Social Connection and the Power to Heal

By MaryBeth Kurland, CAE, MPA, CAE, ICE-CCP
CEO, Commission for Case Manager Certification

Over the past few years, we have come to appreciate the importance of the bonds of family, friendship, and community. However, although we as human beings are social animals, we often fall short of filling that innate need for connection—to the detriment of our health and well-being. 

One thing we learned from the COVID-19 pandemic is that social isolation—objectively being alone or having few social contacts—is different from loneliness. The latter is subjective; it's feeling that you lack a desired level of connection with others. You can feel isolated but not lonely. You can also feel lonely when you're surrounded by people. A low level of social connection is associated with lack of protection and resilience to bounce back from emotional and physical setbacks.

This year, the U.S. Surgeon General called Americans out on our lack of social connection and highlighted its consequences. Our Epidemic of Loneliness and Isolation is a wakeup call to harness the power of connection and community for its healing power in our own lives and to cultivate it among those within our sphere of influence. 

The Commission for Case Manager Certification opened its CMLearning Network webinar series this fall with a presentation by the lead scientific editor of that advisory, Julianne Holt-Lunstad, whose research about the impact of isolation and loneliness is eye-opening both personally and professionally. 

According to the report, half of U.S. adults reported feeling lonely in recent years, even before the pandemic. We often think social isolation relates to older adults, and many risk factors for loneliness can be exacerbated by old age: hearing loss, financial struggles, or loss of a close loved one. However, surveys reveal that the highest prevalence is found among young adults—those in the 18 to 24 range. That's the age many in our society leave their family and community ties behind to work or go to school in a new place. Loneliness has no age barriers.

As a society, our lack of social connection can be tied to economic loss as well. Loneliness is estimated to cost $6.7 billion in excess Medicare spending annually; and, among the working population, absenteeism attributed to loneliness costs employers an estimated $154 billion a year.1

The report memorably cites the risks associated with loneliness as comparable to smoking up to 15 cigarettes per day. Case managers and disability management specialists should know that in terms of early mortality, the effects of social connection, isolation, and loneliness surpass the risk from drinking six alcoholic drinks a day, physical inactivity, and obesity, as well as clinical risk factors such as high blood pressure, body mass index, and cholesterol levels. 

Strong family and community ties are not just a nice-to-have. They are essential for good health.

For example, case managers are accustomed to assessing clinical risk factors within the case management process. Knowing that individuals with poor social ties face a 29% higher risk of heart disease and a 32% higher risk of experiencing a stroke should move social isolation into a leading position during case management assessment. In the positive column, family and community ties can offer protective advantages, especially for those battling conditions such as diabetes. When evaluating clients for lack of social connectedness, it's critical to assess both the number of connections and the quality of those connections. For example, just because an older client living alone has adult children who live nearby does not mean they are in frequent contact or can be relied upon to offer needed social interaction.

The consequences of social connectedness should spur us all to cultivate the kinds of relationships that support and feed this essential human need. What's more, case managers and disability management specialists should not overlook their own needs for companionship and contact. As people, we function biologically better in a social environment. When we are alone, or when we are with others who cannot be trusted, our brains are on alert—that's a stress response that can lead to dysregulation across many biological systems. Unabated, stress can have lasting consequences.

The Commission is a network organization for the National Academy of Medicine's Workforce Well-Being initiative because the potential for health consequences and job burnout is a threat to our nation's health and the health workforce as well. Our "Push Pause" series encourages case managers and disability management specialists to take a moment to reflect and re-energize when the challenges feel overwhelming. As case managers and disability management specialists encounter difficult days or when we are face to face with others who may be at risk, it's critical to identify strategies to alleviate stress and isolation, and then foster social connection for their clients.

Dr. Holt-Lunstad's webinar, How Can Social Connection and Community Impact the Health of Our Clients? can be viewed online in the CM Learning Network. There is no cost to watch the recording. However, to earn CE credit for this learning opportunity requires registration and a $25 fee.