercare.

“I think this has been happening in informal and one-off ways for a long time,” said Kate Mulligan, assistant professor at the Dalla Lana School of Public Health and senior director and strategic adviser of the Canadian Institute for Social Prescribing (CISP) . “So there might be individual clinicians who have been in the practice of prescribing exercise or being out in nature or, you know, calling your mom, but it hasn’t been happening in a systematic way.”

Kate Mulligan, assistant professor at the Dalla Lana School of Public Health and Senior Director & Strategic Advisor of the Canadian Institute for Social Prescribing (CISP), says that, since the pandemic, more people understand how damaging social isolation can be. Uploaded external by: Sismondo, Christine

Transforming social prescribing from an informal to a formal practice is a big part of what the CISP, which was established last fall, is trying to do. That, and to raise awareness of the importance of interpersonal connection as a key “social determinant of health” — non-medical things that affect our health.

Social determinants include income inequality, food insecurity and social isolation, among others. Taken together, the evidence points to social determinants of health affecting at least half of our overall health outcomes.

“When we started doing some pilot projects in 2018, people were more focused on the material determinants, like food and housing,” Mulligan recalled. “But we also wanted to explore social isolation and social connectedness because it had emerged as a really significant determinant of health, although not one that we were seeing a lot of action over or interest in.”

That changed over the pandemic. With so many people experiencing isolation at once, an increased awareness of the importance of connectedness started to develop.

“It turns out that social isolation takes years off our lives and has health impacts the equivalent to smoking 15 cigarettes a day,” said Mulligan. “We don’t have to work as hard now to explain how social isolation affects health, but we still have a lot of work to do to actually take action on it.”

Although many of us immediately think of seniors as the greatest at-risk cohort for social isolation, both Mulligan and Fuller-Thomson say social isolation is a problem for all age groups.

“I think our workaholic society is part of the problem because you are rewarded for working too much and not for making social connections,” said Fuller-Thomson, who notes that the most comprehensive data on social isolation is already a decade old.

“It’s probably worse now because I think peoples’ phones are taking up even more of the space that used to be spent on the front porch talking to neighbours or connecting with people or joining the bowling league.”

Although it’ll be some time before social prescribing goes fully mainstream and becomes fully incorporated in the health-care system, it is, at least, the sort of thing we can do something about on an individual and community level.

“The gift of friendship is the gift that keeps on giving,” Fuller-Thomson added. “It gives mental health and it gives well-being so looking out for your more isolated neighbours, acquaintances and workmates is a nice start.”


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